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The Efficacy and Safety of Combined Therapy With Red Yeast Rice and Low-dose Statin:Comparing With Standardized Statin

Primary Purpose

Dyslipidemia, Atherosclerosis

Status
Unknown status
Phase
Phase 3
Locations
China
Study Type
Interventional
Intervention
Red yeast rice and atorvastatin
Atorvastatin alone
Sponsored by
Wenzhou Medical University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Dyslipidemia focused on measuring Red yeast rice, Atorvastatin, Mild cardiovascular disease

Eligibility Criteria

20 Years - 80 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Patients with established mild atherosclerotic cardiovascular disease, defined as coronary and/or carotid and/or peripheral artery lesions <40% lumen diameter stenosis, diagnosed by coronary angiography and carotid and/or peripheral artery ultrasound respectively, together with LDL cholesterol level > 70 mg/dL (1.80 mmol/L).
  2. Female patients must be postmenopausal as defined by no menstruation for at least 12 months, or surgically sterilized for at least three months prior to beginning the study, or have a negative pregnancy test and agree to avoid pregnancy during the study and one month after the end of the study by using two reliable methods of contraception.
  3. Patients must have been informed of all aspects of the study and signed an informed consent form before any study-related activities.
  4. Patients must be willing and able to comply with scheduled visits, treatment plan, laboratory tests, and other study procedures.

Exclusion Criteria:

Patients who have met all the above inclusion criteria will be screened for the following exclusion criteria.

  1. Patients who have been taken lipid-lowering medications including statins or red yeast rice products during the 4 weeks prior to the screening visit.
  2. Documented history of myocardial infarction (MI), unstable angina leading to hospitalization, uncontrolled cardiac arrhythmia, percutaneous coronary intervention (PCI) or coronary artery bypass graft surgery (CABG), carotid surgery or stenting, cerebrovascular accident, transient ischemic attack, endovascular procedure or surgical intervention for peripheral vascular disease.
  3. Planned to undergo scheduled PCI, CABG, carotid or peripheral revascularization during the study.
  4. History of New York Heart Association Class III or IV heart failure within the past 12 months.
  5. Known history of hemorrhagic stroke.
  6. Patients with uncontrolled hypertension at the screening visit. Patients on stable antihypertensive medication may be enrolled provided that the medications and dosage remain stable throughout the study.
  7. Cardiovascular surgery or major operations within 6 months prior to screening visit.
  8. Patients who are taking anticoagulants except aspirin at < 325 mg/day.
  9. Patients with liver dysfunction as indicated by a serum alanine aminotransferase (ALT) or serum aspartate aminotransferase (AST) level of > 1.5-times of upper limit of normal (ULN) range, or clinical symptoms.
  10. Patients with elevated creatine phosphokinase level (above Upper Limit of Normal range).
  11. Patients with renal dysfunction as indicated by a serum creatinine level above ULN range, or clinical symptoms.
  12. Patients with gastric or peptic ulcer within 3 months prior to screening visit.
  13. Patients with medical history of hypothyroidism, pancreatitis, cholestasis, nephrotic syndrome, gall bladder disease, or primary biliary cirrhosis. Patients on thyroid replacement therapy at stable doses may be enrolled if clinically euthyroid.
  14. Patients with clinically relevant illness within 4 weeks prior to screening visit that may interfere with the conduct of this study.
  15. Patients with a history of alcohol or narcotic substance abuse within two years prior to screening visit.
  16. Patients with hypersensitivity to lipid-lowering agents.
  17. Patients who have taken another investigational drug within 4 weeks prior to screening visit.
  18. Patients with uncontrolled metabolic or endocrine disease knowing to influence lipid values.
  19. Patients who are known to be HIV positive.
  20. Patients who have a history or presence of active malignancy (other than non-melanoma skin cancer) or clinically significant psychiatric, neurological, respiratory, hematological, or other conditions that in the opinion of investigators might interfere with or contraindicate participation of the patients in this study.

Sites / Locations

  • The Second Hispital of Wenzhou Medical UniversityRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

Red yeast rice and atorvastatin

Atorvastatin alone

Arm Description

Participants will receive 4 identically appearing capsules twice daily for 24 weeks: 2 300mg of red yeast rice and 2 10mg of atorvastatin.

Participants will receive 4 identically appearing capsules twice daily for 24 weeks: 2 placebo and 2 10mg of atorvastatin.

