Dyslipidemia of Obesity Intervention in Teens (DO IT!)
Primary Purpose
Dyslipidemia, Obesity
Status
Completed
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
Pitavastatin
Placebo
Sponsored by
About this trial
This is an interventional treatment trial for Dyslipidemia focused on measuring dyslipidemia, obesity, pitavastatin, lipids
Eligibility Criteria
Inclusion Criteria:
- Boys and girls aged 10 to 19 years (with 2-year availability for study participation)
- BMI ≥85th percentile (using CDC BMI charts)
Fasting lipid profile x2 each with all of the following:
- LDL-C <160 mg/dL and ≥90 mg/dL, and
- TG <500 mg/dL, and
- TG/HDL-C ratio ≥2.5 or HDL-C <45 mg/dL for boys or HDL-C <50 mg/dL for girls, and
- non-HDL-C ≥120 mg/dL
- Participant consent, or parental/guardian consent and participant assent
Exclusion Criteria:
- Current use of lipid lowering medication, growth hormone, systemic corticosteroids, cyclosporine, protease inhibitors, erythromycin, rifampin, colchicine, warfarin, second generation psychotropic drugs, oral isotretinoin; stable doses of stimulant or antidepressant therapy and antihypertensive medications will be accepted
- Known allergy or hypersensitivity to statin
- Patients who have had bariatric surgery or plan to have bariatric surgery during the trial
- Female who is pregnant, plans to become pregnant or is sexually active without contraception
- Uncontrolled stage 2 hypertension (systolic or diastolic blood pressure ≥95th percentile for age, sex and height percentile + 12 mmHg or ≥140/90, whichever is lower for participants <13 years of age; ≥140/90 for participants ≥13 years of age) confirmed after an appropriate evaluation
- Diabetes (type 1 or type 2) by American Diabetes Association criteria (fasting glucose ≥126 mg/dL, HbA1c ≥6.5%, random glucose ≥200 mg/dL, or 2-hour oral glucose tolerance testing glucose ≥200 mg/dL)
- Use of insulin sensitizing therapy
- Known renal insufficiency (known chronic renal disease, estimated GFR <60 mL/min/1.73m2 at screening)
- Uncontrolled thyroid disease (TSH at screening >1.5x upper limit of normal, clinical or other laboratory evidence of hypothyroidism, or thyroid hormone therapy that has not been stable for 6 weeks prior to screening)
- Proteinuria suggestive of renal disease (more than trace together with an elevated urine protein:creatinine ratio as per local lab)
- Syndromic patients or patients with neurocognitive delay precluding adherence with study drug
- Liver disease other than non-alcoholic fatty liver disease (NAFLD) either diagnosed or suggested by alanine aminotransferase (ALT) ≥ 40 U/L, or severe NAFLD indicated by ALT ≥ 200 U/L
- Unexplained persistent elevated creatine kinase (CK) level >3x upper limit of normal
- Plans to leave the geographic area before completion of the anticipated 2 years of trial participation
- Any unstable medical or emotional condition or chronic disease that would preclude following the protocol or impact valid vascular measurement
- Admits to current smoking, current alcohol consumption
Sites / Locations
- Nemours/Alfred I duPont Hospital for Children
- Children's National Health System
- Emory University School of Medicine
- Riley Hospital for Children at IU Health
- Johns Hopkins University School of Medicine
- Boston Children's Hospital
- Children's Mercy Hospital
- Washington University School of Medicine
- Cincinnati Children's Hospital Medical Center
- The Children's Hospital of Philadelphia
- Children's Hospital of Pittsburgh
- Medical University of South Carolina
- Texas Children's Hospital
- Primary Children's Hospital, University of Utah
- University of Wisconsin
- The Hospital for Sick Children
Arms of the Study
Arm 1
Arm 2
Arm Type
Active Comparator
Placebo Comparator
Arm Label
Pitavastatin
Placebo
Arm Description
Study Drug
Placebo
Outcomes
Primary Outcome Measures
