Effects of Ezetimibe, Simvastatin, and Vytorin on Reducing L5 a Subfraction of LDL in Patients With Metabolic Syndrome.

NCT ID: NCT00988364

Last Updated: 2023-11-30

Study Results

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE4

Total Enrollment

30 participants

Study Classification

INTERVENTIONAL

Study Start Date

2007-03-31

Study Completion Date

2008-02-29

Brief Summary

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The purpose of this study is:

* To identify the common factor for L5 prevalence in patients with Metabolic Syndrome.
* To determine whether Ezetimibe, Simvastatin, and Vytorin can correct the L5- promoting factor and reduce L5 in Metabolic Syndrome patients.

Detailed Description

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Epidemiological evidence indicates that metabolic syndrome (MS) is a strong predisposing condition for atherosclerosis. Elevation of plasma low-density lipoprotein (LDL) cholesterol(LDL-C) concentration is the most important risk factor for atherosclerosis; however, LDL-C elevation is not a criterion for metabolic syndrome, raising the question of LDL's role in the syndrome's association with atherosclerosis. L5, a highly electronegative and mildly oxidized LDL subfraction that we recently isolated from hypercholesterolemic human plasma, may provide a key to answering this question. In cultured vascular endothelial cells (EC), L5 inhibits proliferation and induces apoptosis and monocyte-EC adhesion. In our preliminary studies, L5 could also be detected in patients with MS without elevated LDL-C. Because other LDL subfractions were harmless to EC, the presence of MS-L5 prompted us to hypothesize that the atherogenic role of LDL is not solely determined by plasma LDL-C concentration, but more importantly, by its composition. The proposed study is designed to test this hypothesis. The first question we will address is what lipid factor determines the prevalence of L5 in MS.

Subsequently, we will examine whether treatment with selected medicines can effectively reduce L5 in MS patients by correcting the factor favorable for L5 formation.

We are in the process of identifying the active components of L5 to fully characterize the atherogenic role of L5 in MS,. In the current proposal, we focus our interest on the efficacy of Ezetimibe, Simvastatin, and Vytorin in reducing L5 from the plasma of MS patients.

Conditions

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Metabolic Syndrome

Keywords

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Metabolic Syndrome LDL subfraction L5 The reduction of LDL in patients with Metabolic Syndrome The prevalence of L5 in patients with Metabolic Syndrome The reduction of L5 in patients with Metabolic Syndrome

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Randomized, placebo-controlled clinical trial with 4 arms
Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Caregivers

Study Groups

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Ezetimibe

Randomly chosen participants will receive ezetimibe 10mg daily for 3 months.

Group Type ACTIVE_COMPARATOR

Ezetimibe

Intervention Type DRUG

Ezetimibe 10mg daily for 3 months.

Simvastatin

Randomly chosen participants will receive Simvastatin 20mg daily for 3 months.

Group Type ACTIVE_COMPARATOR

Simvastatin

Intervention Type DRUG

Simvastatin 20mg daily for 3 months.

Vytorin

Randomly chosen participants will receive Vytorin 20/10mg daily for 3 months.

Group Type ACTIVE_COMPARATOR

Vytorin

Intervention Type DRUG

Vytorin 20/10mg daily for 3 months.

Placebo

Randomly chosen participants will receive Placebo tab 1 daily for 3 months.

Group Type PLACEBO_COMPARATOR

Placebo

Intervention Type DRUG

Placebo one tablet daily times 3 months.

Interventions

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Simvastatin

Simvastatin 20mg daily for 3 months.

Intervention Type DRUG

Vytorin

Vytorin 20/10mg daily for 3 months.

Intervention Type DRUG

Placebo

Placebo one tablet daily times 3 months.

Intervention Type DRUG

Ezetimibe

Ezetimibe 10mg daily for 3 months.

Intervention Type DRUG

Other Intervention Names

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Zocor Ezetimibe/Simvastatin Control Zetia

Eligibility Criteria

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Inclusion Criteria

* Participants who meet 3 or more of the 5 criteria specified in the ATPIII guidelines will be recruited.
* The 5 criteria are:

1. abdominal obesity (men\>40 inches, women \>35 inches);
2. TG\> 150mg/dL;
3. low HDL-C (men \< 40mg/dL, women \< 50 mg/dL);
4. high blood pressure (\>or=130/\>or=85 mmHg);
5. fasting glucose \> or = 110mg/dL.
* People with different ethnic backgrounds will be included.

Exclusion Criteria

* symptomatic coronary artery disease
* peripheral vascular disease
* cerebral ischemia (stroke)
* smoking
* hypothyroidism
* kidney diseases
* consumption of antioxidation supplements/drugs or use of lipid-lowering drugs in the last 3 months
* women who are pregnant, nursing, or planning to become pregnant
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Merck Sharp & Dohme LLC

INDUSTRY

Sponsor Role collaborator

Baylor College of Medicine

OTHER

Sponsor Role lead

Responsible Party

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Chu-Huang Chen

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Chu-Huang Chen, M.D., Ph.D.

Role: PRINCIPAL_INVESTIGATOR

Baylor College of Medicine

Christie Ballantyne, M.D.

Role: STUDY_DIRECTOR

Baylor College of Medicine

Locations

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Baylor College of Medicine

Houston, Texas, United States

Site Status

Countries

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United States

References

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Other Identifiers

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MK0653A

Identifier Type: OTHER_GRANT

Identifier Source: secondary_id

H-20169

Identifier Type: -

Identifier Source: org_study_id