Effect of Lapaquistat Acetate Combined With Fenofibrate on Blood Cholesterol Levels
23 de mayo de 2012 actualizado por: Takeda
A Double-blind, Randomized Study to Evaluate the Efficacy and Safety of TAK-475 or Placebo When Coadministered With Fenofibrate in Subjects With Combined Hyperlipidemia
The purpose of this study is to compare changes in cholesterol levels in patients with elevated blood cholesterol with administration of lapaquistat acetate, once daily (QD), and fenofibrate.
Descripción general del estudio
Estado
Terminado
Condiciones
Intervención / Tratamiento
Descripción detallada
Elevated plasma cholesterol (hypercholesterolemia) and various other plasma lipid imbalances (dyslipidemias) are major risk factors for coronary heart disease. It has been established that lowering the low-density lipoprotein cholesterol plasma concentration effectively reduces cardiovascular morbidity and mortality. As a result of this finding, the National Cholesterol Education Program Adult Treatment Panel III identifies control of low-density lipoprotein cholesterol as essential in the prevention and management of coronary heart disease.
Currently, 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins) are the first-line monotherapies prescribed to reduce low-density lipoprotein cholesterol, after diet and therapeutic lifestyle change. However, low doses of statins often fail to produce the Adult Treatment Panel III-recommended levels of low-density lipoprotein cholesterol reduction, making it necessary to increase the dose or add an additional treatment. This in turn may result in decreased tolerability and potential safety concerns.
At higher doses, statins are associated with various myopathies ranging from rare occurrences of rhabdomyolysis and myositis to more frequent symptoms of muscle weakness, cramps, or pain; these can occur with mild or no increases in creatine kinase. Statin use also is associated with increases in liver transaminase levels. These tolerability and safety concerns may contribute to the high discontinuation rates of statins and their prescription at low, and often ineffective, doses.
TAK-475 (lapaquistat acetate) inhibits the cholesterol synthesis pathway at a different step than statins (acting on squalene synthase rather than 3-hydroxy-3-methylglutaryl coenzyme A); it does not reduce concentrations of isoprenylated intermediates believed to be responsible for the myopathies associated with statin use.
This study was conducted to determine whether lapaquistat acetate with fenofibrate has the potential to be more effective than fenofibrate by itself in lowering low-density lipoprotein cholesterol.
Tipo de estudio
Intervencionista
Inscripción (Actual)
213
Fase
- Fase 2
Contactos y Ubicaciones
Esta sección proporciona los datos de contacto de quienes realizan el estudio e información sobre dónde se lleva a cabo este estudio.
Ubicaciones de estudio
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British Columbia
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Coquitlam, British Columbia, Canadá
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Victoria, British Columbia, Canadá
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Ontario
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London, Ontario, Canadá
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Toronto, Ontario, Canadá
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Alabama
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Huntsville, Alabama, Estados Unidos
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Arizona
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Sierra Vista, Arizona, Estados Unidos
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California
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Beverly Hills, California, Estados Unidos
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Long Beach, California, Estados Unidos
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Spring Valley, California, Estados Unidos
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Colorado
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Colorado Springs, Colorado, Estados Unidos
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Golden, Colorado, Estados Unidos
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Connecticut
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Waterbury, Connecticut, Estados Unidos
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Florida
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Jacksonville, Florida, Estados Unidos
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Kissimmee, Florida, Estados Unidos
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Miami, Florida, Estados Unidos
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Ocala, Florida, Estados Unidos
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Pembroke Pines, Florida, Estados Unidos
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Pinellas Park, Florida, Estados Unidos
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West Palm Beach, Florida, Estados Unidos
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Georgia
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Warner Robins, Georgia, Estados Unidos
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Illinois
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Chicago, Illinois, Estados Unidos
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Peoria, Illinois, Estados Unidos
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Indiana
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Indianapolis, Indiana, Estados Unidos
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Kansas
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Wichita, Kansas, Estados Unidos
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Minnesota
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Edina, Minnesota, Estados Unidos
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Missouri
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St. Louis, Missouri, Estados Unidos
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North Carolina
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Raleigh, North Carolina, Estados Unidos
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Winston-Salem, North Carolina, Estados Unidos
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Ohio
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Cincinnati, Ohio, Estados Unidos
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Columbus, Ohio, Estados Unidos
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Oregon
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Hillsboro, Oregon, Estados Unidos
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Pennsylvania
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Beaver, Pennsylvania, Estados Unidos
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South Carolina
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Goose Creek, South Carolina, Estados Unidos
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Tennessee
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Nashville, Tennessee, Estados Unidos
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Virginia
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Norfolk, Virginia, Estados Unidos
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Richmond, Virginia, Estados Unidos
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Criterios de participación
Los investigadores buscan personas que se ajusten a una determinada descripción, denominada criterio de elegibilidad. Algunos ejemplos de estos criterios son el estado de salud general de una persona o tratamientos previos.
