Trial Outcomes & Findings for Combined Effects of Non-statin Treatments on Apolipoprotein A-I Up-Regulation (CENTAUR): A Feasibility Study (NCT NCT00728910)

NCT ID: NCT00728910

Last Updated: 2016-02-29

Results Overview

After receiving total daily caloric intake over 20 hrs as 20 identical small meals, starting at 0600 hrs, subjects took study medications at 0800 hrs. Five hours after the first meal, i.v. 5,5,5-2H3-L-leucine was administered, followed by a primed-constant infusion at 10 mol/kg body weight per hr for 15 hrs during which 14 blood samples were collected. Isotopic enrichment of leucine in apoA1 band excised from polyacrylamide gel was calculated. Assuming steady state apo A-I metabolism, we used a compartment model to fit data, consisting a precursor compartment (Compartment 1), the plasma leucine pool, an intracellular compartment accounting for apoA1 synthesis and lipoprotein assembly (Compartment 2), and compartments to account for dispositional kinetics of the subfractions including a plasma pool compartment (Compartment 3). The apoA1 FCR corresponds to the rate of irreversible loss of leucine pools from Compartment 3.

Recruitment status

COMPLETED

Study phase

PHASE2

Target enrollment

25 participants

Primary outcome timeframe

4 weeks, 12 weeks and 22 weeks

Results posted on

2016-02-29

Participant Flow

Recruitment lasted from June 2008 until February 2009.

Subjects washed out of current lipid lowering medications

Participant milestones

Participant milestones
Measure
Atorvastatin/ABT335/Niaspan
All participants received atorvastatin 10 mg/day for 4 weeks, followed by sequential addition of ABT335 135 mg/day for 8 weeks, and ER niacin 2000 mg/day for 10 weeks, for a total study duration of 22 weeks
Atorvastatin
STARTED
25
Atorvastatin
COMPLETED
22
Atorvastatin
NOT COMPLETED
3
Atorvastatin+ABT335
STARTED
22
Atorvastatin+ABT335
COMPLETED
22
Atorvastatin+ABT335
NOT COMPLETED
0
Atorvastatin+ABT335+ER Niacin
STARTED
22
Atorvastatin+ABT335+ER Niacin
COMPLETED
22
Atorvastatin+ABT335+ER Niacin
NOT COMPLETED
0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Combined Effects of Non-statin Treatments on Apolipoprotein A-I Up-Regulation (CENTAUR): A Feasibility Study

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Group 1
n=25 Participants
All participants received atorvastatin 10 mg/day for 4 weeks, followed by sequential addition of ABT335 135 mg/day for 8 weeks, and ER niacin 2000 mg/day for 10 weeks.
Age, Categorical
<=18 years
0 Participants
n=5 Participants
Age, Categorical
Between 18 and 65 years
25 Participants
n=5 Participants
Age, Categorical
>=65 years
0 Participants
n=5 Participants
Age, Continuous
47 years
STANDARD_DEVIATION 10.74 • n=5 Participants
Sex: Female, Male
Female
13 Participants
n=5 Participants
Sex: Female, Male
Male
12 Participants
n=5 Participants
Region of Enrollment
United States
25 participants
n=5 Participants

PRIMARY outcome

Timeframe: 4 weeks, 12 weeks and 22 weeks

Population: Patients who completed any of the three phases for whom the kinetic study data was available for any phase of treatment

After receiving total daily caloric intake over 20 hrs as 20 identical small meals, starting at 0600 hrs, subjects took study medications at 0800 hrs. Five hours after the first meal, i.v. 5,5,5-2H3-L-leucine was administered, followed by a primed-constant infusion at 10 mol/kg body weight per hr for 15 hrs during which 14 blood samples were collected. Isotopic enrichment of leucine in apoA1 band excised from polyacrylamide gel was calculated. Assuming steady state apo A-I metabolism, we used a compartment model to fit data, consisting a precursor compartment (Compartment 1), the plasma leucine pool, an intracellular compartment accounting for apoA1 synthesis and lipoprotein assembly (Compartment 2), and compartments to account for dispositional kinetics of the subfractions including a plasma pool compartment (Compartment 3). The apoA1 FCR corresponds to the rate of irreversible loss of leucine pools from Compartment 3.