Outcomes

Primary Outcome Measures

Mean percentage change from baseline at week 24 (or the last assessment) on serum low-density lipoprotein cholesterol (LDL-C) level

Secondary Outcome Measures

Mean percentage change from baseline at week 24 (or the last assessment on serum total cholesterol (TC) level
Mean percentage change from baseline at week 24 (or the last assessment) on serum high-density lipoprotein cholesterol (HDL-C) level
Mean percentage change from baseline at week 24 (or the last assessment) on serum triglyceride (TG) level
Mean percentage change from baseline at week 24 (or the last assessment) on serum non-HDL cholesterol level
Percentage of Participants Who Experienced Statin-associated muscle symptoms (SAMs)
SAMs included all muscle-related complaints (e.g. pain, weakness, or cramps). Reported events are muscle-related complaints confirmed by an independent Clinical Events Committee (CEC) according to the nature of the muscle symptoms, the elevation in creatine kinase (CK) levels and their temporal association with statin initiation, discontinuation, and re-challenge.

Full Information

First Posted
March 29, 2016
Last Updated
July 19, 2021
Sponsor
Wenzhou Medical University
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1. Study Identification

Unique Protocol Identification Number
NCT02726555
Brief Title
The Efficacy and Safety of Combined Therapy With Red Yeast Rice and Low-dose Statin:Comparing With Standardized Statin
Official Title
Comparison Between Combined Therapy With Red Yeast Rice and Low-dose Statin and Standardized Statin: a Single-center, Non-inferiority, Randomized Clinical Trial
Study Type
Interventional

2. Study Status

Record Verification Date
July 2021
Overall Recruitment Status
Unknown status
Study Start Date
November 2015 (Actual)
Primary Completion Date
May 2022 (Anticipated)
Study Completion Date
May 2022 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Wenzhou Medical University

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
Double-dose statin regimen achieves merely 6% of decrease in low-density lipoprotein cholesterol (LDL-C) levels, whereas the risk of side effects increased largely. The investigators' previous pilot study (NCT01686451) has suggested that red yeast rice was of similar lipid-lowering efficacy while was associated with less fatigue than statins. The purpose of this study is to evaluate the efficacy and safety of combined therapy with red yeast rice and low-dose atorvastatin in persons with mild atherosclerotic cardiovascular disease and who qualified for statin therapy according to national guidelines.
Detailed Description
Both Red Yeast Rice and Statins are cholesterol-lowering medications are often prescribed for secondary prevention of cardiovascular disease (CVD). The investigators' previous pilot study (NCT01686451) has suggested that red yeast rice was of similar lipid-lowering efficacy while was associated with less fatigue than statins. The aim of this study is to compare the efficacy and safety of combined therapy with red yeast rice at 1.2 g/day and atorvastatin at 10 mg/day with atorvastatin at 20 mg/day in persons with mild atherosclerotic cardiovascular disease and who qualified for statin therapy according to national guidelines. This study will enroll individuals with established mild atherosclerotic cardiovascular disease and who do not currently take lipid-lowering medications. Participants will be randomly assigned to receive combined therapy with red yeast rice at 1.2 g/day and atorvastatin at 10 mg/day or atorvastatin at 20 mg/day for 24 weeks. Study visits will occur at screening, baseline, week 4, week 8, week 16, and week 24. Blood will be collected for laboratory testing, and standardized questionnaires will assess noncardiovascular endpoints. Pill count will be used to assess adherence of treatment. Medication side effects will be monitored and tests of alanine aminotransferase (ALT), aspartate aminotransaminase (AST) and creatine phosphate kinase (CPK) will be performed. Medication efficacy will be assessed and test of low-density lipoprotein cholesterol (LDL-C) will be performed.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Dyslipidemia, Atherosclerosis
Keywords
Red yeast rice, Atorvastatin, Mild cardiovascular disease

