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Assess the Safety and Efficacy of NKPL66 (CaPre™) in the Treatment of Mild-to-high Hypertriglyceridemia

Primary Purpose

Hypertriglyceridemia

Status
Completed
Phase
Phase 2
Locations
Canada
Study Type
Interventional
Intervention
CaPre™
CaPre™
CaPre™
Lipid Lowering Medication
CaPre™
Sponsored by
Acasti Pharma Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Hypertriglyceridemia focused on measuring Hypertriglyceridemia

Eligibility Criteria

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

Inclusion Criteria:

  • Male and female adults aged 18 to 75 years;
  • Fasting plasma levels of TG > 2.28 and < 10 mmol/L (200 and 877 mg/dL) on two occasions within 2 weeks (screening and baseline/part 1 visits).
  • Patients who are currently not on pharmacotherapy for hyperlipidemia and according to the judgement of the physician and Canadian Guidelines for the Diagnosis and Treatment of Dyslipidemia initiation of drug therapy is not indicated for the duration of the study.

OR

  • Patients currently treated with statins and according to the judgement of the physician and the Canadian Guidelines for the Diagnosis and Treatment of Dyslipidemia a change in their current drug regimen is not indicated for the duration of the study.
  • Patients treated with statin must be on stable dose for at least 6 weeks prior to screening;
  • Patients are willing to follow the NCEP Step 1 Diet (see Appendix 4) for the duration of the study;
  • Female participants of childbearing potential (i.e. not surgically sterilized or post-menopausal greater than one year) must have negative serum pregnancy test and must be using an effective birth control method, defined as:

    • continuous use of oral or long acting injected contraceptive for at least 2 months prior to study entry, or;
    • use of an intra-uterine device or implantable contraceptive, or;
    • use of double barrier methods of birth control

Exclusion Criteria:

  • Any concomitant medication which in the opinion of the investigator would preclude the patient from successfully participating in the study;
  • Women who are pregnant or that are breast feeding;
  • Participation in another clinical trial within 30 days from initiation of the study;
  • Participants with a high risk for cardiovascular disease; (The definition of high-risk individuals will follow that of the 2009 Canadian Guidelines and include a) FRS >= 20% 10-year risk; b) All patients with uncontrolled diabetes (DCA guidelines) and c) Evidence of atherosclerosis -when this evidence was ascertained when clinically indicated);
  • Systolic blood pressure > 140 mmHg and/or diastolic blood pressure > 90 mmHg. In diabetic patients, systolic blood pressure > 130 mmHg and/or diastolic blood pressure > 90 mmHg.
  • History of stroke, intermittent claudication or transient ischemic attack;
  • Known unstable (uncontrolled) cardiac disease, within the last 6 months:
  • Patient with a clinically significant abnormal ECG at screening.
  • Patients with uncontrolled diabetes mellitus, with HbA1c > 7.0%;
  • Known diagnosis of hypoglycemia
  • Evidence of active renal disease indicated by a fasting estimated glomerular filtration rate (eGFR) of < 60 ml/min per 1.73 m2;
  • Increased plasma levels (>ULN) of amylase (as per respective lab upper limits) and / or lipase (>160 IU/L) or any indication of pancreatitis (increased alcohol consumption, gallstones);
  • History of pancreatitis;
  • Use of any lipid lowering medication other than statins (e.g niacin, fibrates or ezetimibe) and/or lipid lowering NHP within 6 weeks prior to the screening visit;
  • Intake of > 2 servings per week of fish or regimented use of fish oil/omega-3 supplements within 6 weeks prior to the screening visit;
  • Intake of fortified foods containing plant sterols within 6 weeks prior to the screening visit;
  • Known HIV or Hepatitis B or C positive;
  • Patients with osteoporosis and hormone sensitive conditions;
  • Patients with uncontrolled asthma as defined by the 2010 Consensus Summary of the Canadian Thoracic Society;
  • Known seafood allergy or allergy to any of the medicinal or non-medicinal ingredients of the study medication, including:

    • Omega-3 fatty acids (including EPA and DHA)
    • Phospholipids (mainly phosphatidylcholine)
    • Astaxanthin
    • Bovine gelatin
  • Coagulopathy or on anticoagulants. Platelet aggregation inhibitors (such as aspirin or clopidogrel but not heparin) are permitted in the study; patients taking both aspirin and clopidogrel are not permitted in the study;
  • Unable or unwilling to comply with the protocol;
  • Patient reported weight must be stable for the past 6 months (within 3kg variation);
  • Consumption of more than 14 standard alcoholic drinks a week.

