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Safety & Effectiveness on Vascular Structure and Function of ACZ885 in Atherosclerosis and Either T2DM or IGT Patients

Primary Purpose

Diabetes Mellitus, Type 2, Atherosclerosis, Prediabetic State

Status
Completed
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
ACZ885
Placebo
Sponsored by
Novartis Pharmaceuticals
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Diabetes Mellitus, Type 2 focused on measuring Atherosclerosis,, Type 2 Diabetes Mellitus, T2DM,, Cardiovascular Diseases, ACZ885, impaired glucose tolerance, IGT, Canakinumab

Eligibility Criteria

18 Years - 74 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Patients with known atherosclerotic disease and documented diagnosis of T2DM for ≤ 14 years OR IGT
  • HbA1c between 6.0% and 10.0%
  • On stable statin therapy or statin intolerant
  • Patients who are eligible and able to participate in the study

Exclusion Criteria:

  • Contraindications to MRI
  • NYHA class IV Heart Failure
  • NYHA class I - III heart failure with acute exacerbation in 3 months prior to screening
  • Patients with type 1 diabetes
  • Acute infections
  • HsCRP > 30 mg/dL
  • Aortic aneurysm ≥5cm

Other protocol-defined inclusion/exclusion criteria may apply

Sites / Locations

  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site

Arms of the Study

Arm 1

Arm 2

Arm Type

Placebo Comparator

Experimental

Arm Label

Placebo

ACZ885

Arm Description

subcutaneous (SQ) monthly

150 mg SQ monthly

Outcomes

Primary Outcome Measures

Number of Participants With Adverse Events, Serious Adverse Events and Death
Participants were monitored for adverse events, serious adverse events and death throughout the study.
Change From Baseline in Aortic Distensibility
Two axial, ECG-gated, steady state free precession (SSFP) 'cine' images were acquired during breath-hold to determine aortic distensibility. The first image was obtained at the level of the right pulmonary artery through the ascending and proximal descending aorta and the second through the distal aorta below the diaphragm. Imaging of the aorta also enabled evaluation of the plaque burden and additional vascular function measures.
Change From Baseline in Plaque Burden (Aortic Vessel Wall Area and Carotid Vessel Wall Area)
For assessment of atherosclerotic plaque burden of the aorta, vessel wall images of the aorta were acquired with an ECG gated double-inversion recovery (black blood) fast spin echo sequence applied breath-holding. Using an oblique sagittal image of the aorta as a pilot, serial axial images were acquired to cover a section of the descending thoracic aorta. The midpoint of the right pulmonary artery in cross section was used as the anatomical reference for the first slice in baseline and follow-up scans. For assessment of the atherosclerotic plaque burden in the carotids, vessel wall images were acquired with an axial ECG gated PD (proton density) weighted black blood sequence. The carotid bifurcation was used as the anatomical reference for all three imaging time points (baseline, 12 weeks, 48 weeks) with axial slice planes acquired below the bifurcation region. The mean values reported here for the carotid are reported for the proximal common carotid region.

Secondary Outcome Measures

Change From Baseline in Pulse Wave Velocity and Pulse Wave Velocity Error
Utilizing the SphygmoCor Device, ECG leads placed at the carotid and femoral arteries provided the measure of the pulse wave at that particular arterial location. The distance between the two vascular beds divided by the pulse wave time shift provided a measure of the pulse wave velocity.
Change From Baseline in Plaque Composition
During the carotid MRI acquisition, in addition to the PD weighted ECG gated double inversion fast spin echo sequences T1 and T2 weighted sequences were acquired. In combination with the PD weighted images, the multi-contrast images were analyzed to determine regions of interest with contrast patterns consistent with the presence of necrotic lipid core, calcification and fibrous tissue in participants who had complex carotid plaque present in the bifurcation region.
Change From Baseline in Aortic Strain
Arterial strain was computed directly from the cine SSFP images and the change in lumen diameters over the cardiac cycle. The value was independent of pulse pressure and is unitless ratio derived from the maximum to minimum lumen diameters diastole and systole, respectively..
Change From Baseline in High Sensitivity C-reactive Protein (hsCRP)
Blood samples were collected to analyze hsCRP.
Change From Baseline in Fasting Plasma Glucose
Blood samples were collected to analyze fasting plasma glucose.
Change From Baseline in Hemoglobin A1c (HbA1c)
Blood samples were collected to analyze HbA1c.
Change From Baseline in 2 Hour Glucose Post Oral Glucose Tolerance Test (OGTT)
Blood samples were collected to analyze the 2 hour glucose post OGTT.
Change From Baseline in Beta Cell Function (HOMA-B)
Blood samples were collected to analyze beta cell function. Beta cell function was calculated by the Homeostasis Model Assessments (of beta cell function (HOMA-B) as follows: HOMA-B: The product of 20 and basal insulin (µU/mL) levels divided by the value of basal glucose (mmol/L) concentrations minus 3.5 [i.e., HOMA-B = 20*basal insulin/(basal glucose-3.5)].
Change From Baseline Insulin Resistance (HOMA-IR)
Blood samples were collected to analyze insulin resistance. Insulin resistance was calculated by the Homeostasis Model Assessments of insulin resistance (HOMA-IR)) as follows: HOMA-IR: The product of basal glucose (mmol/L) and insulin (µU/mL) levels divided by 22.5 [i.e., HOMA-IR = basal glucose*basal insulin/22.5].
Pharmacokinetics: ACZ885 Serum Concentrations
Blood samples were collected to analyze the ACZ885 serum concentrations.

