Upfront Lipid-Lowering Therapy With Statins Combined With Hybutimibe in Patients With Acute Ischemic Stroke or Transient Ischemic Attack.
This study aims to evaluate whether an upfront combination lipid-lowering therapy (statins combined with hybutimibe) can further improve the 8-week LDL-C target achievement rate (<1.8 mmol/L and ≥50% reduction from baseline) compared with a sequential lipid-lowering therapy in patients with acute ischemic stroke or transient ischemic attack (TIA)
Studieoversikt
Status
Status
Forhold
Forhold
Intervensjon / Behandling
Intervensjon / Behandling
Studietype
Studietype
Registrering (Antatt)
Registrering
Fase
Fase
- Fase 3
Kontakter og plasseringer
Studiekontakt
Studiekontakt
- Navn: Zhiyuan Feng
- Telefonnummer: 86-010-59975672
- E-post: fzyhhz1996@gmail.com
Deltakelseskriterier
Kvalifikasjonskriterier
Kvalifikasjonskriterier
Alder som er kvalifisert for studier
Tar imot friske frivillige
Kjønn som er kvalifisert for studier
Beskrivelse
Inclusion Criteria:
- Definite diagnosis of acute ischemic stroke or TIA.
- Age ≥18 and <75 years
- Time from onset (last known normal) to enrollment ≤ 72 hours.
- LDL-C level ≥ 1.8 mmol/L prior to enrollment (must obtain LDL-C value after onset to be randomized).
Exclusion Criteria:
-
Use of high-intensity statins, cholesterol absorption inhibitors, PCSK9 inhibitors, or other small interfering RNA cholesterol-lowering drugs within 14 days prior to randomization.
-
Suspected familial hypercholesterolemia.
-
Suspected cardiogenic stroke (e.g., with atrial fibrillation, prosthetic heart valves, atrial myxoma, endocarditis).
-
Acute ischemic stroke suspected to be caused by other etiologies (e.g., arterial dissection, vasculitis, vascular malformation).
-
Presence of isolated sensory symptoms (e.g., numbness) only, isolated visual changes only, or isolated dizziness/vertigo only, in the absence of evidence of acute infarction on baseline head CT or MRI.
-
Pre-stroke mRS score >2.
-
High risk of cerebral hemorrhage (e.g., imaging indicates hemorrhagic transformation after the current stroke, or history of hemorrhagic stroke).
-
Patients with risks or contraindications to statins or hybutimibe:
- Acute liver failure or decompensated cirrhosis.
- Known hypersensitivity to statins or hybutimibe.
- Pregnant or breastfeeding women, or women of childbearing potential who are not using effective contraceptive measures and have no documented pregnancy test.
- Use of immunosuppressants, azole antifungals, amiodarone, fibrates, or other medications that may affect statin metabolism within 14 days prior to randomization, or planned use of such medications during the study period.
- Hepatic or renal impairment (hepatic impairment defined as ALT >2× upper limit of normal [ULN] or AST >2× ULN; renal impairment defined as serum creatinine >1.5× ULN or estimated glomerular filtration rate [eGFR] <20 mL/min).
- Creatine kinase >5× ULN, or a personal or family history of hereditary muscle disease.
-
Planned major surgery or interventional procedure within 8 weeks that may require interruption of the study drug.
-
Severe organic disease with a life expectancy < 8 weeks.
-
Currently participating in other investigational drug or device studies.
-
Inability to complete the 8-week follow-up due to geographic or other reasons (e.g., dementia, severe paralysis, psychiatric disorders).
Studieplan
Hvordan er studiet utformet?
Designdetaljer
- Primært formål: Behandling
- Tildeling: Randomisert
- Intervensjonsmodell: Parallell tildeling
- Masking: Enkelt
Antall våpen
Våpen og intervensjoner
Deltakergruppe / ArmDeltakergruppe / Arm |
Intervensjon / BehandlingIntervensjon / Behandling |
|---|---|
|
Eksperimentell: Upfront combination Lipid Lowering Therapy
Patients will receive a combination of Atorvastatin (40 mg/day) and Hybutimibe (10 mg/day) immediately after enrollment, continuing for 8 weeks |
40 mg/day, administered orally 10 mg/day, administered orally. Used upfront in the experimental group, and sequentially added in the active comparator group if the 4-week LDL-C target is not met. |
|
Aktiv komparator: Sequential Lipid Lowering Therapy
Patients will receive Atorvastatin (40 mg/day) immediately after enrollment for 4 weeks. An LDL-C test will be performed at 4 weeks; if the target is achieved (<1.8 mmol/L and ≥50% reduction from baseline), the same regimen will continue until 8 weeks. If the target is not achieved, Hybutimibe (10 mg/day) will be added to the regimen until 8 weeks |
40 mg/day, administered orally 10 mg/day, administered orally. Used upfront in the experimental group, and sequentially added in the active comparator group if the 4-week LDL-C target is not met. |
Hva måler studien?
