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Efficacy of Lapaquistat Acetate Alone or Combined With Simvastatin in Subjects With Hypercholesterolemia

Primary Purpose

Hypercholesterolemia

Status
Completed
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
Lapaquistat acetate and simvastatin
Lapaquistat acetate and simvastatin
Simvastatin
Sponsored by
Takeda
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Hypercholesterolemia focused on measuring Hyperlipidemia, Drug Therapy

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: Woman of childbearing potential can not to be pregnant, lactating, not planning on becoming pregnant, and agree to use acceptable forms of contraception throughout the course of the study. Prior to Randomization, has a low-density lipoprotein cholesterol level mean greater than or equal to 3.37 mmol/L and less than or equal to 5.70 mmol/L. Prior to Randomization, has a mean triglyceride level less than or equal to 4.52 mmol/L (400 mg/dL). Has clinical laboratory evaluations including clinical chemistry, hematology, and urinalysis within the defined reference range. Exclusion Criteria: Has an alanine aminotransferase or aspartate aminotransferase level of greater than 1.5 times the upper limit of normal, active liver disease or jaundice. Has a serum creatinine of greater than 133 μmol/L. Has a creatine kinase greater than 3 times the upper limit of normal. Has type 1 or 2 diabetes mellitus. Has a previous history of cancer that had been in remission for less than 5 years prior to the first dose of study medication. Has an endocrine disorder, such as Cushing syndrome, hyperthyroidism, or inappropriately treated hypothyroidism, affecting lipid metabolism. Has a history of myocardial infarction, angina pectoris, transient ischemic attacks, cerebrovascular accident, peripheral vascular disease, abdominal aortic aneurysm, coronary revascularization or multiple factors that conferred a 10-year risk for coronary heart disease greater than 20% based on Framingham risk scoring. Has a positive hepatitis B surface antigen, or antibody to hepatitis C virus, as determined by medical history and/or subject's verbal report. Has a positive human immunodeficiency virus status or was taking antiretroviral medications, as determined by medical history. Has exposure to lapaquistat acetate in other studies, was participating in another investigational study, or had participated in an investigational study within the past 30 days or, for drugs with a long half-life, within a period of less than 5 times the drug's half-life. Has a known hypersensitivity or history of adverse reaction to simvastatin. Has a known hypersensitivity or history of adverse reaction to simvastatin. Has a history or presence of clinically significant food allergy that would prevent adherence to the recommended diet. Has a known heterozygous or homozygous familial hypercholesterolemia or known Type III hyperlipoproteinemia (familial dysbetalipoproteinemia). Has fibromyalgia, myopathy, rhabdomyolysis or unexplained muscle pain. Has uncontrolled hypertension Has inflammatory bowel disease, any other malabsorption syndrome, or had gastric bypass or any other surgical procedure for weight loss. Is unwilling or unable, in the opinion of the investigator, to comply with the protocol or scheduled appointments. Has a history of drug abuse or a history of alcohol abuse within the past 2 years. Has any other serious disease or condition that might reduced life expectancy, impaired successful management according to the protocol, or make the participant an unsuitable candidate to receive study medication.

Sites / Locations

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Active Comparator

Arm Label

Lapaquistat Acetate 50 mg QD + Simvastatin

Lapaquistat Acetate 100 mg QD + Simvastatin

Simvastatin

Arm Description

Outcomes

Primary Outcome Measures

Change from Baseline in Low Density Lipoprotein cholesterol

Secondary Outcome Measures

Adverse Events
Physical Examination
Safety Laboratory Tests
12- lead Electrocardiogram assessments
Best Corrected Visual Acuity results
Vital Signs
Change from Baseline in Triglycerides
Change from Baseline in Total Cholesterol
Change from Baseline in High Density Lipoprotein cholesterol
Change from Baseline in Very Low Density Lipoprotein cholesterol
Change from Baseline in apolipoprotein A1
Change from Baseline in apolipoprotein B
Change from Baseline in non- High Density Lipoprotein cholesterol
Change from Baseline in the ratio of Low Density Lipoprotein cholesterol/High Density
Change from Baseline in the ratio of Total Cholesterol/High Density Lipoprotein cholesterol
Change from Baseline in the ratio of apolipoprotein A1/apolipoprotein B
Change from Baseline in high-sensitivity C-reactive protein
Percentage of subjects who achieve Low Density Lipoprotein cholesterol concentrations less than 2.59 mmol/L (100 mg/dL)
Percentage of subjects who achieve Low Density Lipoprotein cholesterol concentrations less than 3.37 mmol/L (130 mg/dL)
Percentage of subjects who achieve Low Density Lipoprotein cholesterol concentrations less than 4.14 mmol/L (160 mg/dL)