Sites / Locations

  • Alberta Health Services Clinical Trials
  • BC Diabetes
  • Entralogix Clinical Research
  • Entralogix Clinical Research
  • Cambridge Cardiac Care Center
  • Thamesview Ctr of Family Med
  • Moran Medical Centre
  • C & L Research
  • Entralogix Clinical Research
  • Entralogix Clinical Research
  • Malton Medical Research Group
  • Entralogix Clinical Research
  • Taunton Health Centre
  • Steeple Hill Medical centre
  • G.S. Cardiac Lab Medicine Professional Corp
  • Entralogix Clinical Research
  • Eric Silver Medicine Professional Corporation
  • Clinique Médicale des Trois Lacs
  • Clinique Medicale Valcartier
  • Clinique Reseau le Trait d'Union
  • Clinique Medicale Mistassini
  • GMF Grand Mere
  • Clinique medicale
  • CRM Lanaudiere
  • Applied Medical Information Research AMIR
  • Clinique Services Sante Rosemere
  • Csss de St-Jerome
  • CSSS Vallee De L'Or
  • Applied Medical Information Research (AMIR)
  • Centre de recherche A&E
  • Clinique des maladies lipidiques de Quebec Inc.

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm 5

Arm Type

Active Comparator

Active Comparator

Active Comparator

Other

Active Comparator

Arm Label

Group A

Group B

Group C

Group D

Group E

Arm Description

0.5g total CaPre™ from baseline to week 4 and 1.0g total CaPre™ from week 4 to week 8

1.0g total CaPre™ from baseline to week 4 and 2.0g total CaPre™ from week 4 to week

2.0g total CaPre™ from baseline to week 4 and 4.0g total CaPre™ from week 4 to week 8

Standard of care

4.0g total CaPre™ from baseline to week 8

Outcomes

Primary Outcome Measures

Percent change in fasting blood circulating serum TGs
The percent change in fasting blood circulating serum TGs between baseline and 4 weeks of treatment.

Secondary Outcome Measures

Absolute change in fasting plasma TGs
Absolute change in fasting plasma TGs;
Patients achieving target TG fasting plasma levels
Percentage (%) of patients achieving target TG fasting plasma levels (TG<1.7 mmol/L);
Change in fasting plasma LDL-C, VLDL-C, HDL-C, total cholesterol, hs-CRP and non-HDL
Absolute change in fasting plasma LDL-C, VLDL-C, HDL-C, total cholesterol, hs-CRP and non-HDL
Change in fasting plasma concentrations of LDL-C, VLDL-C, HDL-C, total cholesterol, hs-CRP and non-HDL
Percentage (%) change in fasting plasma concentrations of LDL-C, VLDL-C, HDL-C, total cholesterol, hs-CRP and non-HDL;
Calculated ratios
Calculated Ratios: Total cholesterol : HDL-C LDL-C : HDL-C TGs : HDL-C
Change in fasting plasma concentrations of biomarkers
Absolute and percent (%) change in fasting plasma concentrations of biomarkers; Glycated Hemoglobin (HbA1c) Glucose Creatinine phosphokinase (CPK)

Full Information

First Posted
January 19, 2012
Last Updated
January 7, 2014
Sponsor
Acasti Pharma Inc.
Collaborators
JSS Medical Research Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT01516151
Brief Title
Assess the Safety and Efficacy of NKPL66 (CaPre™) in the Treatment of Mild-to-high Hypertriglyceridemia
Official Title
A Randomized Open-label Dose-ranging, Multi-center Trial to Assess the Safety and Efficacy of NKPL66(CaPre™) in the Treatment of Mild-to-high Hypertriglyceridemia
Study Type
Interventional

2. Study Status

Record Verification Date
January 2014
Overall Recruitment Status
Completed
Study Start Date
December 2011 (undefined)
Primary Completion Date
May 2013 (Actual)
Study Completion Date
September 2013 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Acasti Pharma Inc.
Collaborators
JSS Medical Research Inc.

