Serum lipid concentrations from baseline
Change in serum lipid concentrations of the following measures (total cholesterol, high-density lipoprotein-cholesterol, triglycerides, non-HDL-C, total cholesterol:HDL-cholesterol ratio, apolipoproteinA1 (apoA1), apolipoproteinB (apoB), apoB:apoA1 ratio) will be analysed. Fasting blood samples (total of ~14 ml) will be collected into vacutainers containing a clot activator for the preparation of serum.
Secondary blood-based outcomes will be analysed using standardised methods. Immunoturbidimetric test kits will be used for analysis of apoA1 and apoB. Total cholesterol:HDL-cholesterol and apoB:apoA1 ratio will be calculated from the results. Non-HDL-cholesterol will be calculated as total cholesterol - HDL-cholesterol.
Blood pressure changes from baseline
Resting systolic and diastolic blood pressure (mmHg) will be measured using an automated blood pressure monitor in a seated position following a 5-minute rest. The average of three measurements (separated by 2 minutes) will be recorded.
Changes in HbA1c from baseline
Whole Ethylenediaminetetraacetic acid (EDTA) blood samples will be collected to analyse haemoglobin A1C (HbA1c) concentration changes during the study period. A Beckman AU480 clinical analyser (Beckman Coulter Inc, Brea, CA, USA) and relevant commercial enzymatic test kits will be used for analysis of HbA1c.
Changes in plasma ox-LDL
Changes in plasma oxidised-low-density lipoprotein will be analysed by commercial ELISA kit. Vacutainers containing K2-EDTA anticoagulant will be used for the preparation of plasma. This assay will be measured on an EnVision Multilabel plate reader (Perkin Elmer, MA, USA).
Changes in serum malondialdehyde
Changes in serum malondialdehyde will be analysed by commercial colorimetric assay kit. This assay will be measured on an EnVision Multilabel plate reader (Perkin Elmer, MA, USA).
Changes to diet
Participant's habitual dietary intake will be assessed at Baseline and 4 month visits using the Automated Self-Administered 24-hour (ASA24-Australia) Dietary Assessment Tool, version (2016), developed and validated by the National Cancer Institute, Bethesda, MD (36). Three 24-hour recalls will be completed at each occasion. At Day 1, participants will complete the first 24-hour recall during a dietitian consultation while the subsequent 24-hour recalls will be completed by the participant at home within 7-days of Day 1 and on days as specified by the dietitian (including 2 week- and 1 weekend day). Overall, all days of the week will be covered by participants. Nutrient analysis is automated through the ASA24 program and uses the Australian Food, Supplement and Nutrient Database (AUSNUT, 2011-13).
Changes in anthropometric measurements - height
Height will be measured at Screening (cm). Height will be measured using a stadiometer.
Waist and hip circumference (cm) will be measured at Baseline, 2- and 4 month or Early Withdrawal visits. Waist will be measured at the top of the iliac crest with a plastic measuring tape and taken at minimal respiration for the average of three consecutive readings. Hip circumference will be measured at the largest circumference of the buttocks.
Changes in anthropometric measurements - weight
Body weight (kg) will be measured at screening and Day 1 and also be collected at the 2 month, 4 month or Early Withdrawal visits. Body weight will be measured using calibrated electronic digital scales.
Changes in anthropometric measurements - BMI
Body mass index (BMI) will be calculated using the formula weight (kg)/height (m)2. BMI will be assessed at screening, baseline, 2 months, and 4 months.
Changes in anthropometric measurements- WHR
Waist:hip ratio (WHR) will be calculated using the formula waist circumference (cm)/hip circumference (cm). WHR will be calculated from measurements taken at Baseline, 2 and-4 months or Early Withdrawal visits.
Changes in body composition
Fat mass and fat free mass will be measured at Baseline, 2- and 4 month or Early Withdrawal visits using a multi-frequency bioelectrical impedance analysis machine with 8 tactile electrodes (InBody 770, Biospace Co. Ltd, Seoul). Measurements will be obtained after voiding. Participants will stand upright, positioning their bare feet on the footpads and their hands on the handles. A small electrical current is passed through the body, resistance is measured, and total body water and the corresponding body composition measures are calculated by the inbuilt software.
