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Renin Angiotensin Aldosterone System (RAAS) and Fibrinolysis in Humans: ACEi and PE5i

Primary Purpose

Metabolic Syndrome

Status
Completed
Phase
Not Applicable
Locations
Study Type
Interventional
Intervention
Ramipril
Tadalafil
placebo
placebo
Sponsored by
Vanderbilt University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional basic science trial for Metabolic Syndrome

Eligibility Criteria

18 Years - 70 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Ambulatory subjects, 18 to 70 years of age, inclusive
  2. For female subjects, the following conditions must be met:

    • Postmenopausal status for at least 1 year,
    • Status-post surgical sterilization, or
    • If of childbearing potential, utilization of adequate birth control, and willingness to undergo urine beta-hcg testing prior to drug treatment and on every study day
  3. Metabolic syndrome as defined by 3 or more of the following:

    • Fasting plasma glucose of at least 100 mg/dL (5.5 mmol/L),
    • Serum triglycerides of at least 150 mg/dL (1.7 mmol/L),
    • Serum HDL cholesterol less than 40 mg/dL (1.04 mmol/L) in males and less than 50mg/dl (1.30mmol/L) in females,
    • Blood pressure of at least 130/85 mmHg, or
    • Waist girth of more than 102 cm in men or 88 cm in women

Exclusion criteria:

Subjects presenting with any of the following will not be included in the study:

  1. Diabetes type 1 or type 2, as defined by a fasting glucose of 126 mg/dL or greater or the use of anti-diabetic medication
  2. Use of hormone replacement therapy
  3. Statin therapy
  4. In hypertensive subjects, a seated systolic blood pressure greater than 179 mmHg or a seated diastolic blood pressure greater than 110 mmHg
  5. Pregnancy
  6. Breast-feeding
  7. Cardiovascular disease such as myocardial infarction within 6 months prior to enrollment, presence of angina pectoris, significant arrhythmia, congestive heart failure (LV hypertrophy acceptable), deep vein thrombosis, pulmonary embolism, second or third degree heart block, mitral valve stenosis, aortic stenosis or hypertrophic cardiomyopathy
  8. Treatment with anticoagulants
  9. History of serious neurologic disease such as cerebral hemorrhage, stroke, or transient ischemic attack
  10. History or presence of immunological or hematological disorders
  11. Diagnosis of asthma
  12. Clinically significant gastrointestinal impairment that could interfere with drug absorption
  13. Impaired hepatic function (aspartate amino transaminase [AST] and/or alanine amino transaminase [ALT] > 1.5 x upper limit of normal range)
  14. Impaired renal function (serum creatinine > 1.5 mg/dl)
  15. Hematocrit < 35%
  16. Any underlying or acute disease requiring regular medication which could possibly pose a threat to the subject or make implementation of the protocol or interpretation of the study results difficult
  17. Treatment with chronic systemic glucocorticoid therapy (more than 7 consecutive days in 1 month)
  18. Treatment with lithium salts
  19. History of alcohol or drug abuse
  20. Treatment with any investigational drug in the 1 month preceding the study
  21. Mental conditions rendering the subject unable to understand the nature, scope and possible consequences of the study
  22. Inability to comply with the protocol, e.g. uncooperative attitude, inability to return for follow-up visits, and unlikelihood of completing the study