Full Information

First Posted
February 1, 2006
Last Updated
May 23, 2012
Sponsor
Takeda
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1. Study Identification

Unique Protocol Identification Number
NCT00286481
Brief Title
Efficacy of Lapaquistat Acetate Alone or Combined With Simvastatin in Subjects With Hypercholesterolemia
Official Title
A Double-Blind, Randomized, Placebo-Controlled Factorial Study to Evaluate the Efficacy and Safety of Lapaquistat and Simvastatin Alone and in Combination in Subjects With Hypercholesterolemia
Study Type
Interventional

2. Study Status

Record Verification Date
May 2012
Overall Recruitment Status
Completed
Study Start Date
March 2006 (undefined)
Primary Completion Date
May 2007 (Actual)
Study Completion Date
May 2007 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Takeda

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this study is to evaluate lapaquistat acetate, once daily (QD), taken alone or with simvastatin on cholesterol levels in treating patients with elevated cholesterol.
Detailed Description
Elevated plasma cholesterol (hypercholesterolemia) and various other plasma lipid imbalances (dyslipidemias) are major risk factors for coronary heart disease. Patients with hypercholesterolemia have elevated low-density lipoprotein cholesterol, which leads to atherosclerotic deposition of cholesterol in the arterial walls. As identified by the National Cholesterol Education Program Adult Treatment Panel III, lowering the low-density lipoprotein cholesterol plasma concentration effectively reduces cardiovascular morbidity and mortality and is essential for the prevention and management of coronary heart disease. Currently, 3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitors (statins) are the first-line monotherapies prescribed to reduce low-density lipoprotein cholesterol, after diet and therapeutic lifestyle change. However, low doses of statins often fail to produce the ATP III-recommended levels of low-density lipoprotein cholesterol reduction, making it necessary to increase the dose or add an additional treatment. Dose increases of statins in turn may result in decreased tolerability and potential safety concerns which contribute to the high discontinuation rates of statins and their prescription at low, and often ineffective, doses. The purpose of this study is to determine whether administration of lapaquistat acetate co-administered with simvastatin will be more efficacious in lowering low-density lipoprotein cholesterol, compared to lapaquistat or simvastatin alone. Total participation time in this study is anticipated to be 19 weeks.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Hypercholesterolemia
Keywords
Hyperlipidemia, Drug Therapy

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Factorial Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
1362 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Lapaquistat Acetate 50 mg QD + Simvastatin
Arm Type
Experimental
Arm Title
Lapaquistat Acetate 100 mg QD + Simvastatin
Arm Type
Experimental
Arm Title
Simvastatin
Arm Type
Active Comparator
Intervention Type
Drug
Intervention Name(s)
Lapaquistat acetate and simvastatin
Other Intervention Name(s)
TAK-475, Zocor
Intervention Description
Lapaquistat acetate 50 mg, tablets, orally, once daily and stable dose of simvastatin for up to 12 weeks.
Intervention Type
Drug
Intervention Name(s)
Lapaquistat acetate and simvastatin
Other Intervention Name(s)
TAK-475, Zocor
Intervention Description
Lapaquistat acetate 100 mg, tablets, orally, once daily and stable dose of simvastatin for up to 12 weeks.
Intervention Type
Drug
Intervention Name(s)
Simvastatin
Other Intervention Name(s)
Zocor
Intervention Description
Lapaquistat acetate placebo-matching tablets, orally, once daily and stable dose of simvastatin for up to 12 weeks.
Primary Outcome Measure Information:
Title
Change from Baseline in Low Density Lipoprotein cholesterol
Time Frame
Week 12 or Final Visit
Secondary Outcome Measure Information:
Title
Adverse Events
Time Frame
Weeks: 2, 4, 8, and 12 or Final Visit
Title
Physical Examination
Time Frame
Week 12 or Final Visit
Title
Safety Laboratory Tests
Time Frame
Weeks: 2, 4, 8, and 12 or Final Visit
Title
12- lead Electrocardiogram assessments
Time Frame
Week 12 or Final Visit
Title
Best Corrected Visual Acuity results
Time Frame
Week 12 or Final Visit
Title
Vital Signs
Time Frame
Weeks: 2, 4, 8, and 12 or Final Visit
Title
Change from Baseline in Triglycerides
Time Frame
Week 12 or Final Visit
Title
Change from Baseline in Total Cholesterol
Time Frame
Week 12 or Final Visit
Title
Change from Baseline in High Density Lipoprotein cholesterol
Time Frame
Week 12 or Final Visit
Title
Change from Baseline in Very Low Density Lipoprotein cholesterol
Time Frame
Week 12 or Final Visit
Title
Change from Baseline in apolipoprotein A1
Time Frame
Week 12 or Final Visit
Title
Change from Baseline in apolipoprotein B
Time Frame
Week 12 or Final Visit
Title
Change from Baseline in non- High Density Lipoprotein cholesterol
Time Frame
Week 12 or Final Visit
Title
Change from Baseline in the ratio of Low Density Lipoprotein cholesterol/High Density
Time Frame
Week 12 or Final Visit
Title
Change from Baseline in the ratio of Total Cholesterol/High Density Lipoprotein cholesterol
Time Frame
Week 12 or Final Visit
Title
Change from Baseline in the ratio of apolipoprotein A1/apolipoprotein B
Time Frame
Week 12 or Final Visit
Title
Change from Baseline in high-sensitivity C-reactive protein
Time Frame
Week 12 or Final Visit
Title
Percentage of subjects who achieve Low Density Lipoprotein cholesterol concentrations less than 2.59 mmol/L (100 mg/dL)
Time Frame
Week 12 or Final Visit
Title
Percentage of subjects who achieve Low Density Lipoprotein cholesterol concentrations less than 3.37 mmol/L (130 mg/dL)
Time Frame
Week 12 or Final Visit
Title
Percentage of subjects who achieve Low Density Lipoprotein cholesterol concentrations less than 4.14 mmol/L (160 mg/dL)
Time Frame
Week 12 or Final Visit