the effect of pitavastatin versus placebo on vascular measures in at least 354 obese adolescents with combined dyslipidemia of obesity (CDO)
Pulse wave velocity (PWV)
Secondary Outcome Measures
the effect of pitavastatin versus placebo on vascular measures in obese adolescents with combined dyslipidemia of obesity (CDO)
carotid intima media thickness (CIMT)
the effect of pitavastatin versus placebo on vascular measures in at least 354 obese adolescents with combined dyslipidemia of obesity
carotid artery stiffness
the effect of pitavastatin versus placebo on Standard Fasting Lipid Profile (FLP)
Change in time in standard fasting lipid profile
the effect of pitavastatin versus placebo on lipid measures
Change in time in apolipoproteins
the effect of pitavastatin versus placebo on Nuclear magnetic resonance (NMR) Spectroscopy Lipoprotein Particle Assessment
Change in time in NMR Spectroscopy Lipoprotein Particle Assessment
the effect of pitavastatin versus placebo on composite outcome of Number of Participants With Abnormal Laboratory Values and/or Adverse Events
Number of abnormal (yes/no) lab values based on Liver function tests (ALT, AST); creatine kinase (CK), muscle symptoms; markers of glycemic control/development of diabetes (fasting plasma glucose, HgbA1c) and change in surrogate markers of insulin sensitivity (fasting insulin, C-peptide, Homeostatic model assessment Insulin resistance (HOMA-IR), 1/insulin, QUICKI); height velocity (change in height z score) and adverse events
the effect of pitavastatin versus placebo on prevalence of adverse events.
Number of adverse events and other subject-reported symptoms (including neurocognitive and depressive symptoms).
the effect of pitavastatin versus placebo on prevalence of abnormal Liver function tests (ALT, AST)
Number of abnormal (yes/no) lab values based on Liver function tests (ALT, AST)
the effect of pitavastatin versus placebo on prevalence of abnormal creatinine kinase (CK) tests
Number of abnormal (yes/no) lab values based on creatinine kinase (CK) tests
the effect of pitavastatin versus placebo on composite outcome of markers of glycemic control/development of diabetes
Number of abnormal (yes/no) lab values based on markers of glycemic control/development of diabetes (fasting plasma glucose, HgbA1c)
the effect of pitavastatin versus placebo on composite outcome of abnormal change in surrogate markers of insulin sensitivity
Number of abnormal (yes/no) lab values based on change in surrogate markers of insulin sensitivity (fasting insulin, C-peptide, HOMA-IR)
the effect of pitavastatin versus placebo on prevalence of abnormal changes in height
Number of abnormal (yes/no) values based on change in height in time
Full Information
NCT ID
NCT02956590
First Posted
October 21, 2016
Last Updated
June 28, 2023
Sponsor
Carelon Research
Collaborators
National Heart, Lung, and Blood Institute (NHLBI)
1. Study Identification
Unique Protocol Identification Number
NCT02956590
Brief Title
Dyslipidemia of Obesity Intervention in Teens
Acronym
DO IT!
Official Title
Dyslipidemia of Obesity Intervention in Teens Trial
Study Type
Interventional
2. Study Status
Record Verification Date
June 2023
Overall Recruitment Status
Completed
Study Start Date
May 1, 2018 (Actual)
Primary Completion Date
April 21, 2023 (Actual)
Study Completion Date
April 21, 2023 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Carelon Research
Collaborators
National Heart, Lung, and Blood Institute (NHLBI)
4. Oversight
Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
This trial of pitavastatin will determine efficacy and safety in this high risk population and provide evidence for clinicians to target this treatable risk factor to achieve an impact on early atherosclerosis, and potentially achieve primary prevention of adult cardiovascular disease.
