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A Study to Evaluate Daily Pravastatin, Fenofibrate or Pravafen in the Treatment of Combined Hyperlipidemia

Phase 3
Completed
Conditions
Combined Hyperlipidemia
Interventions
Registration Number
NCT00459745
Lead Sponsor
Shionogi
Brief Summary

This is a multi-center, double blind, prospective, longitudinal, randomized, 12-week study with a 52-week open-label follow-up to evaluate the safety and efficacy of daily administration of Pravastatin 40 mg or Fenofibrate 160 mg or Pravafen (the combination of both Pravastatin and Fenofibrate 40/160 mg) in the treatment of combined hyperlipidemia. There will be an open-label, 8-week, Selection Phase prior to randomization in which all patients will be stabilized on Pravastatin 40 mg/day. Following the Selection Phase, and if the patients meet all inclusion/exclusion criteria, they will be randomized to a three arm, double blind, 12-week Efficacy Phase during which they would receive either Pravastatin 40 mg or Fenofibrate 160 mg or Pravafen (the combination of Pravastatin and Fenofibrate 40/160 mg). The 12-week Efficacy Phase will be followed by an open-label, 52-week, Safety Phase in which all patients will receive Pravafen.

After the 8-week Selection Phase, patients that still meet the inclusion/exclusion criteria will be randomized on a 1:1:2 ratio to Pravastatin 40 mg or Fenofibrate 160 mg or Pravafen (the combination of both Pravastatin and Fenofibrate 40/160 mg) for 12 weeks. After the completion of the 12-week double-blind phase of the study, all patients that haven't had changes in their well being, will be allowed to roll-over into the 52-week, open-label, follow-up portion of the study. During the 52 week, open label, Safety Phase of the study, all patients will receive Pravafen (the combination of Pravastatin and Fenofibrate 40/160 mg).

Patients will be evaluated at baseline and every three weeks thereafter throughout the initial 12-week Efficacy Phase of the study. Patients that roll-over into the 52-week, open-label, follow-up Safety Phase will be evaluated at 12, 24, 36 and 52 weeks.

Participation in the study can be up to 72 weeks.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
481
Inclusion Criteria

Patients meeting all the criteria listed below may be selected to enroll into the Selection Phase of the study:

  1. Male or female patients from 18-75 years of age, inclusive at the time of dosing with a history of a combined hyperlipidemia.

  2. High LDL cholesterol and TG levels as per the table hereunder:

    Prior treatment LDL Cholesterol TG Naïve to treatment* > 130 mg/dL and ≥ 150 mg/dL and ≤ 400 mg/dL Lipid Lowering Monotherapy > 130 mg/dL and ≥ 150 mg/dL and ≤ 400 mg/dL Lipid Lowering Combination Therapy > 110 mg/dL and ≥ 150 mg/dL and ≤ 400 mg/dL

    * A patient that has received NO lipid lowering therapy within 6 weeks prior to the Selection Visit, will be considered Naïve to treatment.

  3. If the patient is female and of childbearing potential and sexually active, an acceptable birth control method must be used (abstinence, IUD, oral, transdermal, injectable or implantable contraceptives, at least 2 years post-menopausal, one year post hysterectomy, double barrier device and/or partner at least one year post vasectomy), a negative serum pregnancy test must be obtained at the Selection Visit (Visit 1) and a negative urine pregnancy test must be obtained prior to study drug administration at Baseline Visit (Visit 3).

  4. Able to comply with all study procedures.

  5. Patients that provide a written informed consent to participate in the study indicated by a personal signature and date on the patient consent form.

At the end of the Selection Phase, patients meeting all of the criteria listed below may be selected and randomized into the Efficacy Phase of the study:

  1. Selected patients with LDL Cholesterol ≥ 100 mg/dl and/or TG ≥ 150 mg/dl and ≤ 400 mg/dl at Week-1 / Visit 2 after taking Pravastatin 40 mg/day from Visit 1.
  2. Patients still meeting the selection criteria a, c, d and e as listed under section 4.1.
  3. Patients with a compliance ≥ 80% during the 8-week Pravastatin phase of the study.
Exclusion Criteria

Patients will be excluded from the study if any one or more of the following apply:

  1. Female of childbearing potential who is pregnant and/or lactating and/or sexually active but not using an acceptable method of contraception