Safety - Incidence of adverse events (AEs) and serious adverse events (SAEs)
All adverse events will be recorded from dosing until the end of the study (Final Safety Visit or early withdrawal). At clinic visit at month 2 and month 4 and online surveys, participants will be questioned in a non-leading manner regarding the occurrence of any adverse medical event. All AEs will be documented in the source documents and evaluated by the Medical Investigator for severity and causality to study treatment. All SAEs will be reported to the study sponsor as per standard Good Clinical Practice (GCP) requirements.
Safety- Number of participants with significant changes to blood pressure over study period between groups
Vital signs will be measured by a designee while the participant is seated. Resting blood pressure (systolic/diastolic mmHG) will be measured using an automated blood pressure monitor in a seated position following a 5-minute rest. The average of three measurements (separated by 2 minutes) will be recorded.Vital signs will be performed at Screening, Baseline, 2 month and 4 month or Early Withdrawal Visit.
Safety - Number of participants who fall pregnant (WOCBP only)
A urine sample will be collected at Screening, Baseline, 2 and 4 month Visit or Early Withdrawal visit in WOCBP only. Study staff will perform a dipstick urine pregnancy test and record the result in the source documents.
Safety - Number of participants with significant changes to heart rate between groups
Vital signs will be measured by a designee while the participant is seated. Heart rate will be measured as beats/minute by palpating the participants' carotid and radial pulses. Vital signs will be performed at Screening, Baseline, 2 month and 4 month or Early Withdrawal Visit.
Number of participants with changes to heart sounds
The Medical Investigator will perform a non-invasive physical examination of the participants' cardiovascular system by listening to heart sounds to determine whether there is a heart murmur or irregular heart beat.
At Day 1 (Baseline visit) these will be reviewed to establish their baseline characteristics.
A symptom directed physical exam will be conducted at 4 months or Early Withdrawal Visit.
Safety - Number of participants with significant changes to respiratory rate between groups
Respiratory rate will be measured by counting the number of times the chest rises per minute while the participant is at rest. Vital signs will be performed at Screening, Baseline, 2 month and 4 month or Early Withdrawal Visit.
Number of participants with changes to respiratory effort
The Medical Investigator will perform a non-invasive physical examination of the participants' lung function by observing the participants' breathing rhythm and chest movement.
At Day 1 (Baseline visit) these will be reviewed to establish their baseline characteristics.
A symptom directed physical exam will be conducted at 4 months or Early Withdrawal Visit.
Safety - Number of participants with significant changes to core body temperature between groups
Vital signs will be measured by a designee while the participant is seated. Body temperature (°C) will be measured using a digital thermometer.
Safety: Number of participants with macroscopic abnormalities of the eyes
A non-invasive physical examination will be performed by a Medical Investigator and will include an assessment of the appearance of the pupil, iris, cornea, eyelids, eyelashes, conjuctiva and periorbital are including redness, discharge, lesions, ulcers, abrasions or unusual growths.
At Day 1 (Baseline visit) these will be reviewed to establish their baseline characteristics.
A symptom directed physical exam will be conducted at 4 months or Early Withdrawal Visit.
Safety -Number of participants with visual symptoms
Participants will be asked to self-report on any visual symptoms or changes e.g. blurriness, eye strain etc. throughout the study period.
At Day 1 (Baseline visit) these will be reviewed to establish their baseline characteristics.
A symptom directed physical exam will be conducted at 4 months or Early Withdrawal Visit.
Safety: Number of participants with infections in the Ears, Nose, Mouth and Throat
A non-invasive physical examination will be performed by a Medical Investigator and will include
A visual assessment of the ears, nose, mouth and throat to check for signs of infection
Palpation of the cervical chain lymph nodes to check for signs of infection
At Day 1 (Baseline visit) these will be reviewed to establish their baseline characteristics.
A symptom directed physical exam will be conducted at 4 months or Early Withdrawal Visit.
Safety: Number of participants with changes to peripheral vascular function
A non-invasive physical examination will be performed by a Medical Investigator and will include palpating the dorsal pedis pulse, posterior tibial pulse and palpation of the ankles to check for peripheral oedema.
At Day 1 (Baseline visit) these will be reviewed to establish their baseline characteristics.
A symptom directed physical exam will be conducted at 4 months or Early Withdrawal Visit.
