- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02986490
Magnesium Variations and Cardiometabolic Risk in Patients With Antipsychotic Drugs
Influence of Magnesium Variations (Serum and Intra-erythrocyte) on Markers of Cardiometabolic Risk in Long-term Prescription of Antipsychotic Drugs: a Prospective Cohort Study
Background: Antipsychotics can induce metabolic disorders such as obesity, hyperglycemia, dyslipidemia or metabolic syndrome. It has been observed that treatment with antipsychotic could be accompanied by a decrease in the concentration of serum magnesium. Low serum concentrations of magnesium are potentially a risk factor of cardiac sudden death (Peacock, 2010). Hypotheses linking magnesium and pathogenesis of cardiovacuscular diseases are multiple. Also, it seems to exist a close relationship between magnesium and carbohydrate metabolism. Most studies on the subject have generally studied plasmatic magnesium.
Objective : Describe the relationship between changes in serum and intra-erythrocyte magnesium and cardiometabolic risk in patients innitiating an antipsychotic treatment. A secondary objective is to specify the frequency, magnitude and time to onset of changes in plasma of magnesium levels under antipsychotic treatment.
Methods : This is a pilot single-center prospective cohort. After inclusion, patients status (including magnesium levels) will be evaluated (1 and 3 months of treatment) and that status will define the exposure criterion. Included patients will be followed for 1 year during which cardiometabolic markers will be measured.
Population : patients who are more than 18 years old with schizophrenia schizoaffective disorder or bipolar disorder, naive to antipsychotic treatment or off for more than 3 months and requiring the introduction of antipsychotic drug therapy. Patients will be recruited during consultations and stays in care units of Adult Psychiatry Unit of Montpellier University Hospital.
Factor studied: serum and intra-erythrocytic magnesium levels at beginning and during the antipsychotic treatment measured by a unique analyzer center. Changes in levels of hypomagnesemia expected during the treatment will determine exposure groups.
Outcome: cardiometabolic risk markers measured at the beginning and during the treatment will be fasting blood glucose, fasting plasma insulin, HOMA-IR [Ins (uU / mL) x Gly (mmol / L) / 22.5], lipid profile (total cholesterol, LDL, HDL), BMI, waist circumference and ECG (QTc).
Cofactors: age, sex, personal and family medical history, blood pressure, smoking, diet, physical activity, psychiatric disease, Global Impressions, anti-psychotic treatment and comedications.
Perspectives : to show that decreased in magnesium levels observed among patients starting antipsychotic treatment is associated with deterioration of cardiometabolic risk markers. The demonstration of this association could explain at least part the increased cardiovascular risk observed in this population. In the longer term, the results of this study would argue the implementation of an intervention research project studying magnesium supplementation to minimize the metabolic effects of antipsychotic medications.
Study Overview
Status
Intervention / Treatment
Detailed Description
This is a pilot single-center prospective cohort. After inclusion, patients status (including magnesium levels) will be evaluated (1 and 3 months of treatment) and that status will define the exposure criterion. Included patients will be followed for 1 year during which cardiometabolic markers will be measured.
Patients will be recruited during consultations and stays in care units of Adult Psychiatry Unit of Montpellier University Hospital.
Study Type
Enrollment (Anticipated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Jean-Luc FAILLIE, MD PhD
- Phone Number: +33 4 67 33 67 52
- Email: jl-faillie@chu-montpellier.fr
Study Locations
-
-
-
Montpellier, France, 34295
- Recruiting
-
Contact:
- Jean-Luc FAILLIE, MD PhD
- Phone Number: +33 4 67 33 67 52
- Email: jl-faillie@chu-montpellier.fr
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion criteria:
- Patient with severe mental illness (schizophrenia and other disorders chronic psychotic, schizoaffective disorder and bipolar disorder.
- Patient naive to antipsychotic treatment or stopped for more than 3 months (more than 6 months for antipsychotic action extended) and requiring the introduction of antipsychotic therapy
- Patient informed and accepting the proposed follow-up (himself or his/her legal representative)
- Patient available for one year monitoring
- Patient affiliated or beneficiary of a social security insurance
Exclusion criteria:
- patient's opposition
- Pregnant or breastfeeding patient
- Patients on anti-psychotic or treatment stopped for less than 3 months (6 months for antipsychotic prolonged action)
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Other: patient with antipsychotic/neuroleptic
Blood sample performed on patients requiring the establishment of treatment with antipsychotic / neuroleptic
|
Blood sample
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Proportion of patients with changes from baseline cardiometabolic risk
Time Frame: At 12 months
|
Changes from baseline cardiometabolic risk is defined the following composite outcome : 15% increase in fasting plasma glucose and/or 15% increase in plasma fasting insulin and/or 15% increase in HOMA-IR [Ins (uU / mL) x Gly (mmol / L) / 22.5] and/or 15% increase in total cholesterol levels, or LDL-cholesterol and/or reduction of 15% of HDL-cholesterol and/or 2 points increased in BMI and/or increase of 5 cm in waist circumference and/or 10 msec increase in the QTc interval of the ECG.
|
At 12 months
|
Secondary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Proportion of patients with changes from baseline cardiometabolic risk
Time Frame: At 3 months
|
At 3 months
|
Proportion of patients with changes from baseline cardiometabolic risk
Time Frame: At 6 months
|
At 6 months
|
Proportion of patients with 15% increase in fasting plasma glucose
Time Frame: From baseline at 12 months
|
From baseline at 12 months
|
Proportion of patients with 15% increase in plasma fasting insulin
Time Frame: From baseline at 12 months
|
From baseline at 12 months
|
Proportion of patients with 15% increase in HOMA-IR [Ins (uU / mL) x Gly (mmol / L) / 22.5]
Time Frame: From baseline at 12 months
|
From baseline at 12 months
|
Proportion of patients with 15% increase in total cholesterol levels, or LDL-cholesterol and/or reduction of 15% of HDL-cholesterol
Time Frame: From baseline at 12 months
|
From baseline at 12 months
|
Proportion of patients with 2 points increased in BMI and/or increase of 5 cm in waist circumference
Time Frame: From baseline at 12 months
|
From baseline at 12 months
|
9. Proportion of patients with 10 msec increase in the QTc interval of the ECG
Time Frame: From baseline at 12 months
|
From baseline at 12 months
|
Change in zincemia
Time Frame: From baseline at 12 months
|
From baseline at 12 months
|
Change in zincemia
Time Frame: From baseline at 3 months
|
From baseline at 3 months
|
Change in zincemia
Time Frame: From baseline at 6 months
|
From baseline at 6 months
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Jean-Luc FAILLIE, MD PhD, Montpellier University Hospital
Study record dates
Study Major Dates
Study Start
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Estimate)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- UF 9362
- 2014-A00381-46 (Other Identifier: FRANCE: Agence Nationale de Sécurité des Médicaments)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
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