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantOutcomes Assessor
Allocation
Randomized
Enrollment
240 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Red yeast rice and atorvastatin
Arm Type
Experimental
Arm Description
Participants will receive 4 identically appearing capsules twice daily for 24 weeks: 2 300mg of red yeast rice and 2 10mg of atorvastatin.
Arm Title
Atorvastatin alone
Arm Type
Active Comparator
Arm Description
Participants will receive 4 identically appearing capsules twice daily for 24 weeks: 2 placebo and 2 10mg of atorvastatin.
Intervention Type
Drug
Intervention Name(s)
Red yeast rice and atorvastatin
Other Intervention Name(s)
Xuezhikang; Lipitor
Intervention Description
Participants will receive 2 capsules of 300mg red yeast rice and 2 capsules of 10mg atorvastatin for 24 weeks.
Intervention Type
Drug
Intervention Name(s)
Atorvastatin alone
Other Intervention Name(s)
Lipitor
Intervention Description
Participants will receive 2 capsules of placebo and 2 capsules of 10mg atorvastatin for 24 weeks.
Primary Outcome Measure Information:
Title
Mean percentage change from baseline at week 24 (or the last assessment) on serum low-density lipoprotein cholesterol (LDL-C) level
Time Frame
Measured at screening, baseline, week 4, week 8, week 16, and week 24
Secondary Outcome Measure Information:
Title
Mean percentage change from baseline at week 24 (or the last assessment on serum total cholesterol (TC) level
Time Frame
Measured at screening, baseline, week 4, week 8, week 16, and week 24
Title
Mean percentage change from baseline at week 24 (or the last assessment) on serum high-density lipoprotein cholesterol (HDL-C) level
Time Frame
Measured at screening, baseline, week 4, week 8, week 16, and week 24
Title
Mean percentage change from baseline at week 24 (or the last assessment) on serum triglyceride (TG) level
Time Frame
Measured at screening, baseline, week 4, week 8, week 16, and week 24
Title
Mean percentage change from baseline at week 24 (or the last assessment) on serum non-HDL cholesterol level
Time Frame
Measured at screening, baseline, week 4, week 8, week 16, and week 24
Title
Percentage of Participants Who Experienced Statin-associated muscle symptoms (SAMs)
Description
SAMs included all muscle-related complaints (e.g. pain, weakness, or cramps). Reported events are muscle-related complaints confirmed by an independent Clinical Events Committee (CEC) according to the nature of the muscle symptoms, the elevation in creatine kinase (CK) levels and their temporal association with statin initiation, discontinuation, and re-challenge.
Time Frame
Measured at week 4, week 8, week 16, and week 24
Other Pre-specified Outcome Measures:
Title
Mean percentage change from baseline at week 24 (or the last assessment) on serum fasting blood glucose level
Time Frame
Measured at baseline, week 4, week 8, week 16, and week 24
Title
Mean percentage change from baseline at week 24 (or the last assessment) on serum glycosylated hemoglobin level
Time Frame
Measured at baseline, week 4, week 8, week 16, and week 24
Title
Mean percentage change from baseline at week 24 (or the last assessment) on Physical Activity Level
Description
Physical activity level will be estimated by short version of international physical activity questionnaire (IPAQ).
Time Frame
Measured at baseline, week 4, week 8, week 16, and week 24
Title
Mean percentage change from baseline at week 24 (or the last assessment) on fatigue scores
Description
Fatigue score is self-rated, ranging from 0-10. For the severity scale, 0=not present, 10=most severe.
Time Frame
Measured at baseline, week 4, week 8, week 16, and week 24
Title
Mean percentage change from baseline at week 24 (or the last assessment) on Memory problems score
Description
Memory problems score is self-rated, ranging from 0-10. For the severity scale, 0=not present, 10=most severe.
Time Frame
Measured at baseline, week 4, week 8, week 16, and week 24
Title
Mean percentage change from baseline at week 24 (or the last assessment) on Attention/concentration problems score
Description
Attention/concentration problems score is self-rated, ranging from 0-10. For the severity scale, 0=not present, 10=most severe.
Time Frame
Measured at baseline, week 4, week 8, week 16, and week 24
Title
Mean percentage change from baseline at week 24 (or the last assessment) on Calculation problems score
Description
Calculation problems score is self-rated, ranging from 0-10. For the severity scale, 0=not present, 10=most severe.
Time Frame
Measured at baseline, week 4, week 8, week 16, and week 24
Title
Mean percentage change from baseline at week 24 (or the last assessment) on Depression/hopelessness score
Description
Depression/hopelessness score is self-rated, ranging from 0-10. For the severity scale, 0=not present, 10=most severe.
Time Frame
Measured at baseline, week 4, week 8, week 16, and week 24
Title
Mean percentage change from baseline at week 24 (or the last assessment) on Anxiety score
Description
Anxiety included restless, impatience, irritability, nervous, anxious. Anxiety score is self-rated, ranging from 0-10. For the severity scale, 0=not present, 10=most severe.
Time Frame
Measured at baseline, week 4, week 8, week 16, and week 24
Title
Mean percentage change from baseline at week 24 (or the last assessment) on Sleep problems score
Description
Sleep problems score is self-rated, ranging from 0-10. For the severity scale, 0=not present, 10=most severe.
Time Frame
Measured at baseline, week 4, week 8, week 16, and week 24
Title
Safety will be assessed by the incidence of adverse events (AEs), discontinuation due to the AEs, clinically relevant changes on laboratory test results, vital signs, physical examinations, and 12-lead electrocardiograms (ECG).
Description
ECG and Physical exam only at Screening and Week 24
Time Frame
Screening, Baseline, Week 4, Week 8, week 16, and week 24

