Effects of Simvastatin and Ezetimibe on Cardiovascular Risk Markers in Patients With Dyslipidemia
Study of Lipoprotein Subfractions, Inflammation, Oxidative Stress and Endothelial Function After Treatment With Simvastatin and Ezetimibe Administered Alone and in Combination in Hyperlipidemic Patients
Studieoversigt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Detaljeret beskrivelse
Undersøgelsestype
Undersøgelsestype
Tilmelding (Faktiske)
Tilmelding
Fase
Fase
- Ikke anvendelig
Deltagelseskriterier
Berettigelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
Tager imod sunde frivillige
Køn, der er berettiget til at studere
Beskrivelse
Inclusion Criteria:
- LDL cholesterol concentration of between 160-190 mg/dl in patients with less than 2 cardiovascular risk factors
- LDL concentration of between 130-160 mg/dl in patients that presented 2 or more cardiovascular risk factors.
Cardiovascular risk factors were defined as: age (≥ 45 years in men and ≥55 years in women), a smoking habit, hypertension (≥140/90 mmHg), diabetes mellitus, a high-density lipoprotein (HDL) cholesterol concentration of ≤ 40mg/dl, and a family history of cardiovascular disease.
Exclusion Criteria:
- Triglyceride concentration > 400 mg/dl
- Diabetes Mellitus
- Kidney, liver, or thyroid disease
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
- Tildeling: Randomiseret
- Interventionel model: Parallel tildeling
- Maskning: Ingen (Åben etiket)
Antal våben
Våben og indgreb
Deltagergruppe / ArmDeltagergruppe / Arm |
Intervention / BehandlingIntervention / Behandling |
|---|---|
|
Eksperimentel: Simvastatin
Hyperlipidemic patients received simvastatin (40 mg/day) for 4 weeks, after they were administered combined therapy (simvastatin, 40 mg/day plus ezetimibe,10 mg/day) for an additional 4-week period.
Lipid profile, lipoprotein subfractions of LDL and HDL, inflammatory, oxidative stress and endothelial function parameters were evaluated.
|
simvastatin (40 mg/day) for 4 weeks
combined therapy simvastatin (40 mg/day) + ezetimibe (10 mg/day) for 4-week period
|
|
Eksperimentel: Ezetimibe
Hyperlipidemic patients received ezetimibe (10 mg/day) for 4 weeks, after they were administered combined therapy (simvastatin, 40 mg/day plus ezetimibe,10 mg/day) for an additional 4-week period.
Lipid profile, lipoprotein subfractions of LDL and HDL, inflammatory, oxidative stress and endothelial function parameters were evaluated.
|
combined therapy simvastatin (40 mg/day) + ezetimibe (10 mg/day) for 4-week period
ezetimibe (10 mg/day) for 4 weeks
|
Hvad måler undersøgelsen?
Primære resultatmål
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Total Cholesterol Before and After Simvastatin/Ezetimibe Administration
Tidsramme: Baseline, 4 weeks and 8 weeks
|
Total cholesterol concentration was measured by enzymatic assay
|
Baseline, 4 weeks and 8 weeks
|
|
Low-density Lipoprotein Cholesterol (LDLc) Before and After Simvastatin/Ezetimibe Administration
Tidsramme: Baseline, 4 weeks and 8 weeks
|
Low-density lipoprotein cholesterol (LDLc) concentration was calculated using the method of Friedewald.
|
Baseline, 4 weeks and 8 weeks
|
|
High-density Lipoprotein Cholesterol (HDLc) Before and After Simvastatin/Ezetimibe Administration
Tidsramme: Baseline, 4 weeks and 8 weeks
|
High-density lipoprotein cholesterol (HDLc) concentration was measured using a direct method
|
Baseline, 4 weeks and 8 weeks
|
|
Triglycerides Before and After Simvastatin/Ezetimibe Administration
Tidsramme: Baseline, 4 weeks and 8 weeks
|
Triglyceride concentration were measured by enzymatic assay
|
Baseline, 4 weeks and 8 weeks
|
|
Non-HDL Cholesterol Before and After Simvastatin/Ezetimibe Administration
Tidsramme: Baseline, 4 weeks and 8 weeks
|
Non-HDLc concentration was obtained by calculating the difference between total cholesterol and HDLc
|
Baseline, 4 weeks and 8 weeks
|
|
Low Density Lipoprotein Size Before and After Simvastatin/Ezetimibe Administration
Tidsramme: Baseline, 4 weeks and 8 weeks
|
LDL subfractions were separated by high-resolution polyacrylamide gel tubes using the Lipoprint® system.
