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Metabolic Effects of Hydroxychloroquine (MetaHcQ)

Primary Purpose

Type 2 Diabetes Mellitus

Status
Suspended
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Hydroxychloroquine
Hydroxychloroquine Placebo
Sponsored by
Washington University School of Medicine
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional other trial for Type 2 Diabetes Mellitus focused on measuring Type 2 Diabetes, Overweight

Eligibility Criteria

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

Inclusion Criteria:

  • Subjects between the age of 18 and 75, either gender, any ethnic group
  • Subjects must have type 2 diabetes and the following:
  • A1c of 6.5-9.0%
  • Treated with at least 1000 mg of metformin daily with or without a dipeptidyl peptidase-4(DPP4)inhibitor, a sulfonylurea (glipizide, glyburide, glimepiride),bromocriptine or colesevelam.
  • Subjects should have a BMI >27

Exclusion Criteria:

  • Prior treatment with chloroquine or hydroxychloroquine as follows:

    1. any exposure in the past 2 years,
    2. >30 days of therapy if exposure was between 2 and 5 years ago,
    3. >90 days of therapy if exposure was between 5 and 10 years ago,
    4. >6 months of therapy if exposure was 10 to 20 years ago,
    5. >1 year of therapy if exposure was 20 to 30 years ago,
    6. No limit if last exposure was >30 years ago, e.g. during the Vietnam conflict.
  • Morbid obesity (BMI >45)
  • Coronary artery disease or other vascular disease
  • History of stroke
  • Serum creatinine >-4 mg/dl for women and >-5 mg/dl for men.
  • Seizure disorder
  • History of psoriasis
  • Hematologic disorders, including anemia (WHO criteria for anemia:hemoglobin <13g/dL in men and <12 g/dL in women)
  • Current malignancy or active treatment for recurrence prevention,e.g. tamoxifen. Cancer considered to be cured, either as a result of surgery or other treatment is not exclusionary.
  • Asthma requiring daily beta agonist therapy or intermittent oral steroids is exclusionary. Inhaled steroids are acceptable. Obstructive sleep apnea will be allowed if continuous positive airway pressure(CPAP) or other therapy has been stable for 6 months. Other active respiratory diseases are excluded.
  • Treatment with 50mg or greater of Metoprolol or treatment with digoxin
  • Liver disease, or Liver Function Test >2 times normal
  • Active infection (including HIV)
  • Serious illness requiring ongoing medical care or medication
  • Treatment with atypical anti-psychotic medication. Treatment with any other medication for psychiatric illness, unless on a stable dose for 6 weeks prior to enrollment. Patients with unstable psychiatric disorders are excluded per the decision of the study MD regardless of medication history.
  • Taking any of the following lipid lowering medications: niacin, fibrates, and greater than 1 gm/day of fish oils
  • Uncontrolled hypertension (BP >150/90 mm Hg) at enrollment
  • Need for daily Over The Counter medications, or currently taking cimetidine or >1000 IU vitamin E daily and unwilling to reduce or discontinue vitamin E or discontinue cimetidine for the duration of the study. Patients taking more than 1000 IU vitamin E daily should reduce or discontinue the vitamin for 30 days before randomization.
  • Pregnant or lactating women, or women intending to become pregnant
  • Women not using adequate birth control (hormonal birth control is acceptable, also double barrier)
  • QT corrected >450 msec on screening ECG
  • Glucose-6-phosphate dehydrogenase (G6PD) deficiency

Sites / Locations

  • Washington University

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Placebo Comparator

Arm Label

hydroxychloroquine

Placebo

Arm Description

hydroxychloroquine twice daily for 4 weeks

hydroxychloroquine placebo twice daily for 4 weeks

Outcomes

Primary Outcome Measures

Insulin sensitivity
determined by hyperinsulinemic euglycemic clamp

Secondary Outcome Measures

Effect of HCQ on fasting blood glucose
determined by fasting blood glucose performed at baseline and follow-up
Effect of HCQ on fasting low density lipoprotein
determined by lipid profile with calculated LDL performed at baseline and follow-up
Effect of HcQ on serum biomarkers of inflammation
determined by biomarker testing performed at baseline and follow-up

Full Information

First Posted
December 24, 2013
Last Updated
June 15, 2022
Sponsor
Washington University School of Medicine
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1. Study Identification

Unique Protocol Identification Number
NCT02026232
Brief Title
Metabolic Effects of Hydroxychloroquine
Acronym
MetaHcQ
Official Title
Metabolic Effects of Hydroxychloroquine
Study Type
Interventional