  2. History of allergy or contraindications to:

    • fenofibrate or similar compounds
    • HMG-CoA reductase inhibitors
  3. History of uncontrolled or unstable;

    • diabetes ((i.e., diabetic nephropathy etc.),
    • hepatic impairment/insufficiency,
    • renal impairment/insufficiency (i.e., nephritis, polycystic kidney disease, acute or chronic renal failure, end-stage renal disease, GFR < 60 ml/min, etc.),
    • neurological,
    • gastrointestinal (ulcerative colitis, Barrett's, etc.),
    • gallbladder disease (patients with prior cholecystectomy can be allowed to participate),
    • psychiatric disease,
    • sleep apnea
    • any other clinically significant medical or surgical history that could affect the safety of the patient or hinder the evaluation of drug effect based on Investigator or Medical Monitor discretion
  4. Acute liver disease or persistent elevations in liver function tests (2 times the upper normal limit or greater)

  5. Levels of creatine phosphokinase (CK) 3 times the upper normal limit or greater

  6. Change in diuretic or β-blocker treatment for hypertension within 30 days of enrollment into the selection phase (Visit 1)

  7. Positive personal history of abuse of any of the following:

    • Alcohol (as per the DSM-IV criteria) and/or
    • Recreational drugs (as per the DSM-IV criteria)
  8. Usage of any of the following medications (patients must have discontinued these medications for 5 or more half-lives or for 30 days, whichever is greater prior to study drug administration on Visit 3 / Day 0) :

    • Corticosteroids
    • Immunosuppressants
    • Macrolide antibiotics
    • Azole antifungal agents, or
  9. Recent use of any investigational drug. These drugs must have been discontinued for either 5 or more half-lives or for 30 days whichever is greater prior to Visit 1

  10. Hyperlipidemia type I-IIa-IV-V

  11. LDL < 100 mg/dL

  12. TG < 150 mg/dL or > 400 mg/dL

  13. Uncontrolled primary hypothyroidism

  14. History of an acute myocardial infarction, stroke within the last 6 month prior to Visit 1; unstable angina or clinically significant heart failure

  15. Uncontrolled hypertension, as defined by SBP >160 mmHg or DBP >100 mmHg while on anti-hypertensive medication

  16. Type 1 diabetes or type 2 diabetes mellitus requiring insulin, and diabetic patients with poor control (HbA1c level > 8.5%), abnormal renal function (GFR < 60 ml/mn) or any renal disease likely to lead to renal dysfunctions)

  17. Use of any of the prohibited medications as detailed in the concomitant medication section

  18. Non adherence to the American Heart Association Step II diet introduced at Visit 1

  19. Presence of any other condition or illness, which, in the opinion of the Principal Investigator, would interfere with the patient's participation in the study

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Pravafen (Parvastatin and Fenofibrate)PravafenCombined Therapy of Pravastatin 40 mg and Fenofibrate 160 mg.
FenofibrateFenofibrateFenofibrate 160 mg
PravastatinPravastatinPravastatin 40 mg
Primary Outcome Measures
NameTimeMethod
Primary endpoints will assess differences in change from baseline in non-HDL-C, for the patients receiving Pravafen versus the patients receiving Pravastatin or Fenofibrate at the end of the 12-week portion of the study.bBaseline to 12 weeks

Change in HDL

Secondary Outcome Measures
NameTimeMethod
Secondary endpoints will assess differences in change from baseline in TC, TG, LDL-C, HDL-C and TC/HDL-C for the pts receiving the combo therapy vs the pts receiving Pravastatin or FenofibrateBaseline to 12 weeks

Changes in TC, TG, LDL-C, HDL-C and TC/HDL-C

Differences in change from baseline in ALT, AST and CK as well as overall safety for the pts receiving the combo therapy vs the pts receiving Pravastatin or Fenofibrate at the end of the 12-week of the studyBaseline to 12 weeks

Changes in ALT, AST and CK and overall safety

Trial Locations

Locations (55)

East-West Medical Research Institute

🇺🇸

Honolulu, Hawaii, United States

Welborn Clinic Gateway

🇺🇸

Newburgh, Indiana, United States

Memorial Research Medical Clinic

🇺🇸

Long Beach, California, United States

Cochise Clinical Research

🇺🇸

Sierra Vista, Arizona, United States

Orange County Research Center

🇺🇸

Tustin, California, United States

Drug Study Institute

🇺🇸

Jupiter, Florida, United States

Clinical Trials Research

🇺🇸

Austin, Texas, United States

Southern Berks Family Medicine

🇺🇸

Reading, Pennsylvania, United States

Wells Institute for Health Awareness

🇺🇸

Kettering, Ohio, United States

Texas Medical Research LLC

🇺🇸

San Antonio, Texas, United States

Jacksonville Center for Clinical Research

🇺🇸

Jacksonville, Florida, United States

Bluegrass Clinical Research, Inc.

