Trial Outcomes & Findings for Atorvastatin to Treat Pulmonary Sarcoidosis (NCT NCT00279708)

NCT ID: NCT00279708

Last Updated: 2017-05-22

Results Overview

The duration of steroid sparing was defined as the date when the target dose of prednisone was reached until the date at which the dose was increased and/or met the relapse (flare) criteria; or until the 12 month study phase ended if no prednisone dose increase was required. The steroid sparing period was measured in units of days. The prednisone target dose was defined as a 90% reduction of the baseline dose or an absolute prednisone dose of 4 mg/day or less.

Recruitment status

COMPLETED

Study phase

PHASE2

Target enrollment

55 participants

Primary outcome timeframe

1 year

Results posted on

2017-05-22

Participant Flow

Subjects were recruited by national advertising (self-referrals), physician referrals, and through a medical clinic sponsored by the NIH, from March 2006 through March 2015.

Subjects were screened by telephone and later during clinical testing a evaluation at the NIH Clinical Center. During this time subjects were evaluated to determine if they met the enrollment criteria, including that of treatment requiring disease, and relatively stable dosing prior to entry.

Participant milestones

Participant milestones
Measure
Intervention Group (Atorvastatin)
Atorvastatin Subjects were assigned to the treatment intervention by way of double blind masking. Atorvastatin 80 mg/day was the initial treatment given, as tolerated for a 12 month period. During the study, a 50% dose reduction was applied for subjects meeting pre-specified criteria.
Control Group (Placebo)
Placebo In a double-blind fashion, subjects were assigned to receive the sham intervention which appeared the same as the intervention agent. For subjects meeting pre-specified criteria, a 50% dose reduction was applied during the 12 month treatment phase of the study.
Overall Study
STARTED
27
28
Overall Study
COMPLETED
24
24
Overall Study
NOT COMPLETED
3
4

Reasons for withdrawal

Reasons for withdrawal
Measure
Intervention Group (Atorvastatin)
Atorvastatin Subjects were assigned to the treatment intervention by way of double blind masking. Atorvastatin 80 mg/day was the initial treatment given, as tolerated for a 12 month period. During the study, a 50% dose reduction was applied for subjects meeting pre-specified criteria.
Control Group (Placebo)
Placebo In a double-blind fashion, subjects were assigned to receive the sham intervention which appeared the same as the intervention agent. For subjects meeting pre-specified criteria, a 50% dose reduction was applied during the 12 month treatment phase of the study.
Overall Study
Withdrawal by Subject
2
3
Overall Study
Adverse Event
1
1

Baseline Characteristics

Atorvastatin to Treat Pulmonary Sarcoidosis

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Intervention Group (Atorvastatin)
n=27 Participants
Atorvastatin: Subjects were assigned to the treatment intervention by way of double blind masking. Atorvastatin 80 mg/day was the initial treatment given, as tolerated for a 12 month period. During the study, a 50% dose reduction was applied for subjects meeting pre-specified criteria.
Control Group (Placebo)
n=28 Participants
Placebo: In a double-blind fashion, subjects were assigned to receive the sham intervention which appeared the same as the intervention agent. For subjects meeting pre-specified criteria, a 50% dose reduction was applied during the 12 month treatment phase of the study.
Total
n=55 Participants
Total of all reporting groups
Age, Categorical
<=18 years
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Age, Categorical
Between 18 and 65 years
26 Participants
n=5 Participants
28 Participants
n=7 Participants
54 Participants
n=5 Participants
Age, Categorical
>=65 years
1 Participants
n=5 Participants
0 Participants
n=7 Participants
1 Participants
n=5 Participants
Age, Continuous
48.9 years
STANDARD_DEVIATION 7.95 • n=5 Participants
46.8 years
STANDARD_DEVIATION 9.12 • n=7 Participants
47.8 years
STANDARD_DEVIATION 8.57 • n=5 Participants
Sex: Female, Male
Female
17 Participants
n=5 Participants
16 Participants
n=7 Participants
33 Participants
n=5 Participants
Sex: Female, Male
Male
10 Participants
n=5 Participants
12 Participants
n=7 Participants
22 Participants
n=5 Participants
Region of Enrollment
United States
27 participants
n=5 Participants
28 participants
n=7 Participants
55 participants
n=5 Participants

PRIMARY outcome

Timeframe: 1 year

The duration of steroid sparing was defined as the date when the target dose of prednisone was reached until the date at which the dose was increased and/or met the relapse (flare) criteria; or until the 12 month study phase ended if no prednisone dose increase was required. The steroid sparing period was measured in units of days. The prednisone target dose was defined as a 90% reduction of the baseline dose or an absolute prednisone dose of 4 mg/day or less.

