Effects of Colesevelam HCl On Bile Acid Kinetics

NCT ID: NCT00476710

Last Updated: 2015-04-01

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

36 participants

Study Classification

OBSERVATIONAL

Study Start Date

2007-05-31

Study Completion Date

2009-04-30

Brief Summary

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This project will compare the amount of bile acids and their kinetics in overweight and obese people with normal glucose metabolism, impaired glucose tolerance and frank type 2 diabetes. We hypothesize that bile acids will behave differently in these groups. We will also explore the effects of Colesevelam HCl, a medicine that lowers LDL cholesterol by binding bile acids, on bile acids in those groups. We hypothesize the drug may have different actions on bile acids in subjects with different degrees of abnormal glucose metabolism.

Detailed Description

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Bile acids, which are synthesized from cholesterol in the liver, play a key role in digestion as they solubilize dietary lipids and aid their absorption in the digestive tract. While for many years bile acids have been characterized by this digestive role, recent research indicates that bile acids play other important roles. Because bile acids have been shown to act in signaling pathways that affect metabolism, there has been renewed interest in investigations of their effects. This study explores potential differences in bile acid kinetics based on insulin resistance or type 2 diabetes at baseline.

Colesevelam HCl is a bile acid sequestrant, which in addition to its primary role in lowering serum LDL-C levels, has secondarily been implicated in lowering blood glucose levels. This study explores the relationship between insulin resistance and type 2 diabetes and changes in bile acid pool sizes and kinetics with colesevelam treatment. Isotopically labeled bile acids will be administered to subjects before and after treatment with colesevelam and comparisons will be made in bile acid pool size, fractional turnover rate, and synthesis rate in the three study groups.

Conditions

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Type 2 Diabetes Mellitus Impaired Glucose Tolerance

Study Design

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Observational Model Type

CASE_CONTROL

Study Time Perspective

RETROSPECTIVE

Study Groups

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Normal Glucose Metabolism

Overweight and obese individuals that have normal glucose metabolism and their response to Colesevelam HCl

Colesevelam HCl

Intervention Type DRUG

Impaired Glucose Tolerance

Overweight and obese individuals that have impaired glucose tolerance and their response to Colesevelam HCl

Colesevelam HCl

Intervention Type DRUG

Frank type 2 diabetes

Overweight and obese individuals that have frank type 2 diabetes and their response to Colesevelam HCl

Colesevelam HCl

Intervention Type DRUG

Interventions

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Colesevelam HCl

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Have given written informed consent
* BMI 25-35 kg/m\^2, inclusive
* Normal liver and thyroid function
* No history of liver, biliary, or intestinal disease

Diabetic Subjects

* Diagnosed Type 2 Diabetes Mellitus
* HbA1C = 6.7-10%

Normal Subjects

* 2 hr OGTT glucose \< 140 mg/dL
* fasting glucose \< 100 mg/dL
* TG \< 150 mg/dL
* HDL cholesterol \>= 40 mg/dL

Impaired Glucose Tolerance Subjects

* 2 hr OGTT glucose \>= 140 and \< 200 mg/dL

Exclusion Criteria

* T1DM or history of diabetic ketoacidosis
* treatment with blood pressure lowering therapy that has not been stable for three months before screening
* colesevelam HCl, cholestyramine, or colestipol treatment for hyperlipidemia within the last three months
* treatment with thiazolidinedione (TZD) at any time
* treatment with insulin within past 6 months
* treatment with antibiotics within last 3 months
* extreme sportsmen
* treatment with medication affecting liver or intestinal function within the last 3 months
* allergic or toxic rxn to colesevelam HCl
* history of dysphagia, swallowing disorders, or intestinal motility disorder
* Serum Triglycerides \> 500 mg/dL at visit 1
* Serum LDL-C \< 60 mg/dL at visit 1
* any condition or therapy investigator believes not in subjects best interest
* use of any investigational drug within 30 days before screening
* chronic treatment with oral corticosteroids at any time or acute treatment within last three months
* hyperthyroidism or treatment with thyroid hormone/levothyroxine
Minimum Eligible Age

40 Years

Maximum Eligible Age

60 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Daiichi Sankyo

INDUSTRY

Sponsor Role collaborator

University Medical Center Groningen

OTHER

Sponsor Role collaborator

Diabetes & Glandular Disease Research Associates

UNKNOWN

Sponsor Role collaborator

KineMed

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Elizabeth J Murphy, MD

Role: PRINCIPAL_INVESTIGATOR

KineMed, Inc.

