LDL Cholesterol Reduction Following Ezetimibe Initiation (EZE-TRACK)
Low-density Lipoprotein Cholesterol Reduction Following Ezetimibe Initiation: Patterns of Treatment Response
This clinical trial will study why some people have a larger drop in low-density lipoprotein cholesterol (LDL-C), known as "bad cholesterol," after starting ezetimibe. Ezetimibe is a medicine used to lower cholesterol when current treatment is not enough. Adults aged 18 to 75 years who need additional cholesterol treatment will take ezetimibe, either alone or added to their usual stable medication. Researchers will examine whether diet, salt intake, physical activity, and personal health factors influence how much LDL-C levels fall after treatment. Participants will have blood tests before and after starting ezetimibe, complete diet and activity questionnaires, and provide a 24-hour urine sample. The goal is to help doctors better understand who benefits most from ezetimibe and improve personalized cholesterol treatment.
Tutkimuksen yleiskatsaus
Tila
Ehdot
Interventio / Hoito
Yksityiskohtainen kuvaus
Reduction of low-density lipoprotein cholesterol (LDL-C) is a central strategy for cardiovascular risk reduction. Although ezetimibe provides additional LDL-C lowering when added to background therapy, substantial interindividual variability in treatment response has been observed. Determinants of this variability, particularly modifiable lifestyle factors, remain insufficiently defined. This prospective, single-centre, open-label, pragmatic interventional study is conducted in routine clinical practice to identify baseline clinical and lifestyle predictors of lipid response following ezetimibe initiation. Adults with a clinical indication for ezetimibe will initiate treatment at the approved standard dose, either as monotherapy or added to stable background lipid-lowering therapy. Baseline assessments will include demographic and clinical characteristics, comorbidities, concomitant medications, and laboratory parameters. Dietary intake will be assessed using a validated food frequency questionnaire and objective 24-hour urinary measurements of sodium, potassium, and urea. Physical activity will be evaluated using a validated questionnaire. Lipid parameters will be reassessed after treatment initiation to determine percentage change in LDL-C, non-high-density lipoprotein cholesterol, and apolipoprotein B. Multivariable regression analyses will be performed to identify independent predictors of lipid response. The results may inform personalized lipid-lowering strategies and improve selection of patients most likely to benefit from ezetimibe therapy in real-world clinical settings.
Opintotyyppi
Ilmoittautuminen (Arvioitu)
Vaihe
- Vaihe 4
Yhteystiedot ja paikat
Opiskeluyhteys
- Nimi: Pedro Marques, MD.
- Puhelinnumero: (+351) (+351) 220426820
- Sähköposti: pmmarques@med.up.pt
Opiskelupaikat
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Porto, Portugali, 4200-319
- Rekrytointi
- Unidade Local de Saúde São João
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Ottaa yhteyttä:
- Marques M. Pedro, MD.
- Puhelinnumero: (+351) (+351) 22 042 68 20
- Sähköposti: pmmarques@med.up.pt
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Päätutkija:
- Pedro M. Marques, MD.
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Osallistumiskriteerit
Kelpoisuusvaatimukset
Opintokelpoiset iät
Hyväksyy terveitä vapaaehtoisia
Sukupuolet, jotka voivat opiskella
Kuvaus
Inclusion criteria:
- Age ≥18 and ≤75 years at the time of ezetimibe initiation;
- Initiation of ezetimibe as monotherapy or, in patients already treated with statins or other LDL-C-lowering agents, provided that neither the compound nor the dose of the concomitant LDL-C-lowering therapy was modified at the time of ezetimibe initiation.
Exclusion criteria:
- Absence of indication for ezetimibe therapy as determined by the treating physician;
- Initiation of ezetimibe with concomitant modification of statin or other LDL-C-lowering medication type or dosage;
- Initiation of ezetimibe/statin combination therapy as the first lipid-lowering regimen.
Opintosuunnitelma
Miten tutkimus on suunniteltu?
Suunnittelun yksityiskohdat
- Ensisijainen käyttötarkoitus: Hoito
- Jako: Ei käytössä
- Inventiomalli: Yksittäinen ryhmätehtävä
- Naamiointi: Ei mitään (avoin tarra)
Aseet ja interventiot
Osallistujaryhmä / Arm |
Interventio / Hoito |
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Kokeellinen: Ezetimibe treatment
Participants will initiate ezetimibe therapy according to clinical indication, either as monotherapy or added to stable background lipid-lowering treatment without modification of concomitant drug type or dose. The study will assess lipid response and identify clinical and lifestyle predictors of LDL-C reduction following ezetimibe initiation. |
Ezetimibe will be initiated at the approved standard dose of 10 mg once daily, either as monotherapy or added to stable background lipid-lowering therapy (e.g., statins) without modification of concomitant drug type or dosage at the time of initiation. Treatment will be prescribed according to routine clinical practice and guideline-based indications. Lipid profile and clinical parameters will be assessed before and after ezetimibe initiation to evaluate treatment response. |
Mitä tutkimuksessa mitataan?