Criterio de elegibilidad
Edades elegibles para estudiar
18 años y mayores (Adulto, Adulto Mayor)
Acepta Voluntarios Saludables
No
Géneros elegibles para el estudio
Todos
Descripción
Inclusion Criteria:
- Women of childbearing potential must not be pregnant as determined by a negative serum human chorionic gonadotropin, not lactating, not planning on becoming pregnant between Screening and 30 days following the last dose of study medication, and agreed to use acceptable forms of contraception during the study.
- Prior to Randomization, must have a mean low density lipoprotein cholesterol greater than or equal to 100 mg/dL (2.59 mmol/L) for 2 consecutive samples. The difference between the two individual low density lipoprotein cholesterol values not to exceed 15% of the higher value.
- Prior to Randomization, must have mean triglycerides greater than or equal to 150 and less than or equal to 600 mg/dL (1.70 and 6.78 mmol/L, respectively) for 2 consecutive samples. The upper value for either triglycerides sample must have been less than or equal to 650 mg/dL (7.35 mmol/L).
- Clinical laboratory evaluations (including clinical chemistry [fasted for at least 10 hours], hematology and urinalysis) within the reference range for the testing laboratory unless results deemed not clinically significant or considered within normal limits for this subject by the investigator or the sponsor.
- Willing and able to continue to comply with a standardized low cholesterol diet.
Exclusion Criteria:
- Alanine aminotransferase or aspartate aminotransferase level of greater than 1.5 times the upper limit of normal, active liver disease or jaundice.
- Serum creatinine greater than 1.5 mg/dL (133 μmol/L).
- Creatine phosphokinase greater than 3 times the upper limit of normal.
- Diabetes with a hemoglobin A1c greater than 8 % at Visit 1.
- Previous history of cancer in remission for less than 5 years prior to the first dose of study medication. Does not include those subjects with basal cell or stage I squamous cell carcinoma of the skin.
- An endocrine disorder, such as Cushing's syndrome, hyperthyroidism, or inappropriately treated hypothyroidism, affecting lipid metabolism. Subjects with hypothyroidism on appropriate replacement therapy (defined as stable thyroid hormone replacement therapy at least 3 months prior to Visit 1 and thyrotropin levels less than 1.5 times the upper limit of normal) are eligible for enrollment. If thyrotropin is greater than 1.5 times upper limit of normal, a free thyroxine level is to be determined. If the free thyroxine is within normal limits for that subject, the subject may continue in the study.
- History of myocardial infarction, unstable angina, transient ischemic attacks, cerebrovascular accident, percutaneous coronary intervention, coronary or peripheral arterial surgery (bypass graft surgery) in the 6 months prior to Visit 1.
- Positive hepatitis B surface antigen, or hepatitis C virus antibody, as determined by medical history and/or subject's verbal report.
- Positive human immunodeficiency virus status or is taking anti-retroviral medications, as determined by medical history and/or subject's verbal report.
- Unable or unwilling to discontinue excluded medications or to continue stable doses of "stable dose" medications or required treatment with any excluded medication during the study.
- Exposure to TAK-475 in other studies or currently is participating in another investigational study or has participated in an investigational study within the past 30 days or, for drugs with a long half-life, within a period of less than 5 times the drug's halflife.
- Known hypersensitivity or history of adverse reaction to any fibrate.
- History or presence of clinically significant food allergy that would prevent adherence to the therapeutic lifestyle change (or equivalent) diet.
- Known homozygous familial hypercholesterolemia or known Type III hyperlipoproteinemia (familial dysbetalipoproteinemia).
- Active cholecystitis or known cholelithiasis (a fibrate risk factor).
- Severe renal or hepatic dysfunction, including biliary cirrhosis during Run-In or at Randomization (a fibrate risk factor).
- Fibromyalgia, myopathy, rhabdomyolysis or unexplained muscle pain.
- Uncontrolled hypertension (defined as resting diastolic blood pressure greater than100 mm Hg or resting systolic blood pressure greater than 160 mm Hg) at Visit 1.
- Inflammatory bowel disease or any other malabsorption syndrome or has had gastric bypass or any other surgical procedure for weight loss.
- Unwilling or unable, in the opinion of the investigator, to comply with the protocol or scheduled appointments.
- Unable to understand verbal or written English or any other language for which a certified translation of the approved informed consent was available.
- History of drug abuse (defined as illicit drug use) or a history of alcohol abuse (defined as regular or daily consumption of more than 2 alcoholic drinks per day) within the past 2 years.
- Any other serious disease or condition at Screening or at Randomization that might reduce life expectancy, impair successful management according to the protocol, or make the subject an unsuitable candidate to receive study medication.
Plan de estudios
Esta sección proporciona detalles del plan de estudio, incluido cómo está diseñado el estudio y qué mide el estudio.
¿Cómo está diseñado el estudio?