The LDL electrophoretic profile allows 2 patterns to be defined: pattern A or large and buoyant LDL, and pattern non-A or small and dense LDL.
|
Baseline, 4 weeks and 8 weeks
|
|
Apolipoprotein B Before and After Simvastatin/Ezetimibe Administration
Tidsramme: Baseline, 4 weeks and 8 weeks
|
Levels of apolipoprotein B were determined by inmunonephelometry
|
Baseline, 4 weeks and 8 weeks
|
Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Levels of High-sensitive C-reactive Protein (hsCRP) Before and After Simvastatin/Ezetimibe Administration
Tidsramme: Baseline, 4 weeks and 8 weeks
|
Levels of high-sensitive C-reactive protein (hsCRP) were analysed by a latex-enhanced inmunonephelometric assay
|
Baseline, 4 weeks and 8 weeks
|
|
Levels of Interleukin-6 (IL-6) Before and After Simvastatin/Ezetimibe Administration
Tidsramme: Baseline, 4 weeks and 8 weeks
|
Levels of proinflammatory cytokines (interleukin-6 (IL-6)) were analysed with a Luminex® 200™ system
|
Baseline, 4 weeks and 8 weeks
|
|
Levels of Tumor Necrosis Factor α (TNF-α) Before and After Simvastatin/Ezetimibe Administration
Tidsramme: Baseline, 4 weeks and 8 weeks
|
Levels of proinflammatory cytokines (tumor necrosis factor α (TNF-α)) were analysed with a Luminex® 200™ system
|
Baseline, 4 weeks and 8 weeks
|
|
Mitochondrial Oxygen (O2) Consumption Before and After Simvastatin/Ezetimibe Administration
Tidsramme: Baseline, 4 weeks and 8 weeks
|
Oxidative stress markers (mitochondrial oxygen (O2) consumption) was measured at baseline and after treatment by Clark electrode
|
Baseline, 4 weeks and 8 weeks
|
|
Reactive Oxygen Species (ROS) Production Before and After Simvastatin/Ezetimibe Administration
Tidsramme: Baseline, 4 weeks and 8 weeks
|
Oxidative stress markers (Reactive oxygen species (ROS) production) was measured at baseline and after treatment by fluorometric techniques
|
Baseline, 4 weeks and 8 weeks
|
|
Membrane Potential Before and After Simvastatin/Ezetimibe Administration
Tidsramme: Baseline, 4 weeks and 8 weeks
|
Oxidative stress markers (membrane potential) was measured at baseline and after treatment by fluorometric techniques
|
Baseline, 4 weeks and 8 weeks
|
|
Levels of Glutathione (GSH) Before and After Simvastatin/Ezetimibe Administration
Tidsramme: Baseline, 4 weeks and 8 weeks
|
Oxidative stress markers (levels of glutathione (GSH)) was measured at baseline and after treatment by fluorometric techniques
|
Baseline, 4 weeks and 8 weeks
|
|
Leukocyte Rolling Flux Before and After Simvastatin/Ezetimibe Administration
Tidsramme: Baseline, 4 weeks and 8 weeks
|
Interactions between leukocytes and human umbilical vein endothelial cells were evaluated by flow chamber microscopy.
Leukocyte rolling was estimated as the number of leukocytes rolling over 100 μm2 of the endothelial monolayer during a 1-min period.
|
Baseline, 4 weeks and 8 weeks
|
|
Leukocyte Adhesion Before and After Simvastatin/Ezetimibe Administration
Tidsramme: Baseline, 4 weeks and 8 weeks
|
Interactions between leukocytes and human umbilical vein endothelial cells were evaluated by flow chamber microscopy.