Full Information

First Posted
October 15, 2009
Last Updated
June 1, 2015
Sponsor
Novartis Pharmaceuticals
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1. Study Identification

Unique Protocol Identification Number
NCT00995930
Brief Title
Safety & Effectiveness on Vascular Structure and Function of ACZ885 in Atherosclerosis and Either T2DM or IGT Patients
Official Title
A Multi-center, Randomized , Double Blind, Placebo-controlled, Study of the Safety, Tolerability, and Effects on Arterial Structure and Function of ACZ885 in Patients With Clinically Evident Atherosclerosis and Either T2DM or IGT
Study Type
Interventional

2. Study Status

Record Verification Date
June 2015
Overall Recruitment Status
Completed
Study Start Date
December 2009 (undefined)
Primary Completion Date
February 2014 (Actual)
Study Completion Date
February 2014 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Novartis Pharmaceuticals

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This study will evaluate the effect of ACZ885 on vascular function in patients with documented atherosclerotic disease and T2DM or IGT.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Diabetes Mellitus, Type 2, Atherosclerosis, Prediabetic State
Keywords
Atherosclerosis,, Type 2 Diabetes Mellitus, T2DM,, Cardiovascular Diseases, ACZ885, impaired glucose tolerance, IGT, Canakinumab

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
189 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
subcutaneous (SQ) monthly
Arm Title
ACZ885
Arm Type
Experimental
Arm Description
150 mg SQ monthly
Intervention Type
Drug
Intervention Name(s)
ACZ885
Other Intervention Name(s)
Canakinumab
Intervention Description
ACZ885 150 mg was administered subcutaneously once a month for 12 months.
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Matching placebo to ACZ885 was administered subcutaneously once a month for 12 months.
Primary Outcome Measure Information:
Title
Number of Participants With Adverse Events, Serious Adverse Events and Death
Description
Participants were monitored for adverse events, serious adverse events and death throughout the study.
Time Frame
12 months
Title
Change From Baseline in Aortic Distensibility
Description
Two axial, ECG-gated, steady state free precession (SSFP) 'cine' images were acquired during breath-hold to determine aortic distensibility. The first image was obtained at the level of the right pulmonary artery through the ascending and proximal descending aorta and the second through the distal aorta below the diaphragm. Imaging of the aorta also enabled evaluation of the plaque burden and additional vascular function measures.
Time Frame
baseline, 3 months, 12 months
Title
Change From Baseline in Plaque Burden (Aortic Vessel Wall Area and Carotid Vessel Wall Area)
Description
For assessment of atherosclerotic plaque burden of the aorta, vessel wall images of the aorta were acquired with an ECG gated double-inversion recovery (black blood) fast spin echo sequence applied breath-holding. Using an oblique sagittal image of the aorta as a pilot, serial axial images were acquired to cover a section of the descending thoracic aorta. The midpoint of the right pulmonary artery in cross section was used as the anatomical reference for the first slice in baseline and follow-up scans. For assessment of the atherosclerotic plaque burden in the carotids, vessel wall images were acquired with an axial ECG gated PD (proton density) weighted black blood sequence. The carotid bifurcation was used as the anatomical reference for all three imaging time points (baseline, 12 weeks, 48 weeks) with axial slice planes acquired below the bifurcation region. The mean values reported here for the carotid are reported for the proximal common carotid region.
Time Frame
baseline, 3 months, 12 months
Secondary Outcome Measure Information:
Title
Change From Baseline in Pulse Wave Velocity and Pulse Wave Velocity Error
Description
Utilizing the SphygmoCor Device, ECG leads placed at the carotid and femoral arteries provided the measure of the pulse wave at that particular arterial location. The distance between the two vascular beds divided by the pulse wave time shift provided a measure of the pulse wave velocity.
Time Frame
baseline, 3 months, 12 months
Title
Change From Baseline in Plaque Composition
Description
During the carotid MRI acquisition, in addition to the PD weighted ECG gated double inversion fast spin echo sequences T1 and T2 weighted sequences were acquired. In combination with the PD weighted images, the multi-contrast images were analyzed to determine regions of interest with contrast patterns consistent with the presence of necrotic lipid core, calcification and fibrous tissue in participants who had complex carotid plaque present in the bifurcation region.
Time Frame
baseline, 3 months, 12 months
Title
Change From Baseline in Aortic Strain
Description
Arterial strain was computed directly from the cine SSFP images and the change in lumen diameters over the cardiac cycle. The value was independent of pulse pressure and is unitless ratio derived from the maximum to minimum lumen diameters diastole and systole, respectively..
Time Frame
baseline, 3 months, 12 months
Title
Change From Baseline in High Sensitivity C-reactive Protein (hsCRP)
Description
Blood samples were collected to analyze hsCRP.
Time Frame
baseline, 3 months, 12 months
Title
Change From Baseline in Fasting Plasma Glucose
Description
Blood samples were collected to analyze fasting plasma glucose.
Time Frame
baseline, 3 months, 12 months
Title
Change From Baseline in Hemoglobin A1c (HbA1c)
Description
Blood samples were collected to analyze HbA1c.
Time Frame
baseline, 3 months, 12 months
Title
Change From Baseline in 2 Hour Glucose Post Oral Glucose Tolerance Test (OGTT)
Description
Blood samples were collected to analyze the 2 hour glucose post OGTT.
Time Frame
baseline, 3 months, 12 months
Title
Change From Baseline in Beta Cell Function (HOMA-B)
Description
Blood samples were collected to analyze beta cell function. Beta cell function was calculated by the Homeostasis Model Assessments (of beta cell function (HOMA-B) as follows: HOMA-B: The product of 20 and basal insulin (µU/mL) levels divided by the value of basal glucose (mmol/L) concentrations minus 3.5 [i.e., HOMA-B = 20*basal insulin/(basal glucose-3.5)].
Time Frame
baseline, 3 months, 12 months
Title
Change From Baseline Insulin Resistance (HOMA-IR)
Description
Blood samples were collected to analyze insulin resistance. Insulin resistance was calculated by the Homeostasis Model Assessments of insulin resistance (HOMA-IR)) as follows: HOMA-IR: The product of basal glucose (mmol/L) and insulin (µU/mL) levels divided by 22.5 [i.e., HOMA-IR = basal glucose*basal insulin/22.5].
Time Frame
baseline, 3 months, 12 months
Title
Pharmacokinetics: ACZ885 Serum Concentrations
Description
Blood samples were collected to analyze the ACZ885 serum concentrations.
Time Frame
pre-dose, 0.167 day post dose 1, 7 days post dose 1, 14 days post dose 1, every 30 days post each dose from doses 1 through 12, 60 days post dose 12, 90 days post dose 12