Outcome measures

Outcome measures
Measure
Intervention Group (Atorvastatin)
n=27 Participants
Atorvastatin: Subjects were assigned to the treatment intervention by way of double blind masking. Atorvastatin 80 mg/day was the initial treatment given, as tolerated for a 12 month period. During the study, a 50% dose reduction was applied for subjects meeting pre-specified criteria.
Control Group (Placebo)
n=28 Participants
Placebo: In a double-blind fashion, subjects were assigned to receive the sham intervention which appeared the same as the intervention agent. For subjects meeting pre-specified criteria, a 50% dose reduction was applied during the 12 month treatment phase of the study: Placebo vs. Atorvastatin
The Steroid Sparing Period
301 days
Interval 2.0 to 315.0
257 days
Interval 152.0 to 322.0

SECONDARY outcome

Timeframe: 1 year

Flare rates and relative risk: Flares (relapses) were defined as the physiological deterioration in pulmonary function due to worsened pulmonary inflammation. The criteria used for a pulmonary flare included: \> 15% decline in static function (FEV1 post, FVC post); or (\> 20% DLCO adj); or a \> 15% decline in walk distance as measured by the six minute walk test, or via a decline in oxygen consumption collected during a cardiopulmonary exercise test (CPET). Additional factors considered included an increase in dyspnea (\>15% increase in the dyspnea scale (TDI); and/or significant radiographic worsening. Clinical assessment of the patient's status may have been factored into the criteria for flare determination as well.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: 12 month treatment period

Spirometry measurements (FVC and FEV1) obtained post-bronchodilator Diffusion, adjusted for hemoglobin

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: 12 month treatment period

Cardiopulmonary Exercise Tests (VO2 peak, VO2/work, VECO2) Six minute Walk Test (distance, Borg scale)

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: 12 month treatment period

St. George's Respiratory Questionnaire SF-36 Modified MRC Dyspnea Scale

Outcome measures

Outcome data not reported

OTHER_PRE_SPECIFIED outcome

Timeframe: 12 month treatment period

HRCT Chest radiographs

Outcome measures

Outcome data not reported

Adverse Events

Intervention Group (Atorvastatin)

Serious events: 12 serious events
Other events: 16 other events
Deaths: 0 deaths

Control Group (Placebo)

Serious events: 16 serious events
Other events: 12 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Intervention Group (Atorvastatin)
n=27 participants at risk
Atorvastatin: Subjects were assigned to the treatment intervention by way of double blind masking. Atorvastatin 80 mg/day was the initial treatment given, as tolerated for a 12 month period. During the study, a 50% dose reduction was applied for subjects meeting pre-specified criteria.
Control Group (Placebo)
n=28 participants at risk
Placebo: In a double-blind fashion, subjects were assigned to receive the sham intervention which appeared the same as the intervention agent. For subjects meeting pre-specified criteria, a 50% dose reduction was applied during the 12 month treatment phase of the study.
Respiratory, thoracic and mediastinal disorders
Pneumonia
11.1%
3/27 • Number of events 3 • 12 months
3.6%
1/28 • Number of events 1 • 12 months
Musculoskeletal and connective tissue disorders
Muscle weakness
0.00%
0/27 • 12 months
3.6%
1/28 • Number of events 1 • 12 months
Musculoskeletal and connective tissue disorders
Avascular Necrosis
3.7%
1/27 • Number of events 1 • 12 months
0.00%
0/28 • 12 months
Gastrointestinal disorders
Appendicitis
3.7%
1/27 • Number of events 1 • 12 months
0.00%
0/28 • 12 months
Musculoskeletal and connective tissue disorders
Arthritis
0.00%
0/27 • 12 months
3.6%
1/28 • Number of events 1 • 12 months
Hepatobiliary disorders
Aspartate Aminotransferase elevation
3.7%
1/27 • Number of events 1 • 12 months
3.6%
1/28 • Number of events 1 • 12 months
Investigations
Alanine aminotransferase elevation
3.7%
1/27 • Number of events 1 • 12 months
0.00%
0/28 • 12 months
Musculoskeletal and connective tissue disorders
Aldolase increased
0.00%
0/27 • 12 months
3.6%
1/28 • Number of events 1 • 12 months
Investigations
Creatinine Phosphokinase Increase
0.00%
0/27 • 12 months
3.6%
1/28 • Number of events 1 • 12 months
Vascular disorders
Deep Venous Thrombosis
3.7%
1/27 • Number of events 1 • 12 months
0.00%
0/28 • 12 months
Respiratory, thoracic and mediastinal disorders
Diffusion of carbon monoxide
0.00%
0/27 • 12 months
3.6%
1/28 • Number of events 1 • 12 months
Endocrine disorders
Hypoglycemia
0.00%
0/27 • 12 months
7.1%
2/28 • Number of events 2 • 12 months
Respiratory, thoracic and mediastinal disorders
Hypoxia
7.4%
2/27 • Number of events 2 • 12 months
0.00%
0/28 • 12 months
Investigations
Myoglobin Increase
0.00%
0/27 • 12 months
3.6%
1/28 • Number of events 1 • 12 months
Respiratory, thoracic and mediastinal disorders
Obstructive Sleep Apnea
0.00%
0/27 • 12 months
3.6%
1/28 • Number of events 1 • 12 months
Musculoskeletal and connective tissue disorders
Rhabdomyolysis
0.00%
0/27 • 12 months
3.6%
1/28 • Number of events 1 • 12 months
Cardiac disorders
Sinus Bradycardia
0.00%
0/27 • 12 months
3.6%
1/28 • Number of events 1 • 12 months
Infections and infestations
Temperature Elevation
3.7%
1/27 • Number of events 1 • 12 months
0.00%
0/28 • 12 months
Skin and subcutaneous tissue disorders
Pruritis
3.7%
1/27 • Number of events 1 • 12 months
0.00%
0/28 • 12 months
Musculoskeletal and connective tissue disorders
Muscle Weakness unilateral
0.00%
0/27 • 12 months
3.6%
1/28 • Number of events 1 • 12 months
Musculoskeletal and connective tissue disorders
Numbness
0.00%
0/27 • 12 months
3.6%
1/28 • Number of events 1 • 12 months
Musculoskeletal and connective tissue disorders
Pain
0.00%
0/27 • 12 months
3.6%
1/28 • Number of events 1 • 12 months