🇺🇸

Louisville, Kentucky, United States

Hampton Roads Center for Clinical Research

🇺🇸

Norfolk, Virginia, United States

Research Institute of Middle America

🇺🇸

Jeffersonville, Indiana, United States

Philadelphia Clinical Research, LLC

🇺🇸

Philadelphia, Pennsylvania, United States

Ohio Clinical Research

🇺🇸

Hudson, Ohio, United States

Upstate Pharmaceutical Research

🇺🇸

Simpsonville, South Carolina, United States

Welborn Clinic Research Center

🇺🇸

Evansville, Indiana, United States

Cardiology Research Associates

🇺🇸

Ormond Beach, Florida, United States

Bluestem Cardiology

🇺🇸

Bartlesville, Oklahoma, United States

Fleetwood Clinical Research

🇺🇸

Fleetwood, Pennsylvania, United States

TriCities Medical Research Associates

🇺🇸

Bristol, Tennessee, United States

National Clinical Research

🇺🇸

Richmond, Virginia, United States

Ohio Clinical Research, LLC

🇺🇸

Lyndhurst, Ohio, United States

Holston Medical Group

🇺🇸

Kingsport, Tennessee, United States

Palmetto Medical Research Associates

🇺🇸

Mount Pleasant, South Carolina, United States

Sterling Research Group

🇺🇸

Cincinnati, Ohio, United States

The Lindner Clinical Trial Center

🇺🇸

Cincinnati, Ohio, United States

Tipton Medical Center

🇺🇸

Tipton, Pennsylvania, United States

Atlanta Vascular Research Foundation

🇺🇸

Atlanta, Georgia, United States

Mima Century Research Associates

🇺🇸

Melbourne, Florida, United States

MediSphere Medical Research Center LLC

🇺🇸

Evansville, Indiana, United States

Androscoggin Cardiology Associates

🇺🇸

Auburn, Maine, United States

MODEL Clinical Research

🇺🇸

Baltimore, Maryland, United States

Lemarc Research Center

🇺🇸

Louisville, Kentucky, United States

Health Trends Research, LLC

🇺🇸

Baltimore, Maryland, United States

MD Medical Research

🇺🇸

Oxon Hill, Maryland, United States

Clinical Research Center of Cape Cod, Inc

🇺🇸

West Yarmouth, Massachusetts, United States

Clinical Study Site

🇺🇸

Florissant, Missouri, United States

Sensenbrenner Primary Care LLC

🇺🇸

Charlotte, North Carolina, United States

Mercy Medical Group

🇺🇸

Manchester, Missouri, United States

Bronx Nephrology Hypertension, P.C.

🇺🇸

Bronx, New York, United States

Capital Cardiology Associates

🇺🇸

Troy, New York, United States

Comprehensive Clinical Research

🇺🇸

Berlin, New Jersey, United States

Triangle Medical Research Associates

🇺🇸

Raleigh, North Carolina, United States

Wake Research Associates

🇺🇸

Raleigh, North Carolina, United States

Piedmont Medical Research Associates

🇺🇸

Winston-Salem, North Carolina, United States

Crescent Medical Research Associates

🇺🇸

Salisbury, North Carolina, United States

Cedar Research LLC

🇺🇸

Tacoma, Washington, United States

Anasazi Internal Medicine

🇺🇸

Phoenix, Arizona, United States

Metrolina Medical Research

🇺🇸

Charlotte, North Carolina, United States

Willamette Valley Clinical Studies

🇺🇸

Eugene, Oregon, United States

Clinical Research Associates of Tidewater

🇺🇸

Norfolk, Virginia, United States

Rainier Clinical Research Center Inc.

🇺🇸

Renton, Washington, United States

Lynn Institute of Norman

🇺🇸

Norman, Oklahoma, United States

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