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Nutraceutical Combination in Patients With Low-grade Systemic Inflammation

Primary Purpose

Atherosclerosis, Inflammation, Hypercholesterolemia

Status
Completed
Phase
Phase 4
Locations
Study Type
Interventional
Intervention
Nutraceutical Combination
Standard of Care
Placebo
Sponsored by
University Of Perugia
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Atherosclerosis focused on measuring C-Reactive Protein, Endothelial Microparticles, Endothelium, Nutraceutical, Cholesterol

Eligibility Criteria

25 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • LDL cholesterol <160 mg/dl (4,14 mmol/l);
  • hsCRP >2 mg/L;

Exclusion Criteria:

  • triglycerides >500 mg/dL (5.6 mmol/L);
  • current or previous treatment with lipid-lowering drugs or with other drugs supposed to modify vascular damage and/or repair (antiplatelet, anti-hypertensive and antioxidant drugs);
  • current or previous treatment with hormone replacement therapy for menopause vasomotor symptoms;
  • evidence of liver dysfunction or alanine-aminotransferase (ALT) levels twice above the upper normal limit;
  • creatin-kinase (CK) levels thrice above the upper normal limit
  • history or clinical evidence of previous or current cardiovascular disease;
  • presence of strong cardiovascular risk factors such as: serum creatinine levels >2 mg/dL, diabetes mellitus, uncontrolled systemic arterial hypertension (systolic blood pressure >190 mg/dL or diastolic blood pressure >100 mg/dL); history of cancer in the former 5 years before recruitment; not adequately treated hypothyroidism (TSH levels >1,5 times the upper normal limit);
  • history of malignancy in the previous 5 years before screening;
  • not adequately treated hypothyroidism (TSH levels >1,5 times the upper normal limit);
  • previous or current alcohol or drugs abuse;
  • history or clinical evidence of chronic inflammatory disease such as severe arthritis, systemic lupus erythematosus or chronic inflammatory bowel disease;
  • current or previous use of immunosuppressant agents or long term glucocorticoids
  • history or clinical evidence of any severe concomitant disease which may compromise subject's safety or its possibility to carry out the study.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm Type

    Placebo Comparator

    Active Comparator

    Arm Label

    Standard of Care + Placebo

    Nutraceutical combination

    Arm Description

    low-cholesterol/low-saturated fat diet and a regular aerobic physical activity schedule + once daily placebo

    low-cholesterol/low-saturated fat diet and a regular aerobic physical activity schedule + Nutraceutical combination

    Outcomes

    Primary Outcome Measures

    Change from Baseline in LDL cholesterol at 3 months

    Secondary Outcome Measures

    Change from Baseline in Circulating endothelial microparticles at 3 months
    Change from Baseline in C-reactive protein at 3 months

    Full Information

    First Posted
    April 13, 2015
    Last Updated
    April 16, 2015
    Sponsor
    University Of Perugia
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    1. Study Identification

    Unique Protocol Identification Number
    NCT02422927
    Brief Title
    Nutraceutical Combination in Patients With Low-grade Systemic Inflammation
    Official Title
    Effect of a Nutraceutical Combination on Endothelial Injury and C-reactive Protein in Patients With Low-grade Systemic Inflammation
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    April 2015
    Overall Recruitment Status
    Completed
    Study Start Date
    July 2014 (undefined)
    Primary Completion Date
    January 2015 (Actual)
    Study Completion Date
    February 2015 (Actual)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Principal Investigator
    Name of the Sponsor
    University Of Perugia

    4. Oversight

    Data Monitoring Committee
    No

    5. Study Description

    Brief Summary
    The investigators tested if a nutraceutical combination with red yeast rice, berberine and policosanol (NC) can significantly modify inflammation, lipid profile and markers of endothelial injury (endothelial microparticles) in subjects with elevated levels of high-sensitivity C-reactive protein (hsCRP).
    Detailed Description
    Will be included in the study 100 subjects with suboptimal LDL cholesterol levels (LDL 100-160 mg / dL) and hsCRP levels> 2 mg / L, divided into two groups of equal numbers, matched by by sex and age, randomized to receive a nutraceutical combination containing red yeast 200 mg, berberine 500 mg and policosanol 10 mg (NC) in combination with a low-cholesterol diet (<200 mg / day) or a low-cholesterol diet only (Standard of Care - SOC). All subjects at the time of inclusion in the study protocol will be prescribed the SOC for a period of 30 days (Lipid Stabilization Period: LSP); After 30 days LSP it will be performed randomization in the two intervention arms: NC + SOC or SOC.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Atherosclerosis, Inflammation, Hypercholesterolemia
    Keywords
    C-Reactive Protein, Endothelial Microparticles, Endothelium, Nutraceutical, Cholesterol

