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Safety & Effectiveness on Vascular Structure and Function of ACZ885 in Atherosclerosis and Either T2DM or IGT Patients

Phase 2
Completed
Conditions
Diabetes Mellitus, Type 2
Prediabetic State
Atherosclerosis
Interventions
Drug: Placebo
Registration Number
NCT00995930
Lead Sponsor
Novartis Pharmaceuticals
Brief Summary

This study will evaluate the effect of ACZ885 on vascular function in patients with documented atherosclerotic disease and T2DM or IGT.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
189
Inclusion Criteria
  • Patients with known atherosclerotic disease and documented diagnosis of T2DM for ≤ 14 years OR IGT
  • HbA1c between 6.0% and 10.0%
  • On stable statin therapy or statin intolerant
  • Patients who are eligible and able to participate in the study
Exclusion Criteria
  • Contraindications to MRI
  • NYHA class IV Heart Failure
  • NYHA class I - III heart failure with acute exacerbation in 3 months prior to screening
  • Patients with type 1 diabetes
  • Acute infections
  • HsCRP > 30 mg/dL
  • Aortic aneurysm ≥5cm

Other protocol-defined inclusion/exclusion criteria may apply

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
PlaceboPlacebosubcutaneous (SQ) monthly
ACZ885ACZ885150 mg SQ monthly
Primary Outcome Measures
NameTimeMethod
Number of Participants With Adverse Events, Serious Adverse Events and Death12 months

Participants were monitored for adverse events, serious adverse events and death throughout the study.

Change From Baseline in Plaque Burden (Aortic Vessel Wall Area and Carotid Vessel Wall Area)baseline, 3 months, 12 months

For assessment of atherosclerotic plaque burden of the aorta, vessel wall images of the aorta were acquired with an ECG gated double-inversion recovery (black blood) fast spin echo sequence applied breath-holding. Using an oblique sagittal image of the aorta as a pilot, serial axial images were acquired to cover a section of the descending thoracic aorta. The midpoint of the right pulmonary artery in cross section was used as the anatomical reference for the first slice in baseline and follow-up scans. For assessment of the atherosclerotic plaque burden in the carotids, vessel wall images were acquired with an axial ECG gated PD (proton density) weighted black blood sequence. The carotid bifurcation was used as the anatomical reference for all three imaging time points (baseline, 12 weeks, 48 weeks) with axial slice planes acquired below the bifurcation region. The mean values reported here for the carotid are reported for the proximal common carotid region.

Change From Baseline in Aortic Distensibilitybaseline, 3 months, 12 months

Two axial, ECG-gated, steady state free precession (SSFP) 'cine' images were acquired during breath-hold to determine aortic distensibility. The first image was obtained at the level of the right pulmonary artery through the ascending and proximal descending aorta and the second through the distal aorta below the diaphragm. Imaging of the aorta also enabled evaluation of the plaque burden and additional vascular function measures.

Secondary Outcome Measures
NameTimeMethod
Change From Baseline in High Sensitivity C-reactive Protein (hsCRP)baseline, 3 months, 12 months

Blood samples were collected to analyze hsCRP.

Change From Baseline in Aortic Strainbaseline, 3 months, 12 months

Arterial strain was computed directly from the cine SSFP images and the change in lumen diameters over the cardiac cycle. The value was independent of pulse pressure and is unitless ratio derived from the maximum to minimum lumen diameters diastole and systole, respectively..

Change From Baseline in Hemoglobin A1c (HbA1c)baseline, 3 months, 12 months

Blood samples were collected to analyze HbA1c.

Pharmacokinetics: ACZ885 Serum Concentrationspre-dose, 0.167 day post dose 1, 7 days post dose 1, 14 days post dose 1, every 30 days post each dose from doses 1 through 12, 60 days post dose 12, 90 days post dose 12

Blood samples were collected to analyze the ACZ885 serum concentrations.

Change From Baseline in Pulse Wave Velocity and Pulse Wave Velocity Errorbaseline, 3 months, 12 months

Utilizing the SphygmoCor Device, ECG leads placed at the carotid and femoral arteries provided the measure of the pulse wave at that particular arterial location. The distance between the two vascular beds divided by the pulse wave time shift provided a measure of the pulse wave velocity.

Change From Baseline in Plaque Compositionbaseline, 3 months, 12 months

During the carotid MRI acquisition, in addition to the PD weighted ECG gated double inversion fast spin echo sequences T1 and T2 weighted sequences were acquired. In combination with the PD weighted images, the multi-contrast images were analyzed to determine regions of interest with contrast patterns consistent with the presence of necrotic lipid core, calcification and fibrous tissue in participants who had complex carotid plaque present in the bifurcation region.

Change From Baseline in Beta Cell Function (HOMA-B)baseline, 3 months, 12 months

Blood samples were collected to analyze beta cell function. Beta cell function was calculated by the Homeostasis Model Assessments (of beta cell function (HOMA-B) as follows: HOMA-B: The product of 20 and basal insulin (µU/mL) levels divided by the value of basal glucose (mmol/L) concentrations minus 3.5 \[i.e., HOMA-B = 20\*basal insulin/(basal glucose-3.5)\].

Change From Baseline in 2 Hour Glucose Post Oral Glucose Tolerance Test (OGTT)baseline, 3 months, 12 months

Blood samples were collected to analyze the 2 hour glucose post OGTT.

Change From Baseline in Fasting Plasma Glucosebaseline, 3 months, 12 months

Blood samples were collected to analyze fasting plasma glucose.

Change From Baseline Insulin Resistance (HOMA-IR)baseline, 3 months, 12 months

Blood samples were collected to analyze insulin resistance. Insulin resistance was calculated by the Homeostasis Model Assessments of insulin resistance (HOMA-IR)) as follows: HOMA-IR: The product of basal glucose (mmol/L) and insulin (µU/mL) levels divided by 22.5 \[i.e., HOMA-IR = basal glucose\*basal insulin/22.5\].

Trial Locations

Locations (1)

Novartis Investigative Site

🇬🇧

London, United Kingdom

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