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Simvastatin With or Without Ezetimibe and Atherothrombotic Biomarker Assessment

Primary Purpose

Metabolic Syndrome

Status
Completed
Phase
Phase 4
Locations
United States
Study Type
Interventional
Intervention
simvastatin
ezetimibe/simvastatin
Sponsored by
University of Maryland, Baltimore
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Metabolic Syndrome focused on measuring triglycerides, hypertension, low hdl, obesity

Eligibility Criteria

21 Years - undefined (Adult, Older Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  1. Men and women greater than or equal to 21 years of age
  2. Diagnosis of metabolic syndrome. We defined the presence of metabolic syndrome based on the US National Cholesterol Education Program's Adult Treatment Panel III guidelines. Specifically, metabolic syndrome will be diagnosed and documented when 3 of the following 5 characteristics will be present:

    • abdominal obesity, given as waist circumference for men > 102 cm, and for women > 88 cm
    • triglycerides > 150 mg/dL
    • HDL cholesterol < 40 mg/dL for men, and < 50 mg/dL for women
    • blood pressure > 130/85 mm Hg
    • fasting glucose > 100 mg/dL

Exclusion Criteria:

  1. Patients will be excluded for a history of bleeding diathesis
  2. drug or alcohol abuse
  3. prothrombin time greater than 1.5 times control
  4. platelet count < 100,000/mm3
  5. hematocrit < 25%
  6. creatinine > 4.0 mg/dl
  7. surgery or angioplasty performed within 3 months or planned for the future
  8. history of gastrointestinal or other bleeding
  9. history of drug-induced disorders
  10. trauma, cancer, rheumatic diseases, coronary artery disease or stroke
  11. Patients participating in other investigational drug trials within one month of completion will be also excluded
  12. Patients treated with intravenous platelet glycoprotein IIb/IIIa inhibitors or thienopyridines, within past 6 months
  13. Patients treated with statins or aspirin within past four weeks

Sites / Locations

  • VA Maryland Health Care System
  • University of Maryland Medical Center
  • Johns Hopkins Hospital

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Active Comparator

Arm Label

simvastatin

simvastatin/ezetimibe

Arm Description

Simvastatin 40 mg daily

Subjects will receive 6 weeks of ezetimibe/simvastatin 10/40 mg, after which atherothrombotic biomarker assessment will be studied.

Outcomes

Primary Outcome Measures

Ex Vivo Effects of Treatment With Vytorin Versus Zocor for 6 Weeks on Platelet Alpha Thrombin PAR-1 Receptor Expression
Measured using whole blood flow cytometry

Secondary Outcome Measures

Biomarkers of Inflammation

Full Information

First Posted
January 7, 2009
Last Updated
January 10, 2020
Sponsor
University of Maryland, Baltimore
Collaborators
Merck Sharp & Dohme LLC
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1. Study Identification

Unique Protocol Identification Number
NCT00819403
Brief Title
Simvastatin With or Without Ezetimibe and Atherothrombotic Biomarker Assessment
Official Title
The Effects of Ezetimibe/Simvastatin Versus Simvastatin Alone on Platelet and Inflammatory Biomarkers in Patients With the Metabolic Syndrome
Study Type
Interventional

2. Study Status

Record Verification Date
January 2020
Overall Recruitment Status
Completed
Study Start Date
January 2009 (undefined)
Primary Completion Date
November 2011 (Actual)
Study Completion Date
November 2011 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
University of Maryland, Baltimore
Collaborators
Merck Sharp & Dohme LLC

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
To determine whether the combination of ezetimibe and simvastatin improves biomarkers of atherothrombosis compared to simvastatin alone in patients with the metabolic syndrome.
Detailed Description
To assess the ex vivo effects of ezetimibe/simvastatin (E/S) (Vytorin 10/40mg) and simvastatin (S) (Zocor 40mg) on platelet and inflammation biomarkers in patients with documented metabolic syndrome. To compare platelet-related effects including PAR-1 receptor inhibition of E/S with those of the established anti-platelet agents including aspirin, clopidogrel, intravenous and oral glycoprotein IIb/IIIa inhibitors. To determine whether the addition of ezetimibe will yield extra protection beyond lipid modulation in the reduction of inflammation and platelet activation.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Metabolic Syndrome
Keywords
triglycerides, hypertension, low hdl, obesity

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Crossover Assignment
Masking
ParticipantCare ProviderInvestigator
Allocation
Randomized
Enrollment
15 (Actual)

8. Arms, Groups, and Interventions

Arm Title
simvastatin
Arm Type
Active Comparator
Arm Description
Simvastatin 40 mg daily
Arm Title
simvastatin/ezetimibe
Arm Type
Active Comparator
Arm Description
Subjects will receive 6 weeks of ezetimibe/simvastatin 10/40 mg, after which atherothrombotic biomarker assessment will be studied.
Intervention Type
Drug
Intervention Name(s)
simvastatin
Other Intervention Name(s)
zocor
Intervention Description
Subjects will receive 6 weeks of simvastatin 40 mg, after which atherothrombotic biomarker assessment will be studied.
Intervention Type
Drug
Intervention Name(s)
ezetimibe/simvastatin
Other Intervention Name(s)
vytorin
Intervention Description
Subjects will receive 6 weeks of ezetimibe/simvastatin 10/40 mg, after which atherothrombotic biomarker assessment will be studied.
Primary Outcome Measure Information:
Title
Ex Vivo Effects of Treatment With Vytorin Versus Zocor for 6 Weeks on Platelet Alpha Thrombin PAR-1 Receptor Expression
Description
Measured using whole blood flow cytometry
Time Frame
6 weeks
Secondary Outcome Measure Information:
Title
Biomarkers of Inflammation
Time Frame
6 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
21 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Men and women greater than or equal to 21 years of age Diagnosis of metabolic syndrome. We defined the presence of metabolic syndrome based on the US National Cholesterol Education Program's Adult Treatment Panel III guidelines. Specifically, metabolic syndrome will be diagnosed and documented when 3 of the following 5 characteristics will be present: abdominal obesity, given as waist circumference for men > 102 cm, and for women > 88 cm triglycerides > 150 mg/dL HDL cholesterol < 40 mg/dL for men, and < 50 mg/dL for women blood pressure > 130/85 mm Hg fasting glucose > 100 mg/dL Exclusion Criteria: Patients will be excluded for a history of bleeding diathesis drug or alcohol abuse prothrombin time greater than 1.5 times control platelet count < 100,000/mm3 hematocrit < 25% creatinine > 4.0 mg/dl surgery or angioplasty performed within 3 months or planned for the future history of gastrointestinal or other bleeding history of drug-induced disorders trauma, cancer, rheumatic diseases, coronary artery disease or stroke Patients participating in other investigational drug trials within one month of completion will be also excluded Patients treated with intravenous platelet glycoprotein IIb/IIIa inhibitors or thienopyridines, within past 6 months Patients treated with statins or aspirin within past four weeks
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
MICHAEL MILLER, MD
Organizational Affiliation
University of Maryland, College Park
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
VICTOR L. Serebruany, MD, PhD
Organizational Affiliation
President, HeartDrug Research LLC
Official's Role
Study Director
Facility Information:
Facility Name
VA Maryland Health Care System
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21201
Country
United States
Facility Name
University of Maryland Medical Center
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21202
Country
United States
Facility Name
Johns Hopkins Hospital
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21287
Country
United States

12. IPD Sharing Statement

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Simvastatin With or Without Ezetimibe and Atherothrombotic Biomarker Assessment

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