2. Study Status

Record Verification Date
June 2022
Overall Recruitment Status
Suspended
Why Stopped
COVID-19
Study Start Date
March 2012 (undefined)
Primary Completion Date
December 2022 (Anticipated)
Study Completion Date
December 2022 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Washington University School of Medicine

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The basic plan of the study is to randomize otherwise healthy subjects with type 2 diabetes to hydroxychloroquine, 200 mg twice daily or placebo.
Detailed Description
Hydroxychloroquine is a medicine that has been used for a long time to treat patients with malaria, rheumatoid arthritis, lupus and other conditions. It is closely related to chloroquine but with a better side effect profile for long term use. In treating these conditions it was discovered to have some beneficial properties like lowering cholesterol and lowering sugar in the blood of those who have diabetes. The mechanisms underlying these effects are unknown. In animal studies, we have discovered that chloroquine appears to decrease glucose, lower blood pressure and decrease atherosclerosis (hardening of the arteries). This collection of problems commonly occurs in the metabolic syndrome and diabetes mellitus, which affects over 20% and 7% of adults in Western countries respectively. We have recently looked at the effects of chloroquine on the metabolic syndrome in humans which showed that small doses given for a short period of time would reduce insulin resistance in patients with the metabolic syndrome. Several population studies have shown similar effects with hydroxychloroquine. Since hydroxychloroquine is similar to chloroquine, we thus expect similar effects on blood glucose, blood pressure and blood cholesterol in type 2 diabetes. This offers a unique opportunity to develop a novel approach for lowering blood pressure, lipids (cholesterol and triglycerides), and glucose in people at risk for heart disease

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Type 2 Diabetes Mellitus
Keywords
Type 2 Diabetes, Overweight

7. Study Design

Primary Purpose
Other
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigator
Allocation
Randomized
Enrollment
30 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
hydroxychloroquine
Arm Type
Active Comparator
Arm Description
hydroxychloroquine twice daily for 4 weeks
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
hydroxychloroquine placebo twice daily for 4 weeks
Intervention Type
Drug
Intervention Name(s)
Hydroxychloroquine
Other Intervention Name(s)
Plaquenil, Quineprox
Intervention Description
200mg twice daily
Intervention Type
Other
Intervention Name(s)
Hydroxychloroquine Placebo
Other Intervention Name(s)
placebo
Intervention Description
200mg placebo twice daily
Primary Outcome Measure Information:
Title
Insulin sensitivity
Description
determined by hyperinsulinemic euglycemic clamp
Time Frame
4 weeks
Secondary Outcome Measure Information:
Title
Effect of HCQ on fasting blood glucose
Description
determined by fasting blood glucose performed at baseline and follow-up
Time Frame
4 weeks
Title
Effect of HCQ on fasting low density lipoprotein
Description
determined by lipid profile with calculated LDL performed at baseline and follow-up
Time Frame
4 weeks
Title
Effect of HcQ on serum biomarkers of inflammation
Description
determined by biomarker testing performed at baseline and follow-up
Time Frame
4 weeks