Outcome measures

Outcome measures
Measure
Atorvastatin
n=21 Participants
Subjects received atorvastatin 10 mg daily by mouth for 4 weeks followed by apo-A1 kinetics
Atorvastatin+ABT335
n=21 Participants
Subjects received atorvastatin 10 mg daily and ABT335 135 mg daily by mouth for 8 weeks.
Atorvastatin+ABT335+Niaspan
n=20 Participants
Subjects received atorvastatin 10 mg daily, ABT335 135 mg and Niaspan 2000 mg daily by mouth for 10 weeks.
The Apolipoprotein A-I Fractional Catabolic Rate (FCR)
0.294 pools/day
Interval 0.27 to 0.32
0.294 pools/day
Interval 0.27 to 0.32
0.295 pools/day
Interval 0.25 to 0.34

PRIMARY outcome

Timeframe: 4 weeks, 12 weeks and 22 weeks

Population: Patients who completed any phase of treatment for whom kinetic data were available

The apolipoprotein A-I production rate using (5,5,5-2H3-L-leucine) was measured following each of the three study periods i.e following 4 weeks of atorvastatin 10 mg/day, following 8 further weeks of ABT335 135 mg/day added to atorvastatin and following 10 further weeks of ER niacin 2000 mg/day and aspirin 325 mg/day added to atorvastatin+ABT335.

Outcome measures

Outcome measures
Measure
Atorvastatin
n=20 Participants
Subjects received atorvastatin 10 mg daily by mouth for 4 weeks followed by apo-A1 kinetics
Atorvastatin+ABT335
n=20 Participants
Subjects received atorvastatin 10 mg daily and ABT335 135 mg daily by mouth for 8 weeks.
Atorvastatin+ABT335+Niaspan
n=20 Participants
Subjects received atorvastatin 10 mg daily, ABT335 135 mg and Niaspan 2000 mg daily by mouth for 10 weeks.
Apo-A1 Production Rate
14.2 mg/kg/day
Interval 11.0 to 17.0
14.2 mg/kg/day
Interval 12.0 to 17.0
13.8 mg/kg/day
Interval 11.0 to 17.0

PRIMARY outcome

Timeframe: 4 weeks, 12 weeks, 22 weeks

Population: subjects completing any phase of treatment for whom complete post-prandial data were available

Triglyceride iAUC was measured during an oral fat tolerance test administered after 4 weeks of atorvastatin 10 mg/day , a further 8 weeks of atorvastatin 10mg /day+ABT335 135mg/day and then after a further 10 weeks of atorvastatin 10 mg/day+ABT335 135 mg/day+Niaspan 2000 mg/day. The standardized oral fat load was administered one hour post medication dosing and blood was collected prior to drug dosing, prior to the oral fat load and hourly thereafter for 10 hours (0,1,2,3,4,5,6,7,8,9,10,12 hrs post drug dosing)

Outcome measures

Outcome measures
Measure
Atorvastatin
n=22 Participants
Subjects received atorvastatin 10 mg daily by mouth for 4 weeks followed by apo-A1 kinetics
Atorvastatin+ABT335
n=22 Participants
Subjects received atorvastatin 10 mg daily and ABT335 135 mg daily by mouth for 8 weeks.
Atorvastatin+ABT335+Niaspan
n=22 Participants
Subjects received atorvastatin 10 mg daily, ABT335 135 mg and Niaspan 2000 mg daily by mouth for 10 weeks.
Post-prandial Triglyceride Incremental Area Under the Curve (iAUC)
770 mg/dl*h
Interval 618.0 to 921.0
515 mg/dl*h
Interval 361.0 to 670.0
381 mg/dl*h
Interval 214.0 to 547.0

Adverse Events

Atorvastatin/ABT335/Niaspan

Serious events: 1 serious events
Other events: 1 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Atorvastatin/ABT335/Niaspan
n=25 participants at risk
Subjects received atorvastatin 10 mg/day for 4 weeks, followed by addition of ABT335 135 mg/day for a further 8 weeks followed by the addition of Niaspan 2000 mg/day for a further 10 weeks.
Gastrointestinal disorders
ulcer
4.0%
1/25 • Number of events 1 • 22 weeks

Other adverse events

Other adverse events
Measure
Atorvastatin/ABT335/Niaspan
n=25 participants at risk
Subjects received atorvastatin 10 mg/day for 4 weeks, followed by addition of ABT335 135 mg/day for a further 8 weeks followed by the addition of Niaspan 2000 mg/day for a further 10 weeks.
Nervous system disorders
headache
4.0%
1/25 • Number of events 1 • 22 weeks

Additional Information

Richard Dunbar MD

University of Pennsylvania

Phone: 215-662-9024

Results disclosure agreements

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