- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03915795
Statins Study in Kawasaki Disease Children With Coronary Artery Abnormalities
Application of Statins in Long-term Treatments of Kawasaki Disease Complicated With Severe Coronary Artery Abnormalities in Children
Study Overview
Status
Conditions
Detailed Description
Kawasaki disease (KD) is an acute self-limited vasculitis and occurs almost exclusively in childhood. It predominantly affects medium-sized arteries, most commonly the coronary arteries. Although the use of intravenous immunoglobulin (IVIG) has obviously decreased the incidence of coronary arteries (CA) abnormalities, still a part of KD children occur CA abnormalities, even medium, large or giant aneurysms. The coronary aneurysms can develop to thrombus and arterial stenosis, which may cause severe cardiac events, for example, myocardial infarction. It is the main cause of disability and death in KD children. Now KD has been the leading cause of acquired heart disease in children.
Some studies found that ongoing vascular chronic inflammation and oxidative stress persisted in the long-term KD vasculopathy. Endothelial dysfunction, increased stiffness, and intima-media thickening have been noted in both affected coronary arteries and systemic arteries. Statins (hydroxymethylglutaryl coenzyme-A reductase inhibitors) not only are a kind of drug lowering low-density lipoprotein cholesterol, but also have been reported to have potentially beneficial pleiotropic effects on inflammation, endothelial function, oxidative stress, platelet aggregation, coagulation, and fibrinolysis. They have been the cornerstone of therapy for the primary and secondary prevention of atherosclerotic cardiovascular events in adults. In recently years, statins have been considered to be used in KD children with coronary aneurysms. Several short-term small studies in such patients treated with statins have shown reductions in high-sensitivity CRP, improved endothelial function and statins' safety in children. The American Heart Association (AHA) scientific statement on KD published in 2017 suggests that empirical treatment with low-dose statin may be considered for KD patients with past or current aneurysms, regardless of age or sex.
However, the current clinical data about the use of statins in KD children is still very rare. The published researches mainly focused on the endothelial function of peripheral arteries but the effects of statins on CAs and cardiac events have not been included. Therefore, more studies are needed to conform statins' feasibility and safety in children and its clinical application value.
In this study, we will recruit KD children complicated with severe CA abnormalities. These children will be given statins for one year besides other routine treatments. The coronary assessments, clinical and laboratory indexes will be followed up to study the effects of statins on long-term chronic inflammation, CA abnormalities and clinical cardiac events. At the same time, the clinical and laboratory indexes correlated to the side-effects will be monitored regularly to investigate the feasibility and safety of statins in KD children.
Study Type
Enrollment (Actual)
Contacts and Locations
Study Locations
-
-
Shanghai
-
Shanghai, Shanghai, China, 201102
- Children's Hospital of Fudan University
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Sampling Method
Study Population
Description
Inclusion Criteria:
- >3 months after the onset of KD currently complicated with severe coronary artery abnormalities (medium coronary aneurysms or more severe) The follow-up can be achievable All included children's guardian are required to sign the informed consent form
Exclusion Criteria:
- The KD children currently complicated with mild coronary artery abnormalities (small aneurysms or only dilation) The children's age <2 ys The children's guardian don't agree to sign the informed consent
Study Plan
How is the study designed?
Design Details
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change of coronary artery abnormalities measured by echocardiography
Time Frame: At baseline and one year after taking statin
|
Internal lumen diameters(mm) and Z score of coronary artery abnormalities measured by echocardiography
|
At baseline and one year after taking statin
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change of LDL-C
Time Frame: At baseline and one year after taking statin
|
Decrease in LDL-C(mmol/L)
|
At baseline and one year after taking statin
|
Change of high-sensitivity C reactive protein (hsCRP)
Time Frame: At baseline and one year after taking statin
|
Decrease in hsCRP (mg/L) as a chronic inflammation marker
|
At baseline and one year after taking statin
|
Assessment of myocardial ischemia
Time Frame: At baseline and one year after taking statin
|
New onset or improved manifestation of myocardial ischemia, assessed by EKG/stress EKG, radionuclide myocardial imaging and/or magnetic resonance imaging
|
At baseline and one year after taking statin
|
Incidence of new-onset cardiovascular events
Time Frame: One year after taking statin
|
Incidence of new-onset cardiovascular events including chest tightness, chest pain, angina, myocardial infarction and so on
|
One year after taking statin
|
Incidence of side-effects of statin in KD children
Time Frame: At baseline, 3, 6, 9 months and one year after taking statins
|
Incidences of side-effects including abnormal laboratory indexes (elevated muscle enzyme and liver enzyme), adverse clinical events and growth impacts (weight, height and BMI)
|
At baseline, 3, 6, 9 months and one year after taking statins
|
Collaborators and Investigators
Investigators
- Study Director: Fang Liu, MD, Children's Hospital of Fudan University
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- Statins study in KD
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
Clinical Trials on Kawasaki Disease
-
Imperial College LondonCambridge University Hospitals NHS Foundation Trust; Guy's and St Thomas' NHS... and other collaboratorsActive, not recruitingKawasaki Disease | Atypical Kawasaki DiseaseUnited Kingdom
-
Mitsubishi Tanabe Pharma CorporationCompletedKawasaki Disease Refractory to Initial Therapy With Intravenous ImmunoglobulinJapan
-
The First Affiliated Hospital of Yangtze UniversityNot yet recruiting
-
University of NebraskaCompletedHeart Disease | Kawasaki DiseaseUnited States
-
Children's Hospital of Fudan UniversityFirst People's Hospital of Hangzhou; Qilu Hospital of Shandong University; Shengjing... and other collaboratorsRecruiting
-
Children's Hospital of Fudan UniversityShanghai Children's Hospital; Shanghai Children's Medical Center; Xinhua Hospital...CompletedMucocutaneous Lymph Node SyndromeChina
-
Children's Hospital of Fudan UniversityShanghai 10th People's Hospital; Shanghai Children's Hospital; Shanghai Children... and other collaboratorsWithdrawn
-
Lantheus Medical ImagingCompletedKawasaki DiseaseUnited States, Brazil, Canada, Taiwan, Philippines, Thailand, Korea, Republic of
-
Novartis PharmaceuticalsWithdrawn
-
Pontificia Universidad Catolica de ChileBristol-Myers SquibbWithdrawn