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Woman of childbearing potential can not to be pregnant, lactating, not planning on becoming pregnant, and agree to use acceptable forms of contraception throughout the course of the study. Prior to Randomization, has a low-density lipoprotein cholesterol level mean greater than or equal to 3.37 mmol/L and less than or equal to 5.70 mmol/L. Prior to Randomization, has a mean triglyceride level less than or equal to 4.52 mmol/L (400 mg/dL). Has clinical laboratory evaluations including clinical chemistry, hematology, and urinalysis within the defined reference range. Exclusion Criteria: Has an alanine aminotransferase or aspartate aminotransferase level of greater than 1.5 times the upper limit of normal, active liver disease or jaundice. Has a serum creatinine of greater than 133 μmol/L. Has a creatine kinase greater than 3 times the upper limit of normal. Has type 1 or 2 diabetes mellitus. Has a previous history of cancer that had been in remission for less than 5 years prior to the first dose of study medication. Has an endocrine disorder, such as Cushing syndrome, hyperthyroidism, or inappropriately treated hypothyroidism, affecting lipid metabolism. Has a history of myocardial infarction, angina pectoris, transient ischemic attacks, cerebrovascular accident, peripheral vascular disease, abdominal aortic aneurysm, coronary revascularization or multiple factors that conferred a 10-year risk for coronary heart disease greater than 20% based on Framingham risk scoring. Has a positive hepatitis B surface antigen, or antibody to hepatitis C virus, as determined by medical history and/or subject's verbal report. Has a positive human immunodeficiency virus status or was taking antiretroviral medications, as determined by medical history. Has exposure to lapaquistat acetate in other studies, was participating in another investigational study, or had participated in an investigational study within the past 30 days or, for drugs with a long half-life, within a period of less than 5 times the drug's half-life. Has a known hypersensitivity or history of adverse reaction to simvastatin. Has a known hypersensitivity or history of adverse reaction to simvastatin. Has a history or presence of clinically significant food allergy that would prevent adherence to the recommended diet. Has a known heterozygous or homozygous familial hypercholesterolemia or known Type III hyperlipoproteinemia (familial dysbetalipoproteinemia). Has fibromyalgia, myopathy, rhabdomyolysis or unexplained muscle pain. Has uncontrolled hypertension Has inflammatory bowel disease, any other malabsorption syndrome, or had gastric bypass or any other surgical procedure for weight loss. Is unwilling or unable, in the opinion of the investigator, to comply with the protocol or scheduled appointments. Has a history of drug abuse or a history of alcohol abuse within the past 2 years. Has any other serious disease or condition that might reduced life expectancy, impaired successful management according to the protocol, or make the participant an unsuitable candidate to receive study medication.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Medical Director
Organizational Affiliation
Takeda
Official's Role
Study Director
Facility Information:
City
Huntsville
State/Province
Alabama
Country
United States
City
Chandler
State/Province
Arizona
Country
United States
City
Scottsdale
State/Province
Arizona
Country
United States
City
Sierra Vista
State/Province
Arizona
Country
United States
City
Tucson
State/Province
Arizona
Country
United States
City
Beverly Hills
State/Province
California
Country
United States
City
Long Beach
State/Province
California
Country
United States
City
Sacramento
State/Province
California
Country
United States
City
Spring Valley
State/Province
California
Country
United States
City
Colorado Springs
State/Province
Colorado
Country
United States
City
Hialeah
State/Province