Detalles de diseño
- Propósito principal: Tratamiento
- Asignación: Aleatorizado
- Modelo Intervencionista: Asignación paralela
- Enmascaramiento: Cuadruplicar
Armas e Intervenciones
Grupo de participantes/brazo |
Intervención / Tratamiento |
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Experimental: Lapaquistat Acetate 100 mg QD + Fenofibrate 145 mg QD
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Lapaquistat acetate 100 mg, tablets, orally, once daily and fenofibrate 145 mg, tablets, orally, once daily for up to 12 weeks.
Otros nombres:
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Comparador activo: Fenofibrate 145 mg QD
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Lapaquistat acetate placebo-matching tablets, orally, once daily and fenofibrate 145 mg, tablets, orally, once daily for up to 12 weeks.
Otros nombres:
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¿Qué mide el estudio?
Medidas de resultado primarias
Medida de resultado |
Periodo de tiempo |
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Percent change from Baseline in direct fasting plasma low-density lipoprotein cholesterol.
Periodo de tiempo: Week 12 or Final Visit.
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Week 12 or Final Visit.
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Medidas de resultado secundarias
Medida de resultado |
Periodo de tiempo |
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Change from baseline in calculated low-density lipoprotein cholesterol.
Periodo de tiempo: Week 12 or Final Visit.
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Week 12 or Final Visit.
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Change from baseline in non- high-density lipoprotein cholesterol.
Periodo de tiempo: Week 12 or Final Visit.
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Week 12 or Final Visit.
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Change from baseline in total cholesterol.
Periodo de tiempo: Week 12 or Final Visit.
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Week 12 or Final Visit.
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Change from baseline in apolipoprotein B.
Periodo de tiempo: Week 12 or Final Visit.
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Week 12 or Final Visit.
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Change from baseline in triglycerides.
Periodo de tiempo: Week 12 or Final Visit.
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Week 12 or Final Visit.
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Change from baseline in high-density lipoprotein cholesterol.
Periodo de tiempo: Week 12 or Final Visit.
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Week 12 or Final Visit.
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Change from baseline in apolipoprotein A1.
Periodo de tiempo: Week 12 or Final Visit.
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Week 12 or Final Visit.
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Change from baseline in very-low-density lipoprotein cholesterol.
Periodo de tiempo: Week 12 or Final Visit.
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Week 12 or Final Visit.
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Change from baseline in derived ratios including total cholesterol/high-density lipoprotein cholesterol, low-density lipoprotein cholesterol/high-density lipoprotein cholesterol, and apolipoprotein B/ apolipoprotein Al.
Periodo de tiempo: Week 12 or Final Visit.
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Week 12 or Final Visit.
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Change from baseline in high-sensitivity C-reactive protein.
Periodo de tiempo: Week 12 or Final Visit.
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Week 12 or Final Visit.
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Percentage of Subjects Achieving Target Direct low-density lipoprotein cholesterol Levels.
Periodo de tiempo: Week 12 or Final Visit.
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Week 12 or Final Visit.
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Colaboradores e Investigadores
Aquí es donde encontrará personas y organizaciones involucradas en este estudio.
Patrocinador
Investigadores
- Director de estudio: Senior Medical Director, Takeda
Publicaciones y enlaces útiles
La persona responsable de ingresar información sobre el estudio proporciona voluntariamente estas publicaciones. Estos pueden ser sobre cualquier cosa relacionada con el estudio.
Fechas de registro del estudio
Estas fechas rastrean el progreso del registro del estudio y los envíos de resultados resumidos a ClinicalTrials.gov. Los registros del estudio y los resultados informados son revisados por la Biblioteca Nacional de Medicina (NLM) para asegurarse de que cumplan con los estándares de control de calidad específicos antes de publicarlos en el sitio web público.
Fechas importantes del estudio
Inicio del estudio
1 de febrero de 2006
Finalización primaria (Actual)
1 de enero de 2007
Finalización del estudio (Actual)
1 de enero de 2007
Fechas de registro del estudio
Enviado por primera vez
19 de diciembre de 2008
Primero enviado que cumplió con los criterios de control de calidad
19 de diciembre de 2008
Publicado por primera vez (Estimar)
23 de diciembre de 2008
Actualizaciones de registros de estudio
Última actualización publicada (Estimar)
24 de mayo de 2012
Última actualización enviada que cumplió con los criterios de control de calidad
23 de mayo de 2012
Última verificación
1 de mayo de 2012
Más información
Términos relacionados con este estudio
Palabras clave
Términos MeSH relevantes adicionales
Otros números de identificación del estudio
- 01-05-TL-475-031
- U1111-1122-8178 (Identificador de registro: WHO)
Esta información se obtuvo directamente del sitio web clinicaltrials.gov sin cambios. Si tiene alguna solicitud para cambiar, eliminar o actualizar los detalles de su estudio, comuníquese con register@clinicaltrials.gov. Tan pronto como se implemente un cambio en clinicaltrials.gov, también se actualizará automáticamente en nuestro sitio web. .