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Colesevelam Treatment for Impaired Fasting Glucose During Niacin Therapy (CERTAIN)

Primary Purpose

Dyslipidemia, Hyperlipidemia, Hyperglycemia

Status
Completed
Phase
Phase 4
Locations
United States
Study Type
Interventional
Intervention
Placebo
Colesevelam
Sponsored by
Radiant Research
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Dyslipidemia focused on measuring dyslipidemia, hyperlipidemia, hyperglycemia, impaired fasting glucose

Eligibility Criteria

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

Inclusion Criteria:

  1. Men and women ≥ 18 years of age.
  2. Non-HDL-C ≥100 mg/dL and ≤220 mg/dL at Visits 1 and 2.
  3. FPG ≥90 mg/dL and ≤145 mg/dL, at Visits 1 and 2.
  4. HDL-C <60 mg/dL at Visits 1 and 2, regardless of gender.
  5. Untreated dyslipidemia, or statin treatment only with equipotency to atorvastatin ≤40 mg daily for at least 12 weeks prior to Screening Visit 1 and without change or initiation prior to randomization

Exclusion Criteria:

  1. Known intolerance to niacin or bile acid-sequestering drugs or aspirin.
  2. Any contraindication to a study medication (niacin, aspirin or colesevelam).
  3. History of dysphagia, swallowing disorders or intestinal motility disorders.
  4. History of pancreatitis.
  5. Fasting TG >500 mg/dL at Visits 1 and 2
  6. Currently taking medication for diabetes mellitus, Type 1 or 2,or currently taking glucose-lowering drugs (e.g. metformin) for any other indication.
  7. Currently taking drugs that may affect glycemic and/or lipid control (e.g., beta-blockers, etc.) if started within the 12 weeks prior to Visit 1, or prior to randomization. This does not apply to dietary supplements.).
  8. Body mass index (BMI) >40 kg/m2.
  9. History of acute myocardial infarction, unstable angina, transient ischemic attacks, stroke or revascularization procedure within the 3 months prior to Visit 1 or prior to randomization.
  10. Use of prescription strength niacin, bile acid sequestrants, fibrates or omega-3 fatty acids within 8 weeks prior to Visit 1 or prior to randomization. This does not apply to dietary supplements.
  11. Unwilling to abstain, during the study, from weight-loss drugs (including over-the-counter) or weight-loss programs during the study.
  12. Current use, or intended use during the study, of cyclic hormones (e.g., oral or vaginal contraceptives and estrogen replacement therapy).
  13. Females who are pregnant, planning to be pregnant during the study period, lactating, or women of childbearing potential not using an acceptable method of contraception. Acceptable methods include intrauterine device, cervical diaphragm plus spermicide, female condom plus spermicide, or partner's use of condoms plus spermicide. Partner's vasectomy only or use of condoms or spermicide only are not considered acceptable forms of birth control.
  14. Current use, or intended use during the study of cyclosporine.
  15. Recent history (past 12 months) of illicit drug use or excessive ethanol use. Excessive ethanol use will be defined as >14 drinks per week (1 drink = 12 oz beer, 5 oz wine, or 1.5 oz hard liquor).
  16. Exposure to any investigational agent within 30 days prior to Visit 1, and prior to randomization.
  17. Individual has a condition the Investigator believes would interfere with his ability to provide informed consent, comply with study instructions, or which might confound the interpretation of the study results or put the subject at undue risk.

Sites / Locations

  • Radiant Research

Arms of the Study

Arm 1

Arm 2

Arm Type

Placebo Comparator

Experimental

Arm Label

Placebo

Colesevelam

Arm Description

Outcomes

Primary Outcome Measures

Low-density lipoprotein cholesterol (LDL-C)
The primary efficacy endpoint will be the mean percent change from baseline (average of Weeks -1 and 1) to end-of-treatment (average of Weeks 10 and 12) in LDL-C. It will be measured as part of the fasting lipid panel at Visits 1, 2, 3, 7, and 8/ET (Weeks -6 to -2, -1, 1, 10 and 12/ET).