Safety: Number of participants with respiratory disease
The Medical Investigator will perform a non-invasive physical examination of the participants' respiratory system by listening to breath sounds to determine whether there is untreated asthma or other lung disease.
At Day 1 (Baseline visit) these will be reviewed to establish their baseline characteristics.
A symptom directed physical exam will be conducted at 4 months or Early Withdrawal Visit.
Safety: Number of participants with changes to the gastrointestinal tract
Medical Investigator will perform a non-invasive physical exam by observing and palpating the participants' abdomen to check for surgical scars, ascites, organomegaly and abdominal discomfort.
At Day 1 (Baseline visit) these will be reviewed to establish their baseline characteristics.
A symptom directed physical exam will be conducted at 4 months or Early Withdrawal Visit.
Safety: Changes to characteristics in physical examination - musculoskeletal
A non-invasive physical examination will be performed by a Medical Investigator and will include an assessment of joint mobility. Participants will be asked to to stand and sit back down into a chair unassisted, to reach forward and try to touch their toes, and to touch their opposite shoulder blades across their front, behind their neck and behind their back (Apley Shoulder test).
At Day 1 (Baseline visit) these will be reviewed to establish their baseline characteristics.
A symptom directed physical exam will be conducted at 4 months or Early Withdrawal Visit.
Safety: Number of participants with changes to characteristics in skin appearance
A non-invasive physical examination will be performed by a Medical Investigator who will observe the participants' skin colour, looking for central and peripheral cyanosis, jaundice, or any skin rashes or lesions.
At Day 1 (Baseline visit) these will be reviewed to establish their baseline characteristics.
A symptom directed physical exam will be conducted at 4 months or Early Withdrawal Visit.
Safety: Number of participants with clinically significant changes in biochemistry - AST
Fasting blood samples will be collected at Screening, Baseline, 2 Month, 4 Month and Early Withdrawal visits.
Changes in Aspartate aminotransferase (AST) from baseline (U/L) will be analysed by a National Association of Testing Authorities, Australia (NATA) laboratory.
Safety: Number of participants with clinically significant changes in biochemistry- ALT
Fasting blood samples will be collected at Screening, Baseline, 2 Month, 4 Month and Early Withdrawal visits.
Changes in Alanine aminotransferase (ALT) from baseline (U/L) will be analysed by a National Association of Testing Authorities, Australia (NATA) laboratory.
Safety: Number of participants with clinically significant changes in biochemistry - GGT
Fasting blood samples will be collected at Screening, Baseline, 2 Month, 4 Month and Early Withdrawal visits.
Changes in gamma glutamyltransferase from baseline (U/L) will be analysed by a National Association of Testing Authorities, Australia (NATA) laboratory.
Safety: Number of participants with clinically significant changes in biochemistry - ALP
Fasting blood samples will be collected at Screening, Baseline, 2 Month, 4 Month and Early Withdrawal visits.
Changes in Alkaline phosphatase (ALP) (U/L) will be analysed by a National Association of Testing Authorities, Australia (NATA) laboratory.
Safety: Number of participants with clinically significant changes in biochemistry - LD
Fasting blood samples will be collected at Screening, Baseline, 2 Month, 4 Month and Early Withdrawal visits.
Changes in Lactate Dehydrogenase (U/L) will be analysed by a National Association of Testing Authorities, Australia (NATA) laboratory.
Safety: Number of participants with clinically significant changes in biochemistry - creatinine
Fasting blood samples will be collected at Screening, Baseline, 2 Month, 4 Month and Early Withdrawal visits.
Changes in creatinine (µmol/L) will be analysed by a National Association of Testing Authorities, Australia (NATA) laboratory.
Safety: Number of participants with clinically significant changes in biochemistry - creatinine kinase
Fasting blood samples will be collected at Screening, Baseline, 2 Month, 4 Month and Early Withdrawal visits.
Changes in creatinine kinase (U/L) will be analysed by a National Association of Testing Authorities, Australia (NATA) laboratory.
Safety: Number of participants with clinically significant changes in biochemistry - urea nitrogen
Fasting blood samples will be collected at Screening, Baseline, 2 Month, 4 Month and Early Withdrawal visits.
Changes in urea nitrogen (mmol/L) will be analysed by a National Association of Testing Authorities, Australia (NATA) laboratory.