Ensisijaiset tulostoimenpiteet
Tulosmittaus |
Toimenpiteen kuvaus |
Aikaikkuna |
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Percentage change in LDL-C following ezetimibe initiation
Aikaikkuna: At least 8 weeks after ezetimibe initiation.
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Percentage change in LDL-C following ezetimibe initiation, calculated as [(follow-up LDL-C - baseline LDL-C) / baseline LDL-C] × 100 and expressed as a percentage (%). |
At least 8 weeks after ezetimibe initiation.
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Toissijaiset tulostoimenpiteet
Tulosmittaus |
Toimenpiteen kuvaus |
Aikaikkuna |
|---|---|---|
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Percentage change in non-HDL-C following ezetimibe initiation
Aikaikkuna: At least 8 weeks after ezetimibe initiation.
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Percentage change in non-HDL-C following ezetimibe initiation, calculated as [(follow-up non-HDL-C - baseline non-HDL-C) / baseline non-HDL-C] × 100 and expressed as a percentage (%). |
At least 8 weeks after ezetimibe initiation.
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Percentage change in apolipoprotein B (ApoB) following ezetimibe initiation
Aikaikkuna: At least 8 weeks after ezetimibe initiation.
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Percentage change in ApoB following ezetimibe initiation, calculated as [(follow-up ApoB - baseline ApoB) / baseline ApoB] × 100 and expressed as a percentage (%). |
At least 8 weeks after ezetimibe initiation.
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Association between baseline 24-hour urinary sodium excretion and percentage change in LDL-C following ezetimibe initiation
Aikaikkuna: At least 8 weeks after ezetimibe initiation.
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The association between baseline 24-hour urinary sodium excretion and percentage change in LDL-C following ezetimibe initiation will be evaluated using Spearman's rank correlation analysis. The outcome measure will be the Spearman correlation coefficient (ρ), which ranges from -1 to +1. |
At least 8 weeks after ezetimibe initiation.
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Proportion of participants achieving a clinically meaningful change in LDL-C following ezetimibe initiation
Aikaikkuna: At least 8 weeks after ezetimibe initiation.
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Proportion of participants achieving a clinically meaningful LDL-C response, defined as at least a 20% decrease in LDL-C in participants treated with ezetimibe as monotherapy, or at least a 10% additional decrease in LDL-C when ezetimibe is added to high-intensity baseline statin therapy. |
At least 8 weeks after ezetimibe initiation.
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Performance of a multivariable prediction model for LDL-C response following ezetimibe initiation
Aikaikkuna: At least 8 weeks after ezetimibe initiation.
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Performance of a multivariable prediction model developed to predict the percentage change in LDL-C following ezetimibe initiation. Model performance will be evaluated using discrimination (C-statistic / area under the ROC curve, range 0.5-1.0; higher values indicate better discrimination), calibration (calibration slope and calibration-in-the-large / intercept), and predictive accuracy (Brier score, range 0-1; lower values indicate better accuracy). |
At least 8 weeks after ezetimibe initiation.
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Yhteistyökumppanit ja tutkijat
Sponsori
Opintojen ennätyspäivät
Opi tärkeimmät päivämäärät
Opiskelun aloitus (Todellinen)
Ensisijainen valmistuminen (Arvioitu)
Opintojen valmistuminen (Arvioitu)
Opintoihin ilmoittautumispäivät
Ensimmäinen lähetetty
Ensimmäinen toimitettu, joka täytti QC-kriteerit
Ensimmäinen Lähetetty (Todellinen)
Tutkimustietojen päivitykset
Viimeisin päivitys julkaistu (Todellinen)
Viimeisin lähetetty päivitys, joka täytti QC-kriteerit
Viimeksi vahvistettu
Lisää tietoa
Tähän tutkimukseen liittyvät termit
Avainsanat
Muita asiaankuuluvia MeSH-ehtoja
Muut tutkimustunnusnumerot
- EZE-TRACK
Lääke- ja laitetiedot, tutkimusasiakirjat
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