Secondary Outcome Measures

Fasting Plasma Glucose (FPG)
The principal secondary efficacy endpoint is the mean change in FPG from baseline (average of Weeks -1 and 1) to end-of-treatment (average of Weeks 10 and 12).
NMR Lipid subfractions and lipoprotein-IR score
A secondary efficacy endpoint is the mean change from baseline (Week 1) to end-of-treatment(Week 12) in NMR Lipid subfractions and lipoprotein-IR score.
Hemoglobin A1C (HbA1C)
A secondary efficacy endpoint is the mean change from baseline (Week 1) to end-of-treatment(Week 12) in HbA1c.
Fructosamine
A secondary efficacy endpoint is the mean change from baseline (average of Weeks -1 and 1) to end-of-treatment (average of Weeks 10 and 12) in fructosamine.
High sensitivity c-reactive protein (hs-CRP)
A secondary efficacy endpoint is the mean change from baseline (average of Weeks -1 and 1) to end-of-treatment (average of Weeks 10 and 12) in hs-CRP.
Niacin-related flushing
Niacin-associated flushing will be measured using a visual analog scale (VAS)at Weeks 2,4,6,10 and 12.
Homeostasis model assessment of insulin resistance (HOMA-IR) score
A secondary efficacy endpoint is the mean change from baseline (Week 1) to end-of-treatment (Week 12) in HOMA-IR.
High-density lipoprotein cholesterol (HDL-C)
A secondary endpoint is the mean percent change from baseline (average of Weeks -1 and 1) to end-of-treatment (average of Weeks 10 and 12) in HDL-C.
Non-high-density lipoprotein cholesterol (non-HDL-C)
A secondary endpoint is the mean percent change from baseline (average of Weeks -1 and 1) to end-of-treatment (average of Weeks 10 and 12) in non-HDL-C.
Total Cholesterol (TC)
A secondary endpoint is the mean percent change from baseline (average of Weeks -1 and 1) to end-of-treatment (average of Weeks 10 and 12) in TC.
Triglycerides (TG)
A secondary endpoint is the mean percent change from baseline (average of Weeks -1 and 1) to end-of-treatment (average of Weeks 10 and 12) in TG.
Fasting Insulin
A secondary efficacy endpoint is the mean change from baseline (Week 1) to end-of-treatment (Week 12) in fasting insulin.

Full Information

First Posted
November 9, 2010
Last Updated
January 5, 2012
Sponsor
Radiant Research
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1. Study Identification

Unique Protocol Identification Number
NCT01239004
Brief Title
Colesevelam Treatment for Impaired Fasting Glucose During Niacin Therapy
Acronym
CERTAIN
Official Title
A 12-Week, Double-Blind, Randomized, Placebo-Controlled Study to Assess the LDL Cholesterol Lowering and Anti-Hyperglycemic Efficacy of Welchol® (Colesevelam) in Subjects With Impaired Fasting Glucose Who Are Taking Niaspan® (Niacin) for Dyslipidemia
Study Type
Interventional

2. Study Status

Record Verification Date
January 2012
Overall Recruitment Status
Completed
Study Start Date
November 2010 (undefined)
Primary Completion Date
August 2011 (Actual)
Study Completion Date
August 2011 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Radiant Research

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The present study will assess the low-density lipoprotein cholesterol (LDL-C) lowering effect of colesevelam as an adjunct to niacin for the improvement of lipids and glycemic control in dyslipidemic subjects with impaired fasting glucose.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Dyslipidemia, Hyperlipidemia, Hyperglycemia
Keywords
dyslipidemia, hyperlipidemia, hyperglycemia, impaired fasting glucose