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm 3

    Arm 4

    Arm 5

    Arm 6

    Arm 7

    Arm 8

    Arm 9

    Arm 10

    Arm 11

    Arm 12

    Arm Type

    Active Comparator

    Active Comparator

    Active Comparator

    Active Comparator

    Active Comparator

    Active Comparator

    Active Comparator

    Active Comparator

    Active Comparator

    Active Comparator

    Active Comparator

    Active Comparator

    Arm Label

    tadalafil, ramapril, combo, placebo

    ramipril, tadalafil, placebo, combo

    combo, placebo, tadalafil, ramipril

    placebo, combo, ramipril, tadalafil

    tadalafil, placebo, ramipril, combo

    ramipril, combo, tadalfil, placebo

    combo, ramipril, placebo, tadalafil

    placebo, tadalafil, combo, ramipril

    tadalafil, combo, placebo, ramipril

    ramipril, placebo, combo, tadalafil

    combo, tadalafil, ramipril, placebo

    placebo, ramipril, tadalafil, combo

    Arm Description

    placebo+tadalafil for three weeks, washout, placebo+ramipril for three weeks, washout, ramipril + tadalafil, washout, placebo+placebo for three weeks

    placebo+ramipril for three weeks, washout, placebo+tadalafil for three weeks, washout, placebo+placebo for three weeks, washout, ramipril+tadalafil for three weeks

    ramipril+tadalafil for three weeks, washout, placebo+placebo for three weeks, washout, placebo+tadalafil for three weeks, washout, placebo+ramipril for three weeks

    placebo+placebo for three weeks, washout, ramipril+tadalafil for three weeks, washout placebo+ramipril for three weeks, washout, placebo+tadalafil for three weeks

    placebo+tadalafil for three weeks, washout, placebo+placebo for three weeks, washout, placebo+ramipril for three weeks, washout, ramipril+tadalafil for three weeks

    placebo+ramipril for three weeks, washout, ramipril+tadalafil for three weeks, washout, placebo+tadalafil for three weeks, washout, placebo for three weeks

    ramipril+tadalafil for three weeks, washout, placebo+ramipril for three weeks, washout, placebo+placebo for three weeks, washout, placebo+tadalafil for three weeks

    placebo+placebo for three weeks, washout, placebo+tadalafil for three weeks, washout, ramipril+tadalafil for three weeks, washout, placebo+ramipril for three weeks

    placebo+tadalafil for three weeks, washout, ramipril+tadalafil for three weeks, washout, placebo+placebo for three weeks, washout, placebo+ramipril for three weeks

    placebo+ramipril for three weeks, washout, placebo+placebo for three weeks, washout, ramipril+tadalafil for three weeks, washout, placebo+tadalafil for three weeks

    ramipril+tadalafil for three weeks, washout, placebo+tadalafil for three weeks, washout, placebo+ramipril for three weeks, washout, placebo+placebo for three weeks

    placebo+placebo for three weeks, washout, placebo+ramipril for three weeks, washout, placebo+tadalafil for three weeks, washout, ramipril+tadalafil for three weeks

    Outcomes

    Primary Outcome Measures

    Beta Cell Function
    Beta cell function as measured during a frequently sampled IV glucose tolerance test
    Insulin Sensitivity
    As assessed using IV glucose tolerance test and calculated using Min Mod units mU/mm

    Secondary Outcome Measures

    Full Information

    First Posted
    September 5, 2008
    Last Updated
    December 8, 2014
    Sponsor
    Vanderbilt University
    Collaborators
    National Institutes of Health (NIH)
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    1. Study Identification

    Unique Protocol Identification Number
    NCT00750308
    Brief Title
    Renin Angiotensin Aldosterone System (RAAS) and Fibrinolysis in Humans: ACEi and PE5i
    Official Title
    Renin Angiotensin Aldosterone System (RAAS) and Fibrinolysis in Humans: ACEi
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    December 2014
    Overall Recruitment Status
    Completed
    Study Start Date
    December 2006 (undefined)
    Primary Completion Date
    January 2009 (Actual)
    Study Completion Date
    May 2009 (Actual)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Principal Investigator
    Name of the Sponsor
    Vanderbilt University
    Collaborators
    National Institutes of Health (NIH)

    4. Oversight

    Data Monitoring Committee
    No

    5. Study Description

    Brief Summary
    This study will measure the effect of the agent tadalafil on glucose and insulin homeostasis in people with metabolic syndrome in the presence and absence of an ACE inhibitor.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Metabolic Syndrome

