Pharmaco-metabolomic Effects of Statins: METASTATINE
- Conditions
- Cardiovascular Diseases
- Interventions
- Drug: Placebo comparator
- Registration Number
- NCT03837925
- Lead Sponsor
- French Cardiology Society
- Brief Summary
Statins are effective in cardio-vascular prevention by lowering LDL-Cholesterol levels but also through other mechanisms poorly understood. Our hypothesis is that some of these effects are mediated by microbiota alteration, leading to diminution of expression of microbiota derived pro-atherogenic metabolites.
- Detailed Description
The aim of this prospective double blind placebo-controlled study is to evaluate the acute effects of statins on microbiota and its derived metabolites at 2 and 6 weeks.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 120
- Patient with cardiovascular risk requiring statins in primary prevention
- Contraception for women of childbearing age
- Previous antibiotics, proton pomp inhibitors, statins or other hypolipidemic drugs intake in the previous three months
- Renal insufficiency with creatinine clearance <40ml/min
- Contra-indication to statins
- Previously known conditions affecting muscles, or digestive system
- Requirement of statins in secondary prevention
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description PLACEBO Placebo comparator Placebo caps: one daily. 3 patient visits: inclusion / week 2 / week 6. At each visit, blood sampling, stool sampling, ECG to compare the pharmaco-metabolomic effects of the Statine between atorvastatin arm and placebo arm ATORVASTATIN Atorvastatin 40mg Tablet Atorvastatin 40mg caps: one daily. 3 patient visits: inclusion / week 2 / week 6. At each visit, blood sampling, stool sampling, ECG, to evaluate the pharmaco-metabolomic effects of the Statine
- Primary Outcome Measures
Name Time Method Rate of trimethylamine N-oxide trimethylamine oxide in blood, measured post-prandially at week-6 in atorvastatin arm and placebo arm. Week-6 The main objective of the study is to measure the direct effect of Hydroxy-methyl-glutaryl-coenzyme A reductase inhibitors (Atorvastatin) on the production of atherogenic metabolites derived from intestinal microbiota
- Secondary Outcome Measures
Name Time Method Comparison between W0, W2 and W6 after initiation of atorvastatin vs placebo of circulating metabolomic profile (pre- and postprandial) Week 2 and Week 6 To correlate changes in lipid parameters induced by statins with metabolomic and lipidemic changes and microbiome. Rate of 100 metabolites will be analysed, and gathered as follows:
metabolism of acylcarnitine (3), metabolism of bile acids (5), carbohydrate metabolism (1), dietary choline metabolism (3), metabolism of amino acids (34), vitamins and cofactors (7), metabolism of creatine (2), polyamine metabolism (3), purine metabolism (5), pyrimidine metabolism (9), tryptophan / kynurenine metabolism (21), caffeine metabolism (3), Citric Acid cycle (3), urea cycle (1)Rate of trimethylamine N-oxide trimethylamine oxide in blood, measured post-prandially at week-2 in atorvastatin arm and placebo arm. week-2 To evaluate the evolution of the whole circulating metabolomic profile linked to the introduction of statins
Comparison between W0, W2 and W6 after initiation of atorvastatin vs placebo of the microbiome Week 2 and Week 6 To analyze the influence of the microbiota on the variability of response to atorvastatin.
169/5000 The stool will be analyzed by metagenomic sequencing using the "shot gun" technique, a direct sequencing that quantifies the number of bacterial genes and annotates them.Rate of trimethylamine N-oxide trimethylamine oxide in blood, measured pre and post-prandially at week-2 and week-6 in atorvastatin arm. Week-2 and week-6 To evaluate changes in the microbiome related to the introduction of statins
Trial Locations
- Locations (2)
CIC HEGP
🇫🇷Paris, France
CIC La Sapétrière
🇫🇷Paris, France