Detailed Description
Randomized, double-blind, placebo-controlled clinical trial of pitavastatin for 2 years comparing the effect of study drug versus placebo on vascular measures in at least 354 adolescents with excess adiposity and CDO (defined as high non-HDL-C + high triglycerides (TG)/HDL-C ratio or low HDL-C). Enrollment will take place over 36 months.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Dyslipidemia, Obesity
Keywords
dyslipidemia, obesity, pitavastatin, lipids
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
122 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Pitavastatin
Arm Type
Active Comparator
Arm Description
Study Drug
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Placebo
Intervention Type
Drug
Intervention Name(s)
Pitavastatin
Other Intervention Name(s)
Livalo
Intervention Description
Statin
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Placebo
Primary Outcome Measure Information:
Title
the effect of pitavastatin versus placebo on vascular measures in at least 354 obese adolescents with combined dyslipidemia of obesity (CDO)
Description
Pulse wave velocity (PWV)
Time Frame
2 years
Secondary Outcome Measure Information:
Title
the effect of pitavastatin versus placebo on vascular measures in obese adolescents with combined dyslipidemia of obesity (CDO)
Description
carotid intima media thickness (CIMT)
Time Frame
2 years
Title
the effect of pitavastatin versus placebo on vascular measures in at least 354 obese adolescents with combined dyslipidemia of obesity
Description
carotid artery stiffness
Time Frame
2 years
Title
the effect of pitavastatin versus placebo on Standard Fasting Lipid Profile (FLP)
Description
Change in time in standard fasting lipid profile
Time Frame
2 years
Title
the effect of pitavastatin versus placebo on lipid measures
Description
Change in time in apolipoproteins
Time Frame
2 years
Title
the effect of pitavastatin versus placebo on Nuclear magnetic resonance (NMR) Spectroscopy Lipoprotein Particle Assessment
Description
Change in time in NMR Spectroscopy Lipoprotein Particle Assessment
Time Frame
2 years
Title
the effect of pitavastatin versus placebo on composite outcome of Number of Participants With Abnormal Laboratory Values and/or Adverse Events
Description
Number of abnormal (yes/no) lab values based on Liver function tests (ALT, AST); creatine kinase (CK), muscle symptoms; markers of glycemic control/development of diabetes (fasting plasma glucose, HgbA1c) and change in surrogate markers of insulin sensitivity (fasting insulin, C-peptide, Homeostatic model assessment Insulin resistance (HOMA-IR), 1/insulin, QUICKI); height velocity (change in height z score) and adverse events
Time Frame
2 years
Title
the effect of pitavastatin versus placebo on prevalence of adverse events.
Description
Number of adverse events and other subject-reported symptoms (including neurocognitive and depressive symptoms).
Time Frame
2 years
Title
the effect of pitavastatin versus placebo on prevalence of abnormal Liver function tests (ALT, AST)
Description
Number of abnormal (yes/no) lab values based on Liver function tests (ALT, AST)
Time Frame
2 years
Title
the effect of pitavastatin versus placebo on prevalence of abnormal creatinine kinase (CK) tests
Description
Number of abnormal (yes/no) lab values based on creatinine kinase (CK) tests
Time Frame
2 years
Title
the effect of pitavastatin versus placebo on composite outcome of markers of glycemic control/development of diabetes
Description
Number of abnormal (yes/no) lab values based on markers of glycemic control/development of diabetes (fasting plasma glucose, HgbA1c)
Time Frame
2 years
Title
the effect of pitavastatin versus placebo on composite outcome of abnormal change in surrogate markers of insulin sensitivity
Description
Number of abnormal (yes/no) lab values based on change in surrogate markers of insulin sensitivity (fasting insulin, C-peptide, HOMA-IR)
Time Frame
2 years
Title
the effect of pitavastatin versus placebo on prevalence of abnormal changes in height
Description
Number of abnormal (yes/no) values based on change in height in time
Time Frame
2 years
10. Eligibility
Sex
All
Minimum Age & Unit of Time
10 Years
Maximum Age & Unit of Time
19 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Boys and girls aged 10 to 19 years (with 2-year availability for study participation)
BMI ≥85th percentile (using Centers for Disease Control (CDC) BMI charts)
Fasting lipid profile x2 each with all of the following:
LDL-C <160 mg/dL and ≥90 mg/dL, and
TG (triglycerides) <500 mg/dL, and
TG/HDL-C ratio ≥2.5 or HDL-C <45 mg/dL for boys or HDL-C <50 mg/dL for girls, and