Adhesion was evaluated by counting the number of polymorphonuclear cells that maintained stable contact with human umbilical vein endothelial cells (HUVEC) for 30 seconds.
|
Baseline, 4 weeks and 8 weeks
|
|
Leukocyte Rolling Velocity Before and After Simvastatin/Ezetimibe Administration
Tidsramme: Baseline, 4 weeks and 8 weeks
|
Interactions between leukocytes and human umbilical vein endothelial cells were evaluated by flow chamber microscopy.The rolling velocity in the field of focus was determined by measuring the time required by 20 consecutive leukocytes to cover a distance of 100 μm.
|
Baseline, 4 weeks and 8 weeks
|
|
Levels of Vascular Cell Adhesion Molecule 1 (VCAM-1) Before and After Simvastatin/Ezetimibe Administration
Tidsramme: Baseline, 4 weeks and 8 weeks
|
The vascular cell adhesion molecule 1 (VCAM-1) was evaluated in serum by Luminex® 200™ system
|
Baseline, 4 weeks and 8 weeks
|
|
Levels of Intercellular Adhesion Molecule 1 (ICAM-1) Before and After Simvastatin/Ezetimibe Administration
Tidsramme: Baseline, 4 weeks and 8 weeks
|
The intercellular adhesion molecule 1 (ICAM-1) was evaluated in serum by Luminex® 200™ system
|
Baseline, 4 weeks and 8 weeks
|
|
Levels of E-selectin Before and After Simvastatin/Ezetimibe Administration
Tidsramme: Baseline, 4 weeks and 8 weeks
|
E-selectin was evaluated in serum by Luminex® 200™ system
|
Baseline, 4 weeks and 8 weeks
|
Samarbejdspartnere og efterforskere
Sponsor
Sponsor
Efterforskere
Efterforskere
- Ledende efterforsker: Antonio Hernández, MD, Phd, FISABIO - University Hospital Dr Peset
Publikationer og nyttige links
Generelle publikationer
- Berneis K, Rizzo M, Berthold HK, Spinas GA, Krone W, Gouni-Berthold I. Ezetimibe alone or in combination with simvastatin increases small dense low-density lipoproteins in healthy men: a randomized trial. Eur Heart J. 2010 Jul;31(13):1633-9. doi: 10.1093/eurheartj/ehq181. Epub 2010 Jun 6.
- Florentin M, Liberopoulos EN, Moutzouri E, Rizos CV, Tselepis AD, Elisaf MS. The effect of simvastatin alone versus simvastatin plus ezetimibe on the concentration of small dense low-density lipoprotein cholesterol in subjects with primary hypercholesterolemia. Curr Med Res Opin. 2011 Mar;27(3):685-92. doi: 10.1185/03007995.2010.546394. Epub 2011 Jan 27.
- Bays HE, Ose L, Fraser N, Tribble DL, Quinto K, Reyes R, Johnson-Levonas AO, Sapre A, Donahue SR; Ezetimibe Study Group. A multicenter, randomized, double-blind, placebo-controlled, factorial design study to evaluate the lipid-altering efficacy and safety profile of the ezetimibe/simvastatin tablet compared with ezetimibe and simvastatin monotherapy in patients with primary hypercholesterolemia. Clin Ther. 2004 Nov;26(11):1758-73. doi: 10.1016/j.clinthera.2004.11.016.
Datoer for undersøgelser
Studer store datoer
Studiestart
Studiestart
Primær færdiggørelse (Faktiske)
Primær færdiggørelse
Studieafslutning (Faktiske)
Studieafslutning
Datoer for studieregistrering
Først indsendt
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først indsendt, der opfyldte QC-kriterier
Først opslået (Skøn)
Først opslået
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering sendt
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Yderligere relevante MeSH-vilkår
- Metaboliske sygdomme
- Lipidmetabolismeforstyrrelser
- Dyslipidæmi
- Molekylære mekanismer for farmakologisk virkning
- Enzymhæmmere
- Antimetabolitter
- Antikolesteræmiske midler
- Hypolipidæmiske midler
- Lipidregulerende midler
- Hydroxymethylglutaryl-CoA-reduktasehæmmere
- Simvastatin
- Ezetimibe
- Ezetimibe, Simvastatin lægemiddelkombination
Andre undersøgelses-id-numre
Andre undersøgelses-id-numre
- SIM-EZE-2009-01
Disse oplysninger blev hentet direkte fra webstedet clinicaltrials.gov uden ændringer. Hvis du har nogen anmodninger om at ændre, fjerne eller opdatere dine undersøgelsesoplysninger, bedes du kontakte register@clinicaltrials.gov. Så snart en ændring er implementeret på clinicaltrials.gov, vil denne også blive opdateret automatisk på vores hjemmeside .