NUtraceutical TReatment for hYpercholesterolemia in HIV-infected Patients (NU-TRY(HIV))
Primary Purpose
Hypercholesterolemia, Inflammation, Atherosclerosis
Status
Completed
Phase
Phase 4
Locations
Study Type
Interventional
Intervention
Nutraceutical combination (NC)
No nutraceutical combination (noNC)
Sponsored by
About this trial
This is an interventional treatment trial for Hypercholesterolemia focused on measuring cholesterol, nutraceutical, HIV, PCSK9, hsCRP, stiffness
Eligibility Criteria
Inclusion Criteria:
- LDL-C >100 mg/dL
- no history of cardiovascular disease
- stable ART for at least 6 months
Exclusion Criteria:
- current or recent (≤6 months) treatment with lipid-lowering drugs
- chronic kidney disease [estimated glomerular filtration rate (GFR) <60 ml/min]
- liver impairment (AST and/or ALT >3 times upper limit of normal)
- current pregnancy
- opportunistic infections within the past 3 months,
- having received an organ transplant/immunosuppressive therapy
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Active Comparator
Arm Label
Nutraceutical combination (NC)
No nutraceutical combination (noNC)
Arm Description
Patients on standardized diet regimen taking a NC (red yeast rice-derived monacolin K 3 mg, berberine 500 mg, policosanol 10 mg, astaxanthin 0.5 mg, folic acid 0.2 mg and coenzyme Q10 2 mg) one pill/day for 3 months
Patients on standardized diet regimen without taking any NC
Outcomes
Primary Outcome Measures
Change from baseline in LDL-C levels at 3 months
plasma LDL-C levels
Secondary Outcome Measures
Change from baseline in PCSK9 levels at 3 months
plasma PCSK9 levels
Change from baseline in subclinical inflammation at 3 months
plasma hs-CRP levels
Change from baseline in arterial stiffness at 3 months
aPWV
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT03470376
Brief Title
NUtraceutical TReatment for hYpercholesterolemia in HIV-infected Patients
Acronym
NU-TRY(HIV)
Official Title
Lipid-lowering and Vascular Effects of a Nutraceutical Combination in HIV-infected Patients on Stable Antiretroviral Therapy
Study Type
Interventional
2. Study Status
Record Verification Date
March 2018
Overall Recruitment Status
Completed
Study Start Date
January 15, 2017 (Actual)
Primary Completion Date
November 15, 2017 (Actual)
Study Completion Date
November 30, 2017 (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 effects of a nutraceutical combination (NC) containing low-dose monacolin K and berberine on lipid profile, proprotein convertase subtilisin/kexin type 9 (PCSK9), subclinical inflammation and arterial stiffness were investigated in human immunodeficiency virus (HIV)-infected patients receiving stable antiretroviral therapy (ART).
Detailed Description
This is a crossover interventional study of 26 HIV-infected patients on stable ART with low density lipoprotein cholesterol (LDL-C) >100 mg/dL, not receiving any lipid-lowering treatment. After a 3-week lipid stabilization period with a standardized diet regimen, the effect of a 3-month oral NC containing red yeast rice-derived monacolin K 3 mg, berberine 500 mg, policosanol 10 mg, astaxanthin 0.5 mg, folic acid 0.2 mg and coenzyme Q10 2 mg vs no active treatment (noNC) was tested on plasma total cholesterol (TC), LDL-C, high density lipoprotein cholesterol (HDL-C), triglyceride, lipoprotein(a), PCSK9, high-sensitivity C-reactive protein (hsCRP) levels and aortic pulse wave velocity (aPWV).
