Ramipril and Clopidogrel in Oxidative Stress, Vascular Inflammation and Endothelial Dysfunction in Type 2 Diabetes and Diabetic Nephropathy

NCT ID: NCT01743014

Last Updated: 2012-12-06

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

UNKNOWN

Clinical Phase

PHASE4

Total Enrollment

60 participants

Study Classification

INTERVENTIONAL

Study Start Date

2012-07-31

Study Completion Date

2015-07-31

Brief Summary

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The purpose of this study is to determine whether the combination with ramipril and clopidogrel leads to further improvement of endothelial function, reduction of oxidative stress and reduction of vascular inflammation, compared with ramipril monotherapy, in patients with Diabetes Mellitus type 2 and diabetic nephropathy.

Detailed Description

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* Cardiovascular disease is the leading cause of deaths in diabetic population with diabetic nephropathy.
* Pharmacologic therapy for patients with diabetes and hypertension should be with a regimen that includes either an angiotensin-converting-enzyme inhibitor (ACEi) or an angiotensin receptor blocker (ARB)
* Diabetic patients at increased cardiovascular risk should receive an antiplatelet agent for primary prevention.

Methods:

An open label,randomized, two period cross-over design study, involving patients with type 2 diabetes and diabetic nephropathy. After a 4 weeks wash out period for ACE inhibitors or Angiotensin receptor blockers (week 0, baseline) 60 patients will be randomized to receive ramipril(10 mg) only or ramipril (10 mg) and clopidogrel (75mg) for 12 weeks exchanging their treatment for a further 12 weeks, after a 2 week wash out period for clopidogrel. Patients will be examined and measurements will be taken at baseline (week 0), and at the end of 12, 14, and 26 weeks.

Conditions

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Diabetes Type 2 Diabetic Nephropathy Vascular Disease

Keywords

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diabetes diabetic nephropathy vascular inflammation oxidative stress endothelial dysfunction Asymmetric dimethylarginine High sensitivity CRP albumine to creatinine ratio isoprostane clopidogrel ramipril carotid intima media thickness

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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ramipril

Ramipril 10 mg tablets. Each dose will be taken orally with water once daily.

Group Type ACTIVE_COMPARATOR

Ramipril

Intervention Type DRUG

Patients will receive 10 mg ramipril throughout the study. Each dose will be taken orally once daily. The duration of treatment with ramipril is 26 weeks

clopidogrel and ramipril

clopidogrel 75mg tablet and ramipril 10mg. Each drug will be taken orally with water once daily

Group Type ACTIVE_COMPARATOR

Ramipril

Intervention Type DRUG

Patients will receive 10 mg ramipril throughout the study. Each dose will be taken orally once daily. The duration of treatment with ramipril is 26 weeks

Clopidogrel

Intervention Type DRUG

12 weeks treatment with ramipril 10 mg and clopidogrel 75 mg once daily followed by a 2 week wash out period for clopidogrel and subsequently additional 12 weeks treatment wit both drugs after cross over.

Interventions

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Ramipril

Patients will receive 10 mg ramipril throughout the study. Each dose will be taken orally once daily. The duration of treatment with ramipril is 26 weeks

Intervention Type DRUG

Clopidogrel

12 weeks treatment with ramipril 10 mg and clopidogrel 75 mg once daily followed by a 2 week wash out period for clopidogrel and subsequently additional 12 weeks treatment wit both drugs after cross over.

Intervention Type DRUG

Other Intervention Names

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Triatec Plavix Iscover

Eligibility Criteria

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Inclusion Criteria

* HbA1c(glycosylated haemoglobin A1c \<7%
* Blood pressure ≤130/80 mmHg
* LDL (Low Density Lipoproteins) \<100 mg/dl
* Informed consent

Exclusion Criteria

* patients with diabetic nephropathy and estimated GFR \<30ml/min with Modification of Diet in Renal Disease equation (MDRD equation)
* baseline potassium \> 5.2 meq/L
* patients with nephrotic proteinuria defined as albumine to creatinine ratio (ACR)\> 3.5 g/g or as proteinuria \>3.5 g per 1.73 m2 per 24 hours
* history or evidence of non-diabetic kidney disease
* history of stroke, peripheral artery disease, coronary artery disease
* history or evidence of a secondary form of hypertension
* history of severe hepatic failure, malignancy, severe endocrinopathy,autoimmune disease or chronic inflammatory disease
* any known bleeding or platelet disorder or platelets \<100.000/μL
* heart failure in New York Heart Association(NYHA) functional class II-IV
* inability or unwillingness on the part of the patient to sign the Patient Consent Form
* known hypersensitivity to ramipril or to clopidogrel
* Women of child-bearing potential
* use of oral anticoagulants or other antithrombotic treatment
* use of glitazones
* patients receiving statins should be on a stable dose of at least 3 months prior to study initiation and dose should be constant during the study
* any surgical or medical condition which in the opinion of the investigator may expose the patient to a higher risk in participation in the study
Minimum Eligible Age

18 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Aristotle University Of Thessaloniki

OTHER

Sponsor Role collaborator

AHEPA University Hospital

OTHER

Sponsor Role lead

Responsible Party

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Vaia Bougatsa

Medical Doctor-Resident of Internal Medicine

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Fotios S Iliadis, Lecturer of Internal Medicine

Role: STUDY_DIRECTOR

AHEPA University Hospital/ Aristotle University of Thessaloniki

Vaia F Bougatsa, Resident of Internal Medicine

Role: PRINCIPAL_INVESTIGATOR

AHEPA University Hospital/ Aristotle University of Thessaloniki

Locations

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AHEPA University Hospital

Thessaloniki, Thessaloniki, Greece

Site Status RECRUITING

Aristotle University of Thessaloniki/ AHEPA University Hospital

Thessaloniki, Thessaloniki, Greece

Site Status RECRUITING

Countries

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Greece

Central Contacts

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Fotios S Iliadis, Lecturer of Internal Medicine

Role: CONTACT

Phone: +306974960728

Email: [email protected]

Vaia F Bougatsa, Resident of internal medicine

Role: CONTACT

Phone: +306944334265

Email: [email protected]

Facility Contacts

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Fotios S Iliadis, Lecturer of Internal Medicine

Role: primary

Vaia F Bougatsa, Resident of Internal Medicine

Role: backup

References

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Natale P, Palmer SC, Saglimbene VM, Ruospo M, Razavian M, Craig JC, Jardine MJ, Webster AC, Strippoli GF. Antiplatelet agents for chronic kidney disease. Cochrane Database Syst Rev. 2022 Feb 28;2(2):CD008834. doi: 10.1002/14651858.CD008834.pub4.

Reference Type DERIVED
PMID: 35224730 (View on PubMed)

Other Identifiers

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15/10-7-2012

Identifier Type: -

Identifier Source: org_study_id