    7. Study Design

    Primary Purpose
    Basic Science
    Study Phase
    Not Applicable
    Interventional Study Model
    Crossover Assignment
    Masking
    ParticipantCare ProviderInvestigatorOutcomes Assessor
    Allocation
    Randomized
    Enrollment
    27 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    tadalafil, ramapril, combo, placebo
    Arm Type
    Active Comparator
    Arm Description
    placebo+tadalafil for three weeks, washout, placebo+ramipril for three weeks, washout, ramipril + tadalafil, washout, placebo+placebo for three weeks
    Arm Title
    ramipril, tadalafil, placebo, combo
    Arm Type
    Active Comparator
    Arm Description
    placebo+ramipril for three weeks, washout, placebo+tadalafil for three weeks, washout, placebo+placebo for three weeks, washout, ramipril+tadalafil for three weeks
    Arm Title
    combo, placebo, tadalafil, ramipril
    Arm Type
    Active Comparator
    Arm Description
    ramipril+tadalafil for three weeks, washout, placebo+placebo for three weeks, washout, placebo+tadalafil for three weeks, washout, placebo+ramipril for three weeks
    Arm Title
    placebo, combo, ramipril, tadalafil
    Arm Type
    Active Comparator
    Arm Description
    placebo+placebo for three weeks, washout, ramipril+tadalafil for three weeks, washout placebo+ramipril for three weeks, washout, placebo+tadalafil for three weeks
    Arm Title
    tadalafil, placebo, ramipril, combo
    Arm Type
    Active Comparator
    Arm Description
    placebo+tadalafil for three weeks, washout, placebo+placebo for three weeks, washout, placebo+ramipril for three weeks, washout, ramipril+tadalafil for three weeks
    Arm Title
    ramipril, combo, tadalfil, placebo
    Arm Type
    Active Comparator
    Arm Description
    placebo+ramipril for three weeks, washout, ramipril+tadalafil for three weeks, washout, placebo+tadalafil for three weeks, washout, placebo for three weeks
    Arm Title
    combo, ramipril, placebo, tadalafil
    Arm Type
    Active Comparator
    Arm Description
    ramipril+tadalafil for three weeks, washout, placebo+ramipril for three weeks, washout, placebo+placebo for three weeks, washout, placebo+tadalafil for three weeks
    Arm Title
    placebo, tadalafil, combo, ramipril
    Arm Type
    Active Comparator
    Arm Description
    placebo+placebo for three weeks, washout, placebo+tadalafil for three weeks, washout, ramipril+tadalafil for three weeks, washout, placebo+ramipril for three weeks
    Arm Title
    tadalafil, combo, placebo, ramipril
    Arm Type
    Active Comparator
    Arm Description
    placebo+tadalafil for three weeks, washout, ramipril+tadalafil for three weeks, washout, placebo+placebo for three weeks, washout, placebo+ramipril for three weeks
    Arm Title
    ramipril, placebo, combo, tadalafil
    Arm Type
    Active Comparator
    Arm Description
    placebo+ramipril for three weeks, washout, placebo+placebo for three weeks, washout, ramipril+tadalafil for three weeks, washout, placebo+tadalafil for three weeks
    Arm Title
    combo, tadalafil, ramipril, placebo
    Arm Type
    Active Comparator
    Arm Description
    ramipril+tadalafil for three weeks, washout, placebo+tadalafil for three weeks, washout, placebo+ramipril for three weeks, washout, placebo+placebo for three weeks
    Arm Title
    placebo, ramipril, tadalafil, combo
    Arm Type
    Active Comparator
    Arm Description
    placebo+placebo for three weeks, washout, placebo+ramipril for three weeks, washout, placebo+tadalafil for three weeks, washout, ramipril+tadalafil for three weeks
    Intervention Type
    Drug
    Intervention Name(s)
    Ramipril
    Other Intervention Name(s)
    Altace
    Intervention Description
    Ramipril 10 mg per day for three weeks
    Intervention Type
    Drug
    Intervention Name(s)
    Tadalafil
    Other Intervention Name(s)
    Cialis
    Intervention Description
    tadalafil 10 mg every other day for three weeks
    Intervention Type
    Drug
    Intervention Name(s)
    placebo
    Other Intervention Name(s)
    matching ramipril
    Intervention Description
    placebo matching ramipril
    Intervention Type
    Drug
    Intervention Name(s)
    placebo
    Other Intervention Name(s)
    matching tadalfil
    Intervention Description
    placebo matching tadalafil
    Primary Outcome Measure Information:
    Title
    Beta Cell Function
    Description
    Beta cell function as measured during a frequently sampled IV glucose tolerance test
    Time Frame
    3 hours
    Title
    Insulin Sensitivity
    Description
    As assessed using IV glucose tolerance test and calculated using Min Mod units mU/mm
    Time Frame
    three weeks