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Hypercholesterolemia, Inflammation, Atherosclerosis
Keywords
cholesterol, nutraceutical, HIV, PCSK9, hsCRP, stiffness
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Crossover Assignment
Model Description
NC vs noNC
Masking
Outcomes Assessor
Masking Description
Patients names and allocation to arms was masked for outcomes assessors
Allocation
Randomized
Enrollment
26 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Nutraceutical combination (NC)
Arm Type
Experimental
Arm Description
Patients on standardized diet regimen taking a NC (red yeast rice-derived monacolin K 3 mg, berberine 500 mg, policosanol 10 mg, astaxanthin 0.5 mg, folic acid 0.2 mg and coenzyme Q10 2 mg) one pill/day for 3 months
Arm Title
No nutraceutical combination (noNC)
Arm Type
Active Comparator
Arm Description
Patients on standardized diet regimen without taking any NC
Intervention Type
Dietary Supplement
Intervention Name(s)
Nutraceutical combination (NC)
Other Intervention Name(s)
Armolipid Plus, Meda Pharma - Mylan
Intervention Description
An oral NC (red yeast rice-derived monacolin K 3 mg, berberine 500 mg, policosanol 10 mg, astaxanthin 0.5 mg, folic acid 0.2 mg and coenzyme Q10 2 mg) one pill/day was administered for 3 months along with prosecution of standardized diet regimen
Intervention Type
Behavioral
Intervention Name(s)
No nutraceutical combination (noNC)
Intervention Description
Prosecution of standardized diet regimen for 3 months
Primary Outcome Measure Information:
Title
Change from baseline in LDL-C levels at 3 months
Description
plasma LDL-C levels
Time Frame
3 months after treatment randomization
Secondary Outcome Measure Information:
Title
Change from baseline in PCSK9 levels at 3 months
Description
plasma PCSK9 levels
Time Frame
3 months after treatment randomization
Title
Change from baseline in subclinical inflammation at 3 months
Description
plasma hs-CRP levels
Time Frame
3 months after treatment randomization
Title
Change from baseline in arterial stiffness at 3 months
Description
aPWV
Time Frame
3 months after treatment randomization
Other Pre-specified Outcome Measures:
Title
Change from baseline in creatine phosphokinase (CPK) levels at 3 months
Description
plasma CPK levels
Time Frame
3 months after treatment randomization
Title
Change from baseline in aspartate transaminase (AST) levels at 3 months
Description
plasma AST levels
Time Frame
3 months after treatment randomization
Title
Change from baseline in alanine transaminase (ALT) levels at 3 months
Description
plasma ALT levels
Time Frame
3 months after treatment randomization
Title
Change from baseline in CD4+ cell count at 3 months
Description
CD4+ cell count
Time Frame
3 months after treatment randomization
Title
Change from baseline in HIV-1 RNA levels at 3 months
Description
HIV-1 RNA levels
Time Frame
3 months after treatment randomization
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
LDL-C >100 mg/dL
no history of cardiovascular disease
stable ART for at least 6 months
Exclusion Criteria:
current or recent (≤6 months) treatment with lipid-lowering drugs
chronic kidney disease [estimated glomerular filtration rate (GFR) <60 ml/min]
liver impairment (AST and/or ALT >3 times upper limit of normal)
current pregnancy
opportunistic infections within the past 3 months,
having received an organ transplant/immunosuppressive therapy
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Matteo Pirro, M.D., PhD
Organizational Affiliation
University Of Perugia
Official's Role
Principal Investigator
12. IPD Sharing Statement
Citations:
PubMed Identifier
25169560
Citation
Kelesidis T, Currier JS. Dyslipidemia and cardiovascular risk in human immunodeficiency virus infection. Endocrinol Metab Clin North Am. 2014 Sep;43(3):665-84. doi: 10.1016/j.ecl.2014.06.003.
Results Reference
background
PubMed Identifier
29067253
Citation
Chastain DB, Stover KR, Riche DM. Evidence-based review of statin use in patients with HIV on antiretroviral therapy. J Clin Transl Endocrinol. 2017 Feb 22;8:6-14. doi: 10.1016/j.jcte.2017.01.004. eCollection 2017 Jun.