7. Study Design

Primary Purpose
Prevention
Study Phase
Phase 4
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
140 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Title
Colesevelam
Arm Type
Experimental
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
6 tablets daily, with up to 2000 mg niacin and 325 mg aspirin daily, for 12 weeks
Intervention Type
Drug
Intervention Name(s)
Colesevelam
Other Intervention Name(s)
Welchol
Intervention Description
6 tablets (3750 mg total) daily, with up to 2000 mg niacin and 325 mg aspirin daily, for 12 weeks
Primary Outcome Measure Information:
Title
Low-density lipoprotein cholesterol (LDL-C)
Description
The primary efficacy endpoint will be the mean percent change from baseline (average of Weeks -1 and 1) to end-of-treatment (average of Weeks 10 and 12) in LDL-C. It will be measured as part of the fasting lipid panel at Visits 1, 2, 3, 7, and 8/ET (Weeks -6 to -2, -1, 1, 10 and 12/ET).
Time Frame
12 weeks
Secondary Outcome Measure Information:
Title
Fasting Plasma Glucose (FPG)
Description
The principal secondary efficacy endpoint is the mean change in FPG from baseline (average of Weeks -1 and 1) to end-of-treatment (average of Weeks 10 and 12).
Time Frame
12 weeks
Title
NMR Lipid subfractions and lipoprotein-IR score
Description
A secondary efficacy endpoint is the mean change from baseline (Week 1) to end-of-treatment(Week 12) in NMR Lipid subfractions and lipoprotein-IR score.
Time Frame
12 weeks
Title
Hemoglobin A1C (HbA1C)
Description
A secondary efficacy endpoint is the mean change from baseline (Week 1) to end-of-treatment(Week 12) in HbA1c.
Time Frame
12 weeks
Title
Fructosamine
Description
A secondary efficacy endpoint is the mean change from baseline (average of Weeks -1 and 1) to end-of-treatment (average of Weeks 10 and 12) in fructosamine.
Time Frame
12 weeks
Title
High sensitivity c-reactive protein (hs-CRP)
Description
A secondary efficacy endpoint is the mean change from baseline (average of Weeks -1 and 1) to end-of-treatment (average of Weeks 10 and 12) in hs-CRP.
Time Frame
12 weeks
Title
Niacin-related flushing
Description
Niacin-associated flushing will be measured using a visual analog scale (VAS)at Weeks 2,4,6,10 and 12.
Time Frame
12 weeks
Title
Homeostasis model assessment of insulin resistance (HOMA-IR) score
Description
A secondary efficacy endpoint is the mean change from baseline (Week 1) to end-of-treatment (Week 12) in HOMA-IR.
Time Frame
12 weeks
Title
High-density lipoprotein cholesterol (HDL-C)
Description
A secondary endpoint is the mean percent change from baseline (average of Weeks -1 and 1) to end-of-treatment (average of Weeks 10 and 12) in HDL-C.
Time Frame
12 weeks
Title
Non-high-density lipoprotein cholesterol (non-HDL-C)
Description
A secondary endpoint is the mean percent change from baseline (average of Weeks -1 and 1) to end-of-treatment (average of Weeks 10 and 12) in non-HDL-C.
Time Frame
12 weeks
Title
Total Cholesterol (TC)
Description
A secondary endpoint is the mean percent change from baseline (average of Weeks -1 and 1) to end-of-treatment (average of Weeks 10 and 12) in TC.
Time Frame
12 weeks
Title
Triglycerides (TG)
Description
A secondary endpoint is the mean percent change from baseline (average of Weeks -1 and 1) to end-of-treatment (average of Weeks 10 and 12) in TG.
Time Frame
12 weeks
Title
Fasting Insulin
Description
A secondary efficacy endpoint is the mean change from baseline (Week 1) to end-of-treatment (Week 12) in fasting insulin.
Time Frame
12 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Men and women ≥ 18 years of age. Non-HDL-C ≥100 mg/dL and ≤220 mg/dL at Visits 1 and 2. FPG ≥90 mg/dL and ≤145 mg/dL, at Visits 1 and 2. HDL-C <60 mg/dL at Visits 1 and 2, regardless of gender. Untreated dyslipidemia, or statin treatment only with equipotency to atorvastatin ≤40 mg daily for at least 12 weeks prior to Screening Visit 1 and without change or initiation prior to randomization Exclusion Criteria: Known intolerance to niacin or bile acid-sequestering drugs or aspirin. Any contraindication to a study medication (niacin, aspirin or colesevelam). History of dysphagia, swallowing disorders or intestinal motility disorders. History of pancreatitis. Fasting TG >500 mg/dL at Visits 1 and 2 Currently taking medication for diabetes mellitus, Type 1 or 2,or currently taking glucose-lowering drugs (e.g. metformin) for any other indication. Currently taking drugs that may affect glycemic and/or lipid control (e.g., beta-blockers, etc.) if started within the 12 weeks prior to Visit 1, or prior to randomization. This does not apply to dietary supplements.). Body mass index (BMI) >40 kg/m2. History of acute myocardial infarction, unstable angina, transient ischemic attacks, stroke or revascularization procedure within the 3 months prior to Visit 1 or prior to randomization. Use of prescription strength niacin, bile acid sequestrants, fibrates or omega-3 fatty acids within 8 weeks prior to Visit 1 or prior to randomization. This does not apply to dietary supplements. Unwilling to abstain, during the study, from weight-loss drugs (including over-the-counter) or weight-loss programs during the study. Current use, or intended use during the study, of cyclic hormones (e.g., oral or vaginal contraceptives and estrogen replacement therapy). Females who are pregnant, planning to be pregnant during the study period, lactating, or women of childbearing potential not using an acceptable method of contraception. Acceptable methods include intrauterine device, cervical diaphragm plus spermicide, female condom plus spermicide, or partner's use of condoms plus spermicide. Partner's vasectomy only or use of condoms or spermicide only are not considered acceptable forms of birth control. Current use, or intended use during the study of cyclosporine. Recent history (past 12 months) of illicit drug use or excessive ethanol use. Excessive ethanol use will be defined as >14 drinks per week (1 drink = 12 oz beer, 5 oz wine, or 1.5 oz hard liquor). Exposure to any investigational agent within 30 days prior to Visit 1, and prior to randomization. Individual has a condition the Investigator believes would interfere with his ability to provide informed consent, comply with study instructions, or which might confound the interpretation of the study results or put the subject at undue risk.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Michael H Davidson, MD, FACC
Organizational Affiliation
Executive Medical Director, Radiant Research
Official's Role
Principal Investigator
Facility Information:
Facility Name
Radiant Research
City
Chicago
State/Province
Illinois
Country
United States
City
Kansas City
State/Province
Kansas
Country
United States
City
Minneapolis
State/Province
Minnesota
Country
United States
City
St Louis
State/Province
Missouri
Country
United States

12. IPD Sharing Statement

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Colesevelam Treatment for Impaired Fasting Glucose During Niacin Therapy

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