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
To evaluate the efficacy of 0.5, 1.0, 2.0 and 4.0 g/ day of CaPre™ in reducing fasting plasma serum triglycerides over a four week period in patients with mild-to-high hypertriglyceridemia as compared to the standard of care alone.
Detailed Description
The data generated from preclinical studies, as well as data accumulated from preclinical and clinical studies conducted with the precursor of CaPre™, NKO® , a natural health product (NPN: 80006416), have shown that CaPre™ is a safe product and well tolerated. In addition, there are preclinical data demonstrating that CaPre™ is effective in reducing circulating plasma concentrations of triglycerides. This effect is also accompanied by the regulation of other blood lipids, glucose tolerance and inflammatory biomarkers. These studies have been conducted in several preclinical adult phenotypes: (1) Healthy Sprague-Dawley (SD) rats, (2) obese and dyslipidemic Zucker Diabetic Fatty (ZDF) rats and(3-5) in three distinct murine phenotypes (normal wild-type C57BL/6, human ApoA-I transgenic mice and homozygous LDL-receptor knockout). As the prevalence of cardiometabolic disorders progressively increase over the years, it is expected that there will be an augmentation in the necessity for new anti-dyslipidemic medications that can most importantly be added in combination to other treatments. Current treatment methods address a specific target indication, but do not offer complete management of dyslipidemia. We are now left with the option to either inadequately treat patients suffering from cardiovascular and metabolic disorders or, to prescribe combination treatments hoping to address the risk factors while mitigating their known side effects. A treatment gap exists since there is no medication that increases HDL-cholesterol and reduces triglycerides while reducing LDL-cholesterol without side effects. At present there is a need to assess the effectiveness of CaPre™ in reducing triglycerides in patients with high hypertriglyceridemia. The current study will address these issues and will generate the evidence that will be required to determine whether this product could be effectively used in the clinical management of this patient population.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Hypertriglyceridemia
Keywords
Hypertriglyceridemia

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
289 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Group A
Arm Type
Active Comparator
Arm Description
0.5g total CaPre™ from baseline to week 4 and 1.0g total CaPre™ from week 4 to week 8
Arm Title
Group B
Arm Type
Active Comparator
Arm Description
1.0g total CaPre™ from baseline to week 4 and 2.0g total CaPre™ from week 4 to week
Arm Title
Group C
Arm Type
Active Comparator
Arm Description
2.0g total CaPre™ from baseline to week 4 and 4.0g total CaPre™ from week 4 to week 8
Arm Title
Group D
Arm Type
Other
Arm Description
Standard of care
Arm Title
Group E
Arm Type
Active Comparator
Arm Description
4.0g total CaPre™ from baseline to week 8
Intervention Type
Dietary Supplement
Intervention Name(s)
CaPre™
Intervention Description
1 capsule of 0.5g total CaPre™ for 4 weeks followed by one 1.0g capsule per day for an additional 4 weeks
Intervention Type
Dietary Supplement
Intervention Name(s)
CaPre™
Intervention Description
1 capsule of 1.0g total CaPre™ for 4 weeks followed by two 1.0g capsules per day for an additional 4 weeks
Intervention Type
Dietary Supplement
Intervention Name(s)
CaPre™
Intervention Description
2 capsules of 1.0g total CaPre™ for 4 weeks followed by 4 capsules of 1.0g total per day for an additional 4 weeks.
Intervention Type
Drug
Intervention Name(s)
Lipid Lowering Medication
Intervention Description
Patient will be treated as per the Standard of care.
Intervention Type
Dietary Supplement
Intervention Name(s)
CaPre™
Intervention Description
4 capsules of 1 g total per day for 8 weeks.
Primary Outcome Measure Information:
Title
Percent change in fasting blood circulating serum TGs
Description
The percent change in fasting blood circulating serum TGs between baseline and 4 weeks of treatment.
Time Frame
Between baseline and 4 weeks of treatment.
Secondary Outcome Measure Information:
Title
Absolute change in fasting plasma TGs
Description
Absolute change in fasting plasma TGs;
Time Frame
Baseline, Week 4 and Week 8
Title
Patients achieving target TG fasting plasma levels
Description
Percentage (%) of patients achieving target TG fasting plasma levels (TG<1.7 mmol/L);
Time Frame
Baseline
Title
Change in fasting plasma LDL-C, VLDL-C, HDL-C, total cholesterol, hs-CRP and non-HDL
Description
Absolute change in fasting plasma LDL-C, VLDL-C, HDL-C, total cholesterol, hs-CRP and non-HDL
Time Frame
Between baseline and 4 and 8 weeks of treatment
Title
Change in fasting plasma concentrations of LDL-C, VLDL-C, HDL-C, total cholesterol, hs-CRP and non-HDL
Description
Percentage (%) change in fasting plasma concentrations of LDL-C, VLDL-C, HDL-C, total cholesterol, hs-CRP and non-HDL;
Time Frame
Between baseline and 4 and 8 weeks of treatment
Title
Calculated ratios
Description
Calculated Ratios: Total cholesterol : HDL-C LDL-C : HDL-C TGs : HDL-C
Time Frame
The percent change in fasting blood circulating serum TGs Between baseline and 4 and 8 weeks of treatment.
Title
Change in fasting plasma concentrations of biomarkers
Description
Absolute and percent (%) change in fasting plasma concentrations of biomarkers; Glycated Hemoglobin (HbA1c) Glucose Creatinine phosphokinase (CPK)
Time Frame
Between baseline and 4 and 8 weeks of treatment