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 4
    Interventional Study Model
    Parallel Assignment
    Masking
    Outcomes Assessor
    Allocation
    Randomized
    Enrollment
    100 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    Standard of Care + Placebo
    Arm Type
    Placebo Comparator
    Arm Description
    low-cholesterol/low-saturated fat diet and a regular aerobic physical activity schedule + once daily placebo
    Arm Title
    Nutraceutical combination
    Arm Type
    Active Comparator
    Arm Description
    low-cholesterol/low-saturated fat diet and a regular aerobic physical activity schedule + Nutraceutical combination
    Intervention Type
    Dietary Supplement
    Intervention Name(s)
    Nutraceutical Combination
    Other Intervention Name(s)
    Armolipid Plus, Rottapharm-Madaus
    Intervention Description
    red yeast rice extract 200 mg (equivalent to 3 mg monacolins), policosanol 10 mg, berberine 500 mg, 0.2 mg folic acid, coenzyme Q10 2 mg, and astaxanthin 0.5 mg once daily
    Intervention Type
    Other
    Intervention Name(s)
    Standard of Care
    Intervention Description
    low-cholesterol/low-saturated fat diet and regular aerobic physical activity schedule
    Intervention Type
    Other
    Intervention Name(s)
    Placebo
    Intervention Description
    placebo
    Primary Outcome Measure Information:
    Title
    Change from Baseline in LDL cholesterol at 3 months
    Time Frame
    3 months after treatment randomization
    Secondary Outcome Measure Information:
    Title
    Change from Baseline in Circulating endothelial microparticles at 3 months
    Time Frame
    3 months after treatment randomization
    Title
    Change from Baseline in C-reactive protein at 3 months
    Time Frame
    3 months after treatment randomization

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    25 Years
    Maximum Age & Unit of Time
    75 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: LDL cholesterol <160 mg/dl (4,14 mmol/l); hsCRP >2 mg/L; Exclusion Criteria: triglycerides >500 mg/dL (5.6 mmol/L); current or previous treatment with lipid-lowering drugs or with other drugs supposed to modify vascular damage and/or repair (antiplatelet, anti-hypertensive and antioxidant drugs); current or previous treatment with hormone replacement therapy for menopause vasomotor symptoms; evidence of liver dysfunction or alanine-aminotransferase (ALT) levels twice above the upper normal limit; creatin-kinase (CK) levels thrice above the upper normal limit history or clinical evidence of previous or current cardiovascular disease; presence of strong cardiovascular risk factors such as: serum creatinine levels >2 mg/dL, diabetes mellitus, uncontrolled systemic arterial hypertension (systolic blood pressure >190 mg/dL or diastolic blood pressure >100 mg/dL); history of cancer in the former 5 years before recruitment; not adequately treated hypothyroidism (TSH levels >1,5 times the upper normal limit); history of malignancy in the previous 5 years before screening; not adequately treated hypothyroidism (TSH levels >1,5 times the upper normal limit); previous or current alcohol or drugs abuse; history or clinical evidence of chronic inflammatory disease such as severe arthritis, systemic lupus erythematosus or chronic inflammatory bowel disease; current or previous use of immunosuppressant agents or long term glucocorticoids history or clinical evidence of any severe concomitant disease which may compromise subject's safety or its possibility to carry out the study.
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Matteo Pirro, MD, PhD
    Organizational Affiliation
    University Of Perugia
    Official's Role
    Principal Investigator