Other adverse events

Other adverse events
Measure
Intervention Group (Atorvastatin)
n=27 participants at risk
Atorvastatin: Subjects were assigned to the treatment intervention by way of double blind masking. Atorvastatin 80 mg/day was the initial treatment given, as tolerated for a 12 month period. During the study, a 50% dose reduction was applied for subjects meeting pre-specified criteria.
Control Group (Placebo)
n=28 participants at risk
Placebo: In a double-blind fashion, subjects were assigned to receive the sham intervention which appeared the same as the intervention agent. For subjects meeting pre-specified criteria, a 50% dose reduction was applied during the 12 month treatment phase of the study.
Investigations
Aldolase Increase
7.4%
2/27 • Number of events 2 • 12 months
10.7%
3/28 • Number of events 3 • 12 months
Investigations
ACE Level increased
7.4%
2/27 • Number of events 2 • 12 months
3.6%
1/28 • Number of events 1 • 12 months
Investigations
Alkaline Phosphatase Increase
11.1%
3/27 • Number of events 3 • 12 months
3.6%
1/28 • Number of events 1 • 12 months
Investigations
Alanine aminotransferase Increased
48.1%
13/27 • Number of events 13 • 12 months
14.3%
4/28 • Number of events 4 • 12 months
Investigations
Asparatate aminotransferase Increased
51.9%
14/27 • Number of events 14 • 12 months
17.9%
5/28 • Number of events 5 • 12 months
Investigations
Amylase Increased
0.00%
0/27 • 12 months
14.3%
4/28 • Number of events 4 • 12 months
Respiratory, thoracic and mediastinal disorders
Bronchial Infection
0.00%
0/27 • 12 months
7.1%
2/28 • Number of events 2 • 12 months
Respiratory, thoracic and mediastinal disorders
Bronchospasm
7.4%
2/27 • Number of events 2 • 12 months
0.00%
0/28 • 12 months
Investigations
Creatine Phosphokinase increased
7.4%
2/27 • Number of events 2 • 12 months
10.7%
3/28 • Number of events 3 • 12 months
Investigations
Creatinine increased
0.00%
0/27 • 12 months
14.3%
4/28 • Number of events 4 • 12 months
Respiratory, thoracic and mediastinal disorders
Diffusion of Carbon Monoxide decreased
7.4%
2/27 • Number of events 2 • 12 months
14.3%
4/28 • Number of events 4 • 12 months
Vascular disorders
Hypotension
0.00%
0/27 • 12 months
7.1%
2/28 • Number of events 2 • 12 months
Investigations
Lipase Increase
3.7%
1/27 • Number of events 1 • 12 months
7.1%
2/28 • Number of events 2 • 12 months
Infections and infestations
Urinary Tract Infection
0.00%
0/27 • 12 months
7.1%
2/28 • Number of events 2 • 12 months

Additional Information

Joseph Fontana, MD

The National Institutes of Health/ The National Heart, Lung, and Blood Institute

Phone: 301-451-7740

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place