Florida
Country
United States
City
Hollywood
State/Province
Florida
Country
United States
City
Jacksonville
State/Province
Florida
Country
United States
City
Jupiter
State/Province
Florida
Country
United States
City
Kissimmee
State/Province
Florida
Country
United States
City
Miami
State/Province
Florida
Country
United States
City
Ocala
State/Province
Florida
Country
United States
City
Pembroke Pines
State/Province
Florida
Country
United States
City
Pinellas Park
State/Province
Florida
Country
United States
City
Stuart
State/Province
Florida
Country
United States
City
West Palm Beach
State/Province
Florida
Country
United States
City
Arlington Heights
State/Province
Illinois
Country
United States
City
Chicago
State/Province
Illinois
Country
United States
City
Peoria
State/Province
Illinois
Country
United States
City
Indianapolis
State/Province
Indiana
Country
United States
City
Overland Park
State/Province
Kansas
Country
United States
City
Wichita
State/Province
Kansas
Country
United States
City
Louisville
State/Province
Kentucky
Country
United States
City
Edina
State/Province
Minnesota
Country
United States
City
St. Louis
State/Province
Missouri
Country
United States
City
Las Vegas
State/Province
Nevada
Country
United States
City
Margate City
State/Province
New Jersey
Country
United States
City
Raleigh
State/Province
North Carolina
Country
United States
City
Statesville
State/Province
North Carolina
Country
United States
City
Winston-Salem
State/Province
North Carolina
Country
United States
City
Cincinnati
State/Province
Ohio
Country
United States
City
Columbus
State/Province
Ohio
Country
United States
City
Kettering
State/Province
Ohio
Country
United States
City
Bartlesville
State/Province
Oklahoma
Country
United States
City
Portland
State/Province
Oregon
Country
United States
City
Beaver
State/Province
Pennsylvania
Country
United States
City
Downingtown
State/Province
Pennsylvania
Country
United States
City
Tipton
State/Province
Pennsylvania
Country
United States
City
Goose Creek
State/Province
South Carolina
Country
United States
City
Jackson
State/Province
Tennessee
Country
United States
City
Nashville
State/Province
Tennessee
Country
United States
City
San Antonio
State/Province
Texas
Country
United States
City
Norfolk
State/Province
Virginia
Country
United States
City
Richmond
State/Province
Virginia
Country
United States
City
Lakewood
State/Province
Washington
Country
United States
City
Abbotsford
State/Province
British Columbia
Country
Canada
City
Coquitlam
State/Province
British Columbia
Country
Canada
City
Victoria
State/Province
British Columbia
Country
Canada
City
Winnipeg
State/Province
Manitoba
Country
Canada
City
Mount Pearl
State/Province
Newfoundland and Labrador
Country
Canada
City
St. John's
State/Province
Newfoundland and Labrador
Country
Canada
City
Cornwall
State/Province
Ontario
Country
Canada
City
London
State/Province
Ontario
Country
Canada
City
Oakville
State/Province
Ontario
Country
Canada
City
Oshawa
State/Province
Ontario
Country
Canada
City
Thornhill
State/Province
Ontario
Country
Canada
City
Toronto
State/Province
Ontario
Country
Canada
City
Cornwall
State/Province
Prince Edward Island
Country
Canada
City
Mirabel
State/Province
Quebec
Country
Canada
City
Sherbrooke
State/Province
Quebec
Country
Canada
City
St. Lambert
State/Province
Quebec
Country
Canada
City
Ste-Foy
State/Province
Quebec
Country
Canada

12. IPD Sharing Statement

Citations:
PubMed Identifier
21518985
Citation
Stein EA, Bays H, O'Brien D, Pedicano J, Piper E, Spezzi A. Lapaquistat acetate: development of a squalene synthase inhibitor for the treatment of hypercholesterolemia. Circulation. 2011 May 10;123(18):1974-85. doi: 10.1161/CIRCULATIONAHA.110.975284. Epub 2011 Apr 25.
Results Reference
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Efficacy of Lapaquistat Acetate Alone or Combined With Simvastatin in Subjects With Hypercholesterolemia

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