    12. IPD Sharing Statement

    Citations:
    PubMed Identifier
    21177699
    Citation
    McGorrian C, Yusuf S, Islam S, Jung H, Rangarajan S, Avezum A, Prabhakaran D, Almahmeed W, Rumboldt Z, Budaj A, Dans AL, Gerstein HC, Teo K, Anand SS; INTERHEART Investigators. Estimating modifiable coronary heart disease risk in multiple regions of the world: the INTERHEART Modifiable Risk Score. Eur Heart J. 2011 Mar;32(5):581-9. doi: 10.1093/eurheartj/ehq448. Epub 2010 Dec 22.
    Results Reference
    background
    PubMed Identifier
    11700160
    Citation
    Pirro M, Bergeron J, Dagenais GR, Bernard PM, Cantin B, Despres JP, Lamarche B. Age and duration of follow-up as modulators of the risk for ischemic heart disease associated with high plasma C-reactive protein levels in men. Arch Intern Med. 2001 Nov 12;161(20):2474-80. doi: 10.1001/archinte.161.20.2474.
    Results Reference
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    PubMed Identifier
    16126969
    Citation
    Gerli R, Sherer Y, Vaudo G, Schillaci G, Gilburd B, Giordano A, Bocci EB, Allegrucci R, Marchesi S, Mannarino E, Shoenfeld Y. Early atherosclerosis in rheumatoid arthritis: effects of smoking on thickness of the carotid artery intima media. Ann N Y Acad Sci. 2005 Jun;1051:281-90. doi: 10.1196/annals.1361.069.
    Results Reference
    background
    PubMed Identifier
    20191479
    Citation
    Gerli R, Vaudo G, Bocci EB, Schillaci G, Alunno A, Luccioli F, Hijazi R, Mannarino E, Shoenfeld Y. Functional impairment of the arterial wall in primary Sjogren's syndrome: combined action of immunologic and inflammatory factors. Arthritis Care Res (Hoboken). 2010 May;62(5):712-8. doi: 10.1002/acr.20117.
    Results Reference
    background
    PubMed Identifier
    16159604
    Citation
    St-Pierre AC, Cantin B, Bergeron J, Pirro M, Dagenais GR, Despres JP, Lamarche B. Inflammatory markers and long-term risk of ischemic heart disease in men A 13-year follow-up of the Quebec Cardiovascular Study. Atherosclerosis. 2005 Oct;182(2):315-21. doi: 10.1016/j.atherosclerosis.2005.02.009.
    Results Reference
    background
    PubMed Identifier
    11430324
    Citation
    Ridker PM, Rifai N, Clearfield M, Downs JR, Weis SE, Miles JS, Gotto AM Jr; Air Force/Texas Coronary Atherosclerosis Prevention Study Investigators. Measurement of C-reactive protein for the targeting of statin therapy in the primary prevention of acute coronary events. N Engl J Med. 2001 Jun 28;344(26):1959-65. doi: 10.1056/NEJM200106283442601.
    Results Reference
    background
    PubMed Identifier
    16946129
    Citation
    Pirro M, Schillaci G, Paltriccia R, Bagaglia F, Menecali C, Mannarino MR, Capanni M, Velardi A, Mannarino E. Increased ratio of CD31+/CD42- microparticles to endothelial progenitors as a novel marker of atherosclerosis in hypercholesterolemia. Arterioscler Thromb Vasc Biol. 2006 Nov;26(11):2530-5. doi: 10.1161/01.ATV.0000243941.72375.15. Epub 2006 Aug 31.
    Results Reference
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    PubMed Identifier
    17720166
    Citation
    Pirro M, Schillaci G, Bagaglia F, Menecali C, Paltriccia R, Mannarino MR, Capanni M, Velardi A, Mannarino E. Microparticles derived from endothelial progenitor cells in patients at different cardiovascular risk. Atherosclerosis. 2008 Apr;197(2):757-67. doi: 10.1016/j.atherosclerosis.2007.07.012. Epub 2007 Aug 27.
    Results Reference
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    PubMed Identifier
    19699071
    Citation
    Affuso F, Ruvolo A, Micillo F, Sacca L, Fazio S. Effects of a nutraceutical combination (berberine, red yeast rice and policosanols) on lipid levels and endothelial function randomized, double-blind, placebo-controlled study. Nutr Metab Cardiovasc Dis. 2010 Nov;20(9):656-61. doi: 10.1016/j.numecd.2009.05.017. Epub 2009 Aug 20.
    Results Reference
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