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: Subjects between the age of 18 and 75, either gender, any ethnic group Subjects must have type 2 diabetes and the following: A1c of 6.5-9.0% Treated with at least 1000 mg of metformin daily with or without a dipeptidyl peptidase-4(DPP4)inhibitor, a sulfonylurea (glipizide, glyburide, glimepiride),bromocriptine or colesevelam. Subjects should have a BMI >27 Exclusion Criteria: Prior treatment with chloroquine or hydroxychloroquine as follows: any exposure in the past 2 years, >30 days of therapy if exposure was between 2 and 5 years ago, >90 days of therapy if exposure was between 5 and 10 years ago, >6 months of therapy if exposure was 10 to 20 years ago, >1 year of therapy if exposure was 20 to 30 years ago, No limit if last exposure was >30 years ago, e.g. during the Vietnam conflict. Morbid obesity (BMI >45) Coronary artery disease or other vascular disease History of stroke Serum creatinine >-4 mg/dl for women and >-5 mg/dl for men. Seizure disorder History of psoriasis Hematologic disorders, including anemia (WHO criteria for anemia:hemoglobin <13g/dL in men and <12 g/dL in women) Current malignancy or active treatment for recurrence prevention,e.g. tamoxifen. Cancer considered to be cured, either as a result of surgery or other treatment is not exclusionary. Asthma requiring daily beta agonist therapy or intermittent oral steroids is exclusionary. Inhaled steroids are acceptable. Obstructive sleep apnea will be allowed if continuous positive airway pressure(CPAP) or other therapy has been stable for 6 months. Other active respiratory diseases are excluded. Treatment with 50mg or greater of Metoprolol or treatment with digoxin Liver disease, or Liver Function Test >2 times normal Active infection (including HIV) Serious illness requiring ongoing medical care or medication Treatment with atypical anti-psychotic medication. Treatment with any other medication for psychiatric illness, unless on a stable dose for 6 weeks prior to enrollment. Patients with unstable psychiatric disorders are excluded per the decision of the study MD regardless of medication history. Taking any of the following lipid lowering medications: niacin, fibrates, and greater than 1 gm/day of fish oils Uncontrolled hypertension (BP >150/90 mm Hg) at enrollment Need for daily Over The Counter medications, or currently taking cimetidine or >1000 IU vitamin E daily and unwilling to reduce or discontinue vitamin E or discontinue cimetidine for the duration of the study. Patients taking more than 1000 IU vitamin E daily should reduce or discontinue the vitamin for 30 days before randomization. Pregnant or lactating women, or women intending to become pregnant Women not using adequate birth control (hormonal birth control is acceptable, also double barrier) QT corrected >450 msec on screening ECG Glucose-6-phosphate dehydrogenase (G6PD) deficiency
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Clay F. Semenkovich, M.D.
Organizational Affiliation
Washington University School of Medicine
Official's Role
Principal Investigator
Facility Information:
Facility Name
Washington University
City
Saint Louis
State/Province
Missouri
ZIP/Postal Code
63110
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
Undecided
Citations:
PubMed Identifier
21366474
Citation
Rao Kondapally Seshasai S, Kaptoge S, Thompson A, Di Angelantonio E, Gao P, Sarwar N, Whincup PH, Mukamal KJ, Gillum RF, Holme I, Njolstad I, Fletcher A, Nilsson P, Lewington S, Collins R, Gudnason V, Thompson SG, Sattar N, Selvin E, Hu FB, Danesh J; Emerging Risk Factors Collaboration. Diabetes mellitus, fasting glucose, and risk of cause-specific death. N Engl J Med. 2011 Mar 3;364(9):829-841. doi: 10.1056/NEJMoa1008862. Erratum In: N Engl J Med. 2011 Mar 31;364(13):1281.
Results Reference
background
PubMed Identifier
18378618
Citation
Schramm TK, Gislason GH, Kober L, Rasmussen S, Rasmussen JN, Abildstrom SZ, Hansen ML, Folke F, Buch P, Madsen M, Vaag A, Torp-Pedersen C. Diabetes patients requiring glucose-lowering therapy and nondiabetics with a prior myocardial infarction carry the same cardiovascular risk: a population study of 3.3 million people. Circulation. 2008 Apr 15;117(15):1945-54. doi: 10.1161/CIRCULATIONAHA.107.720847. Epub 2008 Mar 31.
Results Reference
background
PubMed Identifier
17084711
Citation
Schneider JG, Finck BN, Ren J, Standley KN, Takagi M, Maclean KH, Bernal-Mizrachi C, Muslin AJ, Kastan MB, Semenkovich CF. ATM-dependent suppression of stress signaling reduces vascular disease in metabolic syndrome. Cell Metab. 2006 Nov;4(5):377-89. doi: 10.1016/j.cmet.2006.10.002.
Results Reference
background
PubMed Identifier
21292109
Citation
Marmor MF, Kellner U, Lai TY, Lyons JS, Mieler WF; American Academy of Ophthalmology. Revised recommendations on screening for chloroquine and hydroxychloroquine retinopathy. Ophthalmology. 2011 Feb;118(2):415-22. doi: 10.1016/j.ophtha.2010.11.017.
Results Reference
background
PubMed Identifier
11085839
Citation
Su Y, Swift M. Mortality rates among carriers of ataxia-telangiectasia mutant alleles. Ann Intern Med. 2000 Nov 21;133(10):770-8. doi: 10.7326/0003-4819-133-10-200011210-00009.
Results Reference
background
PubMed Identifier
20208057
Citation
Razani B, Feng C, Semenkovich CF. p53 is required for chloroquine-induced atheroprotection but not insulin sensitization. J Lipid Res. 2010 Jul;51(7):1738-46. doi: 10.1194/jlr.M003681. Epub 2010 Mar 5.
Results Reference
background
Links:
URL
https://rpr.wustl.edu/
Description
Washington University Research Patient Registry
URL
http://endo.wustl.edu/clay-f-semenkovich-m-d/
Description
Clay F. Semenkovich, M.D.

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Metabolic Effects of Hydroxychloroquine

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