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: Male and female adults aged 18 to 75 years; Fasting plasma levels of TG > 2.28 and < 10 mmol/L (200 and 877 mg/dL) on two occasions within 2 weeks (screening and baseline/part 1 visits). Patients who are currently not on pharmacotherapy for hyperlipidemia and according to the judgement of the physician and Canadian Guidelines for the Diagnosis and Treatment of Dyslipidemia initiation of drug therapy is not indicated for the duration of the study. OR Patients currently treated with statins and according to the judgement of the physician and the Canadian Guidelines for the Diagnosis and Treatment of Dyslipidemia a change in their current drug regimen is not indicated for the duration of the study. Patients treated with statin must be on stable dose for at least 6 weeks prior to screening; Patients are willing to follow the NCEP Step 1 Diet (see Appendix 4) for the duration of the study; Female participants of childbearing potential (i.e. not surgically sterilized or post-menopausal greater than one year) must have negative serum pregnancy test and must be using an effective birth control method, defined as: continuous use of oral or long acting injected contraceptive for at least 2 months prior to study entry, or; use of an intra-uterine device or implantable contraceptive, or; use of double barrier methods of birth control Exclusion Criteria: Any concomitant medication which in the opinion of the investigator would preclude the patient from successfully participating in the study; Women who are pregnant or that are breast feeding; Participation in another clinical trial within 30 days from initiation of the study; Participants with a high risk for cardiovascular disease; (The definition of high-risk individuals will follow that of the 2009 Canadian Guidelines and include a) FRS >= 20% 10-year risk; b) All patients with uncontrolled diabetes (DCA guidelines) and c) Evidence of atherosclerosis -when this evidence was ascertained when clinically indicated); Systolic blood pressure > 140 mmHg and/or diastolic blood pressure > 90 mmHg. In diabetic patients, systolic blood pressure > 130 mmHg and/or diastolic blood pressure > 90 mmHg. History of stroke, intermittent claudication or transient ischemic attack; Known unstable (uncontrolled) cardiac disease, within the last 6 months: Patient with a clinically significant abnormal ECG at screening. Patients with uncontrolled diabetes mellitus, with HbA1c > 7.0%; Known diagnosis of hypoglycemia Evidence of active renal disease indicated by a fasting estimated glomerular filtration rate (eGFR) of < 60 ml/min per 1.73 m2; Increased plasma levels (>ULN) of amylase (as per respective lab upper limits) and / or lipase (>160 IU/L) or any indication of pancreatitis (increased alcohol consumption, gallstones); History of pancreatitis; Use of any lipid lowering medication other than statins (e.g niacin, fibrates or ezetimibe) and/or lipid lowering NHP within 6 weeks prior to the screening visit; Intake of > 2 servings per week of fish or regimented use of fish oil/omega-3 supplements within 6 weeks prior to the screening visit; Intake of fortified foods containing plant sterols within 6 weeks prior to the screening visit; Known HIV or Hepatitis B or C positive; Patients with osteoporosis and hormone sensitive conditions; Patients with uncontrolled asthma as defined by the 2010 Consensus Summary of the Canadian Thoracic Society; Known seafood allergy or allergy to any of the medicinal or non-medicinal ingredients of the study medication, including: Omega-3 fatty acids (including EPA and DHA) Phospholipids (mainly phosphatidylcholine) Astaxanthin Bovine gelatin Coagulopathy or on anticoagulants. Platelet aggregation inhibitors (such as aspirin or clopidogrel but not heparin) are permitted in the study; patients taking both aspirin and clopidogrel are not permitted in the study; Unable or unwilling to comply with the protocol; Patient reported weight must be stable for the past 6 months (within 3kg variation); Consumption of more than 14 standard alcoholic drinks a week.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Robert Dufour, M.D.