Results Reference
background
PubMed Identifier
26733388
Citation
Bednasz C, Luque AE, Zingman BS, Fischl MA, Gripshover BM, Venuto CS, Gu J, Feng Z, DiFrancesco R, Morse GD, Ma Q. Lipid-Lowering Therapy in HIV-Infected Patients: Relationship with Antiretroviral Agents and Impact of Substance-Related Disorders. Curr Vasc Pharmacol. 2016;14(3):280-7. doi: 10.2174/1570161114666160106151652.
Results Reference
background
PubMed Identifier
27956024
Citation
Pirro M, Vetrani C, Bianchi C, Mannarino MR, Bernini F, Rivellese AA. Joint position statement on "Nutraceuticals for the treatment of hypercholesterolemia" of the Italian Society of Diabetology (SID) and of the Italian Society for the Study of Arteriosclerosis (SISA). Nutr Metab Cardiovasc Dis. 2017 Jan;27(1):2-17. doi: 10.1016/j.numecd.2016.11.122. Epub 2016 Nov 22.
Results Reference
background
PubMed Identifier
27004462
Citation
Pirro M, Mannarino MR, Ministrini S, Fallarino F, Lupattelli G, Bianconi V, Bagaglia F, Mannarino E. Effects of a nutraceutical combination on lipids, inflammation and endothelial integrity in patients with subclinical inflammation: a randomized clinical trial. Sci Rep. 2016 Mar 23;6:23587. doi: 10.1038/srep23587.
Results Reference
background
PubMed Identifier
27998714
Citation
Barrios V, Escobar C, Cicero AF, Burke D, Fasching P, Banach M, Bruckert E. A nutraceutical approach (Armolipid Plus) to reduce total and LDL cholesterol in individuals with mild to moderate dyslipidemia: Review of the clinical evidence. Atheroscler Suppl. 2017 Feb;24:1-15. doi: 10.1016/j.atherosclerosissup.2016.10.003. Epub 2016 Dec 18.
Results Reference
background
PubMed Identifier
27157250
Citation
Pirro M, Mannarino MR, Bianconi V, Simental-Mendia LE, Bagaglia F, Mannarino E, Sahebkar A. The effects of a nutraceutical combination on plasma lipids and glucose: A systematic review and meta-analysis of randomized controlled trials. Pharmacol Res. 2016 Aug;110:76-88. doi: 10.1016/j.phrs.2016.04.021. Epub 2016 May 6.
Results Reference
background
PubMed Identifier
11844656
Citation
Keithley JK, Swanson B, Sha BE, Zeller JM, Kessler HA, Smith KY. A pilot study of the safety and efficacy of cholestin in treating HIV-related dyslipidemia. Nutrition. 2002 Feb;18(2):201-4. doi: 10.1016/s0899-9007(01)00688-8.
Results Reference
background
PubMed Identifier
17512355
Citation
Kinlay S. Low-density lipoprotein-dependent and -independent effects of cholesterol-lowering therapies on C-reactive protein: a meta-analysis. J Am Coll Cardiol. 2007 May 22;49(20):2003-9. doi: 10.1016/j.jacc.2007.01.083. Epub 2007 May 4.
Results Reference
background
PubMed Identifier
30471555
Citation
Pirro M, Francisci D, Bianconi V, Schiaroli E, Mannarino MR, Barsotti F, Spinozzi A, Bagaglia F, Sahebkar A, Baldelli F. NUtraceutical TReatment for hYpercholesterolemia in HIV-infected patients: The NU-TRY(HIV) randomized cross-over trial. Atherosclerosis. 2019 Jan;280:51-57. doi: 10.1016/j.atherosclerosis.2018.11.026. Epub 2018 Nov 14.
Results Reference
derived
Learn more about this trial
NUtraceutical TReatment for hYpercholesterolemia in HIV-infected Patients
We'll reach out to this number within 24 hrs