Primære resultatmål
Primære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
|---|---|---|
|
Percentage of patients achieving the LDL-C target at 8 weeks
Tidsramme: at 8 weeks
|
Defined as achieving an LDL-C level of <1.8 mmol/L and a reduction of ≥50% from baseline |
at 8 weeks
|
Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
|---|---|---|
|
Percentage change in the lipid profile at 8 weeks
Tidsramme: at 8 weeks
|
Evaluated by the least squares mean percentage change from baseline in LDL-C, non-HDL-C, TG, TC, Lp(a), and ApoB. |
at 8 weeks
|
|
Percentage of patients achieving the general LDL-C target at 8 weeks
Tidsramme: at 8 weeks
|
Defined as achieving an LDL-C level of <1.8 mmol/L at 8 weeks |
at 8 weeks
|
|
Incidence of composite vascular events at 8 weeks
Tidsramme: at 8 weeks
|
Including stroke (ischemic or hemorrhagic stroke), myocardial infarction, and cardiovascular death. |
at 8 weeks
|
|
All-cause mortality rate at 8 weeks
Tidsramme: at 8 weeks
|
Incidence of death from any cause during the study period |
at 8 weeks
|
|
Stroke recurrence rate at 8 weeks
Tidsramme: at 8 weeks
|
Incidence of recurrent stroke events during the follow-up period |
at 8 weeks
|
|
Percentage of patients with a favorable functional outcome at 8 weeks
Tidsramme: at 8 weeks
|
Defined as a modified Rankin Scale (mRS) score of 0 to 2 |
at 8 weeks
|
|
Number of participants with treatment-related adverse events as assessed by CTCAE v4.0 up to 8 weeks
Tidsramme: Up to 8 weeks
|
Defined as the occurrence of any of the following prespecified safety events: study drug discontinuation or dose reduction due to intolerance, newly diagnosed diabetes, muscle-related adverse events (myalgia, myopathy, muscle necrosis), elevated liver enzymes (ALT or AST > 3 times the upper limit of normal), or major bleeding events. |
Up to 8 weeks
|
Samarbeidspartnere og etterforskere
Sponsor
Sponsor
Studierekorddatoer
Studer hoveddatoer
Studiestart (Antatt)
Studiestart
Primær fullføring (Antatt)
Primær fullføring
Studiet fullført (Antatt)
Studiet fullført
Datoer for studieregistrering
Først innsendt
Først innsendt
Først innsendt som oppfylte QC-kriteriene
Først innsendt som oppfylte QC-kriteriene
Først lagt ut (Faktiske)
Først lagt ut
Oppdateringer av studieposter
Sist oppdatering lagt ut (Faktiske)
Sist oppdatering lagt ut
Siste oppdatering sendt inn som oppfylte QC-kriteriene
Siste oppdatering sendt inn som oppfylte QC-kriteriene
Sist bekreftet
Sist bekreftet
Mer informasjon
Begreper knyttet til denne studien
Ytterligere relevante MeSH-vilkår
- Cerebrovaskulære lidelser
- Hjernesykdommer
- Sykdommer i sentralnervesystemet
- Sykdommer i nervesystemet
- Vaskulære sykdommer
- Kardiovaskulære sykdommer
- Hjerneiskemi
- Slag
- Iskemisk hjerneslag
- Iskemisk angrep, forbigående
- Heterocykliske forbindelser, 1-ring
- Heterocykliske forbindelser
- Fettsyrer
- Lipider
- Azoler
- Pyrroles
- Heptansyrer
- Atorvastatin
Andre studie-ID-numre
Andre studie-ID-numre
- 20260528-Hybutimibe
Plan for individuelle deltakerdata (IPD)
Planlegger du å dele individuelle deltakerdata (IPD)?
Legemiddel- og utstyrsinformasjon, studiedokumenter
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