non-HDL-C ≥120 mg/dL
Participant consent, or parental/guardian consent and participant assent
Exclusion Criteria:
Current use of lipid lowering medication, growth hormone, systemic corticosteroids, cyclosporine, protease inhibitors, erythromycin, rifampin, colchicine, warfarin, second generation psychotropic drugs, oral isotretinoin; stable doses of stimulant or antidepressant therapy and antihypertensive medications will be accepted
Known allergy or hypersensitivity to statin
Patients who have had bariatric surgery or plan to have bariatric surgery during the trial
Female who is pregnant, plans to become pregnant or is sexually active without contraception
Uncontrolled stage 2 hypertension (systolic or diastolic blood pressure ≥95th percentile for age, sex and height percentile + 12 mmHg or ≥140/90, whichever is lower for participants <13 years of age; ≥140/90 for participants ≥13 years of age) confirmed after an appropriate evaluation
Diabetes (type 1 or type 2) by American Diabetes Association criteria (fasting glucose ≥126 mg/dL, HbA1c ≥6.5%, random glucose ≥200 mg/dL, or 2-hour oral glucose tolerance testing glucose ≥200 mg/dL)
Use of insulin sensitizing therapy
Known renal insufficiency (known chronic renal disease, estimated glomerular filtration rate (GFR) <60 mL/min/1.73m2 at screening)
Uncontrolled thyroid disease (TSH at screening >1.5x upper limit of normal, clinical or other laboratory evidence of hypothyroidism, or thyroid hormone therapy that has not been stable for 6 weeks prior to screening)
Proteinuria suggestive of renal disease (more than trace together with an elevated urine protein:creatinine ratio as per local lab)
Syndromic patients or patients with neurocognitive delay precluding adherence with study drug
Liver disease other than non-alcoholic fatty liver disease (NAFLD) either diagnosed or suggested by alanine aminotransferase (ALT) ≥ 40 U/L, or severe NAFLD indicated by ALT ≥ 200 U/L
Unexplained persistent elevated creatine kinase (CK) level >3x upper limit of normal
Plans to leave the geographic area before completion of the anticipated 2 years of trial participation
Any unstable medical or emotional condition or chronic disease that would preclude following the protocol or impact valid vascular measurement
Admits to current smoking, current alcohol consumption
Facility Information:
Facility Name
Nemours/Alfred I duPont Hospital for Children
City
Wilmington
State/Province
Delaware
ZIP/Postal Code
19803
Country
United States
Facility Name
Children's National Health System
City
Washington
State/Province
District of Columbia
ZIP/Postal Code
20010
Country
United States
Facility Name
Emory University School of Medicine
City
Atlanta
State/Province
Georgia
ZIP/Postal Code
30322
Country
United States
Facility Name
Riley Hospital for Children at IU Health
City
Indianapolis
State/Province
Indiana
ZIP/Postal Code
46202
Country
United States
Facility Name
Johns Hopkins University School of Medicine
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21287
Country
United States
Facility Name
Boston Children's Hospital
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02114
Country
United States
Facility Name
Children's Mercy Hospital
City
Kansas City
State/Province
Missouri
ZIP/Postal Code
64108
Country
United States
Facility Name
Washington University School of Medicine
City
Saint Louis
State/Province
Missouri
ZIP/Postal Code
63110
Country
United States
Facility Name
Cincinnati Children's Hospital Medical Center
City
Cincinnati
State/Province
Ohio
ZIP/Postal Code
45229
Country
United States
Facility Name
The Children's Hospital of Philadelphia
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19104
Country
United States
Facility Name
Children's Hospital of Pittsburgh
City
Pittsburgh
State/Province
Pennsylvania
ZIP/Postal Code
15224
Country
United States
Facility Name
Medical University of South Carolina
City
Charleston
State/Province
South Carolina
ZIP/Postal Code
29425
Country
United States
Facility Name
Texas Children's Hospital
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States
Facility Name
Primary Children's Hospital, University of Utah
City
Salt Lake City
State/Province
Utah
ZIP/Postal Code
84108
Country
United States
Facility Name
University of Wisconsin
City
Madison
State/Province
Wisconsin
ZIP/Postal Code
53792
Country
United States
Facility Name
The Hospital for Sick Children
City
Toronto
State/Province
Ontario
ZIP/Postal Code
M5g 1X8
Country
Canada
12. IPD Sharing Statement
Learn more about this trial
Dyslipidemia of Obesity Intervention in Teens
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