Safety: Number of participants with clinically significant changes in biochemistry - sodium
Fasting blood samples will be collected at Screening, Baseline, 2 Month, 4 Month and Early Withdrawal visits.
Changes in blood sodium levels (mmol/L) will be analysed by a National Association of Testing Authorities, Australia (NATA) laboratory.
Safety: Number of participants with clinically significant changes in biochemistry - potassium
Fasting blood samples will be collected at Screening, Baseline, 2 Month, 4 Month and Early Withdrawal visits.
Changes in blood potassium levels (mmol/L) will be analysed by a National Association of Testing Authorities, Australia (NATA) laboratory.
Safety: Number of participants with clinically significant changes in biochemistry - chloride
Fasting blood samples will be collected at Screening, Baseline, 2 Month, 4 Month and Early Withdrawal visits.
Changes in blood chloride levels (mmol/L) will be analysed by a National Association of Testing Authorities, Australia (NATA) laboratory.
Safety: Number of participants with clinically significant changes in biochemistry - bicarbonate
Fasting blood samples will be collected at Screening, Baseline, 2 Month, 4 Month and Early Withdrawal visits.
Changes in blood bicarbonate levels (mmol/L) will be analysed by a National Association of Testing Authorities, Australia (NATA) laboratory.
Safety: Number of participants with clinically significant changes in biochemistry - urea
Fasting blood samples will be collected at Screening, Baseline, 2 Month, 4 Month and Early Withdrawal visits.
Changes in blood urea levels (mmol/L) will be analysed by a National Association of Testing Authorities, Australia (NATA) laboratory.
Safety: Number of participants with clinically significant changes in biochemistry - calcium
Fasting blood samples will be collected at Screening, Baseline, 2 Month, 4 Month and Early Withdrawal visits.
Changes in calcium levels (mmol/L) will be analysed by a National Association of Testing Authorities, Australia (NATA) laboratory.
Safety: Number of participants with clinically significant changes in biochemistry - CRP
Fasting blood samples will be collected at Screening, Baseline, 2 Month, 4 Month and Early Withdrawal visits.
Changes in C-reactive protein levels (CRP) measured as mg/L will be analysed by a National Association of Testing Authorities, Australia (NATA) laboratory.
Safety: Number of participants with clinically significant changes in biochemistry - uric acid
Fasting blood samples will be collected at Screening, Baseline, 2 Month, 4 Month and Early Withdrawal visits.
Changes in uric acid measured as mol/mol will be analysed by a National Association of Testing Authorities, Australia (NATA) laboratory.
Safety: Number of participants with clinically significant changes in biochemistry - phosphate
Fasting blood samples will be collected at Screening, Baseline, 2 Month, 4 Month and Early Withdrawal visits.
Changes in phosphate (mmol/L) will be analysed by a National Association of Testing Authorities, Australia (NATA) laboratory.
Safety: Number of participants with clinically significant changes in biochemistry - albumin
Fasting blood samples will be collected at Screening, Baseline, 2 Month, 4 Month and Early Withdrawal visits.
Changes in albumin (g/L) will be analysed by a National Association of Testing Authorities, Australia (NATA) laboratory.
Safety: Number of participants with clinically significant changes in biochemistry - globulins
Fasting blood samples will be collected at Screening, Baseline, 2 Month, 4 Month and Early Withdrawal visits.
Changes in globulins (g/L) will be analysed by a National Association of Testing Authorities, Australia (NATA) laboratory.
Safety: Number of participants with clinically significant changes in biochemistry - protein
Fasting blood samples will be collected at Screening, Baseline, 2 Month, 4 Month and Early Withdrawal visits.
Changes in protein (g/L) will be analysed by a National Association of Testing Authorities, Australia (NATA) laboratory.
Safety: Number of participants with clinically significant changes in biochemistry - total bilirubin
Fasting blood samples will be collected at Screening, Baseline, 2 Month, 4 Month and Early Withdrawal visits.
Changes in total bilirubin (umol/L) will be analysed by a National Association of Testing Authorities, Australia (NATA) laboratory.
Safety: Number of participants with clinically significant changes in biochemistry - glucose
Fasting blood samples will be collected at Screening, Baseline, 2 Month, 4 Month and Early Withdrawal visits.
