- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04247048
Kinetic Study of Lp(a) and PCSK9 in Humans (HuLaUP)
A Kinetic Study of Lipoprotein in Humans for a Better Understanding of Lipoprotein(a) Metabolism Under PCSK9 Variations (Hu-La-u-P Study)
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Elevated plasma levels of lipoprotein(a) [Lp(a)] are independently associated with an increased risk of cardiovascular diseases (CVD). Recently an unexpected and significant 15 to 30 % reduction of Lp(a) was reported with PCSK9 (Proprotein Convertase Subtilisin/Kexin type 9) inhibitors. The relation between Lp(a) and PCSK9 are unclear and debated.
Kinetic studies of lipoprotein are an important tool to decipher the complexity of apolipoprotein metabolism in human. The comparison of apoprotein(a) and PCSK9 kinetic parameters of patients with extreme lipid disorder link to PCSK9 and apo(a) will allow to better understand the impact of PCSK9 on apo(a). From one previous in vitro study, the hypothesize is that PCSK9 increases the production rate and the assembly of Lp(a).
The objectives are to explore the relationship between the plasma concentration of PCSK9 and apo(a) production rate as well as the impact on the catabolic rate. Patients with extreme Lp(a) levels and healthy controls will be explored by performing a continuous infusion of deuterated leucine for 14 hours. LC/MS-MS will be used to analyze the samples and kinetic data of apo(a) and PCSK9 will be generated from a compartmental model. Tracer enrichment analysis could be complicated for proteins with low plasma concentrations as PCSK9. This issue will be solved with SPE and/or immune affinity concentration techniques. Non-parametrical test and multivariate analysis will be use to describe the relationship between these two variables.
This study will provide new knowledge on Lp(a) and PCSK9 metabolism and their interactions in humans.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
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Nantes, France, 44093
- Nantes university hospital
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- age: 18 to 75 years
- For subjects in the "Control" group: Patients with no major LDL-cholesterol deficiency (patients eligible for LDL-apheresis, eg LDL-C> 200 mg / dL for secondary prevention and 300 mg / dl in primary prevention)) and a level of Lp (a) <50 mg / dl or
- For subjects in the "high-dose" group: Patients with no major LDL-cholesterol abnormalities (LDL-apheresis eligible patients, eg LDL-C> 200 mg / dL for secondary prevention and 300 mg / dl in primary prevention)) and a level of Lp (a)> 80 mg / dl Whenever possible, groups will be balanced for age, sex, familial forms of hypercholesterolemia and their major groups of mutations.
Exclusion Criteria:
- Patients treated with PCSK9 antibodies.
- Patients with acute illness and considered incompatible by the investigator
- Uncontrolled diabetes (HbA1c> 8.5%)
- Severe hepatic insufficiency
- Creatinine clearance <30 ml / min
- Patients not covered by a social security scheme or beneficiary of such a scheme
- Patients unable to understand and / or sign consent
- Pregnant or lactating women
- Minors
- Majors under guardianship or trusteeship or safeguard of justice
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Other
- Allocation: Non-Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Control group
Patients with no major LDL cholesterol abnormalities (patients eligible for LDL-apheresis, eg LDL-C> 200 mg / dL for secondary prevention and 300 mg / LDL-C) dl in primary prevention)) and a level of Lp (a) <50 mg / dl
|
A bolus of 6ml of [5,5,5-2H3] -L-leucine tracers will be performed followed by an infusion of 90 ml of [5,5,5-2H3] -L-leucine infused over 14 hours.
This tracer participates in protein synthesis and especially in the synthesis of all apolipoproteins and PCSK9.
Blood samples will be taken at T0, T2min, T5min, T10 minutes, T30 minutes and then every hour until 14 hours (a total of 240 ml of blood will be collected) to measure the stable tracer enrichment in the proteins of interest.
|
Experimental: High-dose group
Patients with no major LDL-cholesterol abnormalities (LDL-apheresis eligible patients, eg LDL-C> 200 mg / dL for secondary prevention and 300 mg / dl in primary prevention)) and a level of Lp (a)> 80 mg / dl
|
A bolus of 6ml of [5,5,5-2H3] -L-leucine tracers will be performed followed by an infusion of 90 ml of [5,5,5-2H3] -L-leucine infused over 14 hours.
This tracer participates in protein synthesis and especially in the synthesis of all apolipoproteins and PCSK9.
Blood samples will be taken at T0, T2min, T5min, T10 minutes, T30 minutes and then every hour until 14 hours (a total of 240 ml of blood will be collected) to measure the stable tracer enrichment in the proteins of interest.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
To study in humans by a study of the kinetics of apo (a), the relationships between the metabolism of Lp (a) and the plasma levels of PCSK9.
Time Frame: 14 hours after leucine infusion
|
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14 hours after leucine infusion
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
To evaluate the impact of PCSK9 metabolism on metabolic parameters of Lp (a).
Time Frame: 14 hours after leucine infusion
|
Correlation between the PCSK9 (fractional production rate (RPF) and absolute production rate (APR) synthesis rate and the rate of synthesis and degradation of apo (a) (fractional production rate (FPR) and absolute production rate ( APR)) and fractional clearance rate (FCR) in patients with Lp (a)> 80 mg / dl and control subjects with Lp (a) <30mg / dl.
|
14 hours after leucine infusion
|
To evaluate the impact of PCSK9 metabolism on metabolic parameters of Lp
Time Frame: 14 hours after leucine infusion
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Correlation between PCSK9 (fractional clearance rate (FCR)) and the rate of synthesis and degradation of apo (fractional production rate (RPF) and absolute production rate (APR)) and (fractional clearance rate spleen (FCR)) in patients with Lp (a)> 80 mg / dl and control subjects with Lp (a) <30mg / dl.
|
14 hours after leucine infusion
|
To measure the impact of PCSK9 metabolism on metabolic parameters of Lp
Time Frame: 14 hours after leucine infusion
|
Correlation between the production and degradation rates of Lp (a), PCSK9 and apoB100 in patients with Lp (a)> 80 mg / dl and control subjects with Lp (a) ) <30 mg / dl.
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14 hours after leucine infusion
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Collaborators and Investigators
Sponsor
Collaborators
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
- RC18_0281
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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