Folkert Kuipers, PhD

Role: PRINCIPAL_INVESTIGATOR

University Medical Center Groningen

Locations

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Diabetes & Glandular Disease Research Associates, Inc.

San Antonio, Texas, United States

Site Status

Countries

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United States

References

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Grundy SM, Ahrens EH Jr, Salen G. Interruption of the enterohepatic circulation of bile acids in man: comparative effects of cholestyramine and ileal exclusion on cholesterol metabolism. J Lab Clin Med. 1971 Jul;78(1):94-121. No abstract available.

Reference Type BACKGROUND
PMID: 5569253 (View on PubMed)

Shepherd J, Packard CJ, Bicker S, Lawrie TD, Morgan HG. Cholestyramine promotes receptor-mediated low-density-lipoprotein catabolism. N Engl J Med. 1980 May 29;302(22):1219-22. doi: 10.1056/NEJM198005293022202.

Reference Type BACKGROUND
PMID: 7366673 (View on PubMed)

Zieve FJ, Kalin MF, Schwartz SL, Jones MR, Bailey WL. Results of the glucose-lowering effect of WelChol study (GLOWS): a randomized, double-blind, placebo-controlled pilot study evaluating the effect of colesevelam hydrochloride on glycemic control in subjects with type 2 diabetes. Clin Ther. 2007 Jan;29(1):74-83. doi: 10.1016/j.clinthera.2007.01.003.

Reference Type BACKGROUND
PMID: 17379048 (View on PubMed)

Abrams JJ, Ginsberg H, Grundy SM. Metabolism of cholesterol and plasma triglycerides in nonketotic diabetes mellitus. Diabetes. 1982 Oct;31(10):903-10. doi: 10.2337/diab.31.10.903.

Reference Type BACKGROUND
PMID: 6759223 (View on PubMed)

Andersen E, Karlaganis G, Sjovall J. Altered bile acid profiles in duodenal bile and urine in diabetic subjects. Eur J Clin Invest. 1988 Apr;18(2):166-72. doi: 10.1111/j.1365-2362.1988.tb02408.x.

Reference Type BACKGROUND
PMID: 3133222 (View on PubMed)

Bennion LJ, Grundy SM. Effects of diabetes mellitus on cholesterol metabolism in man. N Engl J Med. 1977 Jun 16;296(24):1365-71. doi: 10.1056/NEJM197706162962401.

Reference Type BACKGROUND
PMID: 870827 (View on PubMed)

Hulzebos CV, Renfurm L, Bandsma RH, Verkade HJ, Boer T, Boverhof R, Tanaka H, Mierau I, Sauer PJ, Kuipers F, Stellaard F. Measurement of parameters of cholic acid kinetics in plasma using a microscale stable isotope dilution technique: application to rodents and humans. J Lipid Res. 2001 Nov;42(11):1923-9.

Reference Type BACKGROUND
PMID: 11714862 (View on PubMed)

Brufau G, Stellaard F, Prado K, Bloks VW, Jonkers E, Boverhof R, Kuipers F, Murphy EJ. Improved glycemic control with colesevelam treatment in patients with type 2 diabetes is not directly associated with changes in bile acid metabolism. Hepatology. 2010 Oct;52(4):1455-64. doi: 10.1002/hep.23831.

Reference Type DERIVED
PMID: 20725912 (View on PubMed)

Related Links

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Other Identifiers

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KM-11B

Identifier Type: -

Identifier Source: org_study_id

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