10. Eligibility

Sex
All
Minimum Age & Unit of Time
20 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patients with established mild atherosclerotic cardiovascular disease, defined as coronary and/or carotid and/or peripheral artery lesions <40% lumen diameter stenosis, diagnosed by coronary angiography and carotid and/or peripheral artery ultrasound respectively, together with LDL cholesterol level > 70 mg/dL (1.80 mmol/L). Female patients must be postmenopausal as defined by no menstruation for at least 12 months, or surgically sterilized for at least three months prior to beginning the study, or have a negative pregnancy test and agree to avoid pregnancy during the study and one month after the end of the study by using two reliable methods of contraception. Patients must have been informed of all aspects of the study and signed an informed consent form before any study-related activities. Patients must be willing and able to comply with scheduled visits, treatment plan, laboratory tests, and other study procedures. Exclusion Criteria: Patients who have met all the above inclusion criteria will be screened for the following exclusion criteria. Patients who have been taken lipid-lowering medications including statins or red yeast rice products during the 4 weeks prior to the screening visit. Documented history of myocardial infarction (MI), unstable angina leading to hospitalization, uncontrolled cardiac arrhythmia, percutaneous coronary intervention (PCI) or coronary artery bypass graft surgery (CABG), carotid surgery or stenting, cerebrovascular accident, transient ischemic attack, endovascular procedure or surgical intervention for peripheral vascular disease. Planned to undergo scheduled PCI, CABG, carotid or peripheral revascularization during the study. History of New York Heart Association Class III or IV heart failure within the past 12 months. Known history of hemorrhagic stroke. Patients with uncontrolled hypertension at the screening visit. Patients on stable antihypertensive medication may be enrolled provided that the medications and dosage remain stable throughout the study. Cardiovascular surgery or major operations within 6 months prior to screening visit. Patients who are taking anticoagulants except aspirin at < 325 mg/day. Patients with liver dysfunction as indicated by a serum alanine aminotransferase (ALT) or serum aspartate aminotransferase (AST) level of > 1.5-times of upper limit of normal (ULN) range, or clinical symptoms. Patients with elevated creatine phosphokinase level (above Upper Limit of Normal range). Patients with renal dysfunction as indicated by a serum creatinine level above ULN range, or clinical symptoms. Patients with gastric or peptic ulcer within 3 months prior to screening visit. Patients with medical history of hypothyroidism, pancreatitis, cholestasis, nephrotic syndrome, gall bladder disease, or primary biliary cirrhosis. Patients on thyroid replacement therapy at stable doses may be enrolled if clinically euthyroid. Patients with clinically relevant illness within 4 weeks prior to screening visit that may interfere with the conduct of this study. Patients with a history of alcohol or narcotic substance abuse within two years prior to screening visit. Patients with hypersensitivity to lipid-lowering agents. Patients who have taken another investigational drug within 4 weeks prior to screening visit. Patients with uncontrolled metabolic or endocrine disease knowing to influence lipid values. Patients who are known to be HIV positive. Patients who have a history or presence of active malignancy (other than non-melanoma skin cancer) or clinically significant psychiatric, neurological, respiratory, hematological, or other conditions that in the opinion of investigators might interfere with or contraindicate participation of the patients in this study.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Kangting Ji, MD
Phone
+8613676403180
Email
jikt@wzmc.edu.cn
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Kangting Ji, MD
Organizational Affiliation
The Second Hispital of Wenzhou Medical University
Official's Role
Principal Investigator
Facility Information:
Facility Name
The Second Hispital of Wenzhou Medical University
City
Wenzhou
State/Province
Zhejiang
ZIP/Postal Code
325000
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Kangting Ji, MD
Phone
+8613676403180
Email
jikt@wzmc.edu.cn

12. IPD Sharing Statement

Plan to Share IPD
Undecided

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The Efficacy and Safety of Combined Therapy With Red Yeast Rice and Low-dose Statin:Comparing With Standardized Statin

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