Changes in fasting glucose (mmol/L) will be analysed by a National Association of Testing Authorities, Australia (NATA) laboratory.
Safety: Number of participants with clinically significant changes in haematology - RDW
Fasting blood samples will be collected at Screening, Baseline, 2 Month, 4 Month and Early Withdrawal visits.
Changes in red cell distribution (RDW) will be analysed by a National Association of Testing Authorities, Australia (NATA) laboratory.
Safety: Number of participants with clinically significant changes in haematology - haemoglobin
Fasting blood samples will be collected at Screening, Baseline, 2 Month, 4 Month and Early Withdrawal visits.
Changes in haemoglobin (g/L) will be analysed by a National Association of Testing Authorities, Australia (NATA) laboratory.
Safety: Number of participants with clinically significant changes in haematology - RBC
Fasting blood samples will be collected at Screening, Baseline, 2 Month, 4 Month and Early Withdrawal visits.
Changes in red blood cell count (RBC) will be analysed by a National Association of Testing Authorities, Australia (NATA) laboratory.
Safety: Number of participants with clinically significant changes in haematology - PCV
Fasting blood samples will be collected at Screening, Baseline, 2 Month, 4 Month and Early Withdrawal visits.
Changes in packed cell volume (PCV) will be analysed by a National Association of Testing Authorities, Australia (NATA) laboratory.
Safety: Number of participants with clinically significant changes in haematology - MCV
Fasting blood samples will be collected at Screening, Baseline, 2 Month, 4 Month and Early Withdrawal visits.
Changes in mean cell volume (MCV) will be analysed by a National Association of Testing Authorities, Australia (NATA) laboratory.
Safety: Number of participants with clinically significant changes in haematology - MCHC
Fasting blood samples will be collected at Screening, Baseline, 2 Month, 4 Month and Early Withdrawal visits.
Changes in mean cell hemoglobin concentrations (MCHC) measured as g/L will be analysed by a National Association of Testing Authorities, Australia (NATA) laboratory.
Safety: Number of participants with clinically significant changes in haematology - platelets
Fasting blood samples will be collected at Screening, Baseline, 2 Month, 4 Month and Early Withdrawal visits.
Changes in the number of platelets will be analysed by a National Association of Testing Authorities, Australia (NATA) laboratory.
Safety: Number of participants with clinically significant changes in haematology - white cell count (WCC)
Fasting blood samples will be collected at Screening, Baseline, 2 Month, 4 Month and Early Withdrawal visits.
Changes in the number of white cells will be analysed by a National Association of Testing Authorities, Australia (NATA) laboratory.
Safety: Number of participants with clinically significant changes in haematology - neutrophils
Fasting blood samples will be collected at Screening, Baseline, 2 Month, 4 Month and Early Withdrawal visits.
A white cell count differential test will be conducted. Changes in the number of neutrophils will be analysed by a National Association of Testing Authorities, Australia (NATA) laboratory.
Safety: Number of participants with clinically significant changes in haematology - lymphocytes
Fasting blood samples will be collected at Screening, Baseline, 2 Month, 4 Month and Early Withdrawal visits.
A white cell count differential test will be conducted. Changes in the number of lymphocytes will be analysed by a National Association of Testing Authorities, Australia (NATA) laboratory.
Safety: Number of participants with clinically significant changes in haematology - monocytes
Fasting blood samples will be collected at Screening, Baseline, 2 Month, 4 Month and Early Withdrawal visits.
A white cell count differential test will be conducted. Changes in the number of monocytes will be analysed by a National Association of Testing Authorities, Australia (NATA) laboratory.
Safety: Number of participants with clinically significant changes in haematology - eosinophils
Fasting blood samples will be collected at Screening, Baseline, 2 Month, 4 Month and Early Withdrawal visits.
A white cell count differential test will be conducted. Changes in the number of eosinophils will be analysed by a National Association of Testing Authorities, Australia (NATA) laboratory.
Safety: Number of participants with clinically significant changes in haematology - basophils
Fasting blood samples will be collected at Screening, Baseline, 2 Month, 4 Month and Early Withdrawal visits.
A white cell count differential test will be conducted. Changes in the number of basophils will be analysed by a National Association of Testing Authorities, Australia (NATA) laboratory.