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Maximum Age & Unit of Time
    70 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Ambulatory subjects, 18 to 70 years of age, inclusive For female subjects, the following conditions must be met: Postmenopausal status for at least 1 year, Status-post surgical sterilization, or If of childbearing potential, utilization of adequate birth control, and willingness to undergo urine beta-hcg testing prior to drug treatment and on every study day Metabolic syndrome as defined by 3 or more of the following: Fasting plasma glucose of at least 100 mg/dL (5.5 mmol/L), Serum triglycerides of at least 150 mg/dL (1.7 mmol/L), Serum HDL cholesterol less than 40 mg/dL (1.04 mmol/L) in males and less than 50mg/dl (1.30mmol/L) in females, Blood pressure of at least 130/85 mmHg, or Waist girth of more than 102 cm in men or 88 cm in women Exclusion criteria: Subjects presenting with any of the following will not be included in the study: Diabetes type 1 or type 2, as defined by a fasting glucose of 126 mg/dL or greater or the use of anti-diabetic medication Use of hormone replacement therapy Statin therapy In hypertensive subjects, a seated systolic blood pressure greater than 179 mmHg or a seated diastolic blood pressure greater than 110 mmHg Pregnancy Breast-feeding Cardiovascular disease such as myocardial infarction within 6 months prior to enrollment, presence of angina pectoris, significant arrhythmia, congestive heart failure (LV hypertrophy acceptable), deep vein thrombosis, pulmonary embolism, second or third degree heart block, mitral valve stenosis, aortic stenosis or hypertrophic cardiomyopathy Treatment with anticoagulants History of serious neurologic disease such as cerebral hemorrhage, stroke, or transient ischemic attack History or presence of immunological or hematological disorders Diagnosis of asthma Clinically significant gastrointestinal impairment that could interfere with drug absorption Impaired hepatic function (aspartate amino transaminase [AST] and/or alanine amino transaminase [ALT] > 1.5 x upper limit of normal range) Impaired renal function (serum creatinine > 1.5 mg/dl) Hematocrit < 35% Any underlying or acute disease requiring regular medication which could possibly pose a threat to the subject or make implementation of the protocol or interpretation of the study results difficult Treatment with chronic systemic glucocorticoid therapy (more than 7 consecutive days in 1 month) Treatment with lithium salts History of alcohol or drug abuse Treatment with any investigational drug in the 1 month preceding the study Mental conditions rendering the subject unable to understand the nature, scope and possible consequences of the study Inability to comply with the protocol, e.g. uncooperative attitude, inability to return for follow-up visits, and unlikelihood of completing the study
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Nancy J Brown, M.D.
    Organizational Affiliation
    Vanderbilt University Medical Center
    Official's Role
    Principal Investigator

    12. IPD Sharing Statement

    Learn more about this trial

    Renin Angiotensin Aldosterone System (RAAS) and Fibrinolysis in Humans: ACEi and PE5i

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