Organizational Affiliation
Institut de Recherches Cliniques de Montreal
Official's Role
Principal Investigator
Facility Information:
Facility Name
Alberta Health Services Clinical Trials
City
Red Deer
State/Province
Alberta
Country
Canada
City
Abbotsford
State/Province
British Columbia
Country
Canada
City
Kelowna
State/Province
British Columbia
Country
Canada
Facility Name
BC Diabetes
City
Vancouver
State/Province
British Columbia
Country
Canada
City
Victoria
State/Province
British Columbia
Country
Canada
City
Winnipeg
State/Province
Manitoba
Country
Canada
City
Dieppe
State/Province
New Brunswick
Country
Canada
Facility Name
Entralogix Clinical Research
City
Aurora
State/Province
Ontario
Country
Canada
Facility Name
Entralogix Clinical Research
City
Brampton
State/Province
Ontario
Country
Canada
Facility Name
Cambridge Cardiac Care Center
City
Cambridge
State/Province
Ontario
Country
Canada
Facility Name
Thamesview Ctr of Family Med
City
Chatam
State/Province
Ontario
Country
Canada
Facility Name
Moran Medical Centre
City
Colingwood
State/Province
Ontario
Country
Canada
Facility Name
C & L Research
City
Fort Erie
State/Province
Ontario
Country
Canada
City
Hamilton
State/Province
Ontario
Country
Canada
Facility Name
Entralogix Clinical Research
City
Kitchener
State/Province
Ontario
Country
Canada
Facility Name
Entralogix Clinical Research
City
Mississauga
State/Province
Ontario
Country
Canada
Facility Name
Malton Medical Research Group
City
Mississauga
State/Province
Ontario
Country
Canada
City
Niagara Falls
State/Province
Ontario
Country
Canada
Facility Name
Entralogix Clinical Research
City
North York
State/Province
Ontario
Country
Canada
Facility Name
Taunton Health Centre
City
Oshawa
State/Province
Ontario
Country
Canada
Facility Name
Steeple Hill Medical centre
City
Pickering
State/Province
Ontario
Country
Canada
Facility Name
G.S. Cardiac Lab Medicine Professional Corp
City
Sudbury
State/Province
Ontario
Country
Canada
Facility Name
Entralogix Clinical Research
City
Toronto
State/Province
Ontario
Country
Canada
Facility Name
Eric Silver Medicine Professional Corporation
City
Toronto
State/Province
Ontario
Country
Canada
Facility Name
Clinique Médicale des Trois Lacs
City
Vaudreuil Dorion
State/Province
Ontario
Country
Canada
Facility Name
Clinique Medicale Valcartier
City
Courcelette
State/Province
Quebec
Country
Canada
Facility Name
Clinique Reseau le Trait d'Union
City
Delson
State/Province
Quebec
Country
Canada
Facility Name
Clinique Medicale Mistassini
City
Dolbeau-Mistassini
State/Province
Quebec
Country
Canada
Facility Name
GMF Grand Mere
City
Grand Mere
State/Province
Quebec
Country
Canada
Facility Name
Clinique medicale
City
Grand-Mere
State/Province
Quebec
Country
Canada
Facility Name
CRM Lanaudiere
City
Joliette
State/Province
Quebec
Country
Canada
Facility Name
Applied Medical Information Research AMIR
City
Montreal
State/Province
Quebec
Country
Canada
Facility Name
Clinique Services Sante Rosemere
City
Rosemere
State/Province
Quebec
Country
Canada
Facility Name
Csss de St-Jerome
City
Saint-Jerome
State/Province
Quebec
Country
Canada
Facility Name
CSSS Vallee De L'Or
City
Val d'Or
State/Province
Quebec
Country
Canada
Facility Name
Applied Medical Information Research (AMIR)
City
Westmount
State/Province
Quebec
Country
Canada
Facility Name
Centre de recherche A&E
City
Quebec
Country
Canada
Facility Name
Clinique des maladies lipidiques de Quebec Inc.
City
Quebec
Country
Canada

12. IPD Sharing Statement

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Assess the Safety and Efficacy of NKPL66 (CaPre™) in the Treatment of Mild-to-high Hypertriglyceridemia

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