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
74 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patients with known atherosclerotic disease and documented diagnosis of T2DM for ≤ 14 years OR IGT HbA1c between 6.0% and 10.0% On stable statin therapy or statin intolerant Patients who are eligible and able to participate in the study Exclusion Criteria: Contraindications to MRI NYHA class IV Heart Failure NYHA class I - III heart failure with acute exacerbation in 3 months prior to screening Patients with type 1 diabetes Acute infections HsCRP > 30 mg/dL Aortic aneurysm ≥5cm Other protocol-defined inclusion/exclusion criteria may apply
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Novartis Pharmaceuticals
Organizational Affiliation
Novartis Pharmaceuticals
Official's Role
Study Director
Facility Information:
Facility Name
Novartis Investigative Site
City
New York
State/Province
New York
ZIP/Postal Code
10029
Country
United States
Facility Name
Novartis Investigative Site
City
Cincinnati
State/Province
Ohio
ZIP/Postal Code
45219
Country
United States
Facility Name
Novartis Investigative Site
City
Montreal
State/Province
Quebec
ZIP/Postal Code
H1T 1C8
Country
Canada
Facility Name
Novartis Investigative Site
City
Mainz
ZIP/Postal Code
55116
Country
Germany
Facility Name
Novartis Investigative Site
City
Neuss
ZIP/Postal Code
41460
Country
Germany
Facility Name
Novartis Investigative Site
City
Ulm
ZIP/Postal Code
89081
Country
Germany
Facility Name
Novartis Investigative Site
City
Jerusalem
ZIP/Postal Code
91120
Country
Israel
Facility Name
Novartis Investigative Site
City
Oxford
State/Province
UK
ZIP/Postal Code
OX2 6HE
Country
United Kingdom
Facility Name
Novartis Investigative Site
City
London
ZIP/Postal Code
EC1M 6BQ
Country
United Kingdom

12. IPD Sharing Statement

Citations:
PubMed Identifier
27737744
Citation
Choudhury RP, Birks JS, Mani V, Biasiolli L, Robson MD, L'Allier PL, Gingras MA, Alie N, McLaughlin MA, Basson CT, Schecter AD, Svensson EC, Zhang Y, Yates D, Tardif JC, Fayad ZA. Arterial Effects of Canakinumab in Patients With Atherosclerosis and Type 2 Diabetes or Glucose Intolerance. J Am Coll Cardiol. 2016 Oct 18;68(16):1769-1780. doi: 10.1016/j.jacc.2016.07.768.
Results Reference
derived

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Safety & Effectiveness on Vascular Structure and Function of ACZ885 in Atherosclerosis and Either T2DM or IGT Patients

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