A Clinical Trial of STAtin Therapy for Reducing Events in the Elderly (STAREE)

NCT ID: NCT02099123

Last Updated: 2024-11-21

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

ACTIVE_NOT_RECRUITING

Clinical Phase

PHASE4

Total Enrollment

9971 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-07-31

Study Completion Date

2025-12-31

Brief Summary

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The STAREE study will examine whether treatment with statin (atorvastatin 40mg) compared with placebo will prolong disability free survival and reduce major cardiovascular events amongst healthy elderly people (≥70 years).

Detailed Description

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Statin therapy has been shown to reduce the risk of vascular events in younger individuals with manifest atherosclerotic disease or at high risk of vascular events. However, data derived from meta-analyses of existing trials suggests that the efficacy of statins may decline sharply amongst those over 70-75 years of age. Insufficient patients of this age group have been included in major trials to be certain of the benefit. Within this age group part of the benefit of statin therapy may be offset by adverse effects including myopathy, development of diabetes, cancer and cognitive impairment, all of which are more prevalent in the elderly in any event.

The use of statins in the over 70 age group raises fundamental questions about the purpose of preventive drug therapy in this age group. When a preventive agent is used in the context of competing mortality, polypharmacy and a higher incidence of adverse effects its use should be justified by an improvement in quality of life or some other composite measure that demonstrates that the benefit outweighs other factors.

STAREE will determine whether taking daily statin therapy (40 mg atorvastatin) will extend the length of a disability-free life, determined from survival outside permanent residential care, in healthy participants aged 70 years and above.

Conditions

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Independent Living Disability Free Survival Elderly Healthy

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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Atorvastatin

40 mg atorvastatin (2 x 20 mg atorvastatin), taken orally once daily

Group Type EXPERIMENTAL

Atorvastatin

Intervention Type DRUG

Atorvastatin 20 mg tablet

Placebo

Placebo (2 x 20 mg placebo) taken orally once daily

Group Type PLACEBO_COMPARATOR

Placebo (for Atorvastatin)

Intervention Type DRUG

Inactive pill manufactured to mimic Atorvastatin 20 mg tablet

Interventions

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Atorvastatin

Atorvastatin 20 mg tablet

Intervention Type DRUG

Placebo (for Atorvastatin)

Inactive pill manufactured to mimic Atorvastatin 20 mg tablet

Intervention Type DRUG

Other Intervention Names

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Lipitor, , , Cadivast, Caduet, Lorstat, Torvastat, Trovas Atorachol Cadatin no other names

Eligibility Criteria

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Inclusion Criteria

* Men and women aged ≥70 years living independently in the community
* Willing and able to provide informed consent and accept the study requirements (Note: competent physical ability to participate in the trial is assessed using the KATZ ADL questionnaire)

Exclusion Criteria

A history of cardiovascular disease (defined as myocardial infarction, stroke, peripheral vascular disease, angina, transient ischaemic attack, coronary artery angioplasty and/or stenting, coronary artery bypass grafting, carotid stenosis, abdominal aortic aneurysm or heart failure),

* A history of dementia or a 3MS score \<78 on screening,
* A history of diabetes,
* Total cholesterol \>7.5 mmol/L,
* Moderate or severe chronic kidney disease (persistent proteinuria (Urine albumin:creatinine ratio \>30mg/mmol or Urine protein:creatinine ratios \>45 mg/mmol)45 and/or eGFR \<45ml/min/1.73m2),
* Moderate or severe liver disease (persistent elevations of transaminases of more than 3 times the upper limit of the normal laboratory reference range),
* Serious inter-current illness likely to cause death within the next 5 years such as terminal cancer or obstructive airways disease,
* Current participation in a clinical trial,
* Absolute contraindication to statin therapy,
* Current use of statin therapy or other lipid lowering therapy for primary prevention and unwilling to stop therapy,
* Current long term or permanent use of the following cytochrome P450 (CYP) 3A4 inhibitors : Amiodarone, Boceprevir, Cimetidine, Cyclosporin, Danazol, Fosamprenavir, Indinavir, Lopinavir + Ritonavir, Erythromycin, Fluconazole, Itraconazole, Ketoconazole.
Minimum Eligible Age

70 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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National Health and Medical Research Council, Australia

OTHER

Sponsor Role collaborator

National Heart Foundation, Australia

OTHER

Sponsor Role collaborator

Monash University

OTHER

Sponsor Role lead

Responsible Party

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Sophia Zoungas

Professor Sophia Zoungas

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Sophia Zoungas, MBBS, FRACP

Role: PRINCIPAL_INVESTIGATOR

Monash University

Locations

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Tasmania

Hobart, Tasmania, Australia

Site Status

Victoria

Melbourne, Victoria, Australia

Site Status

South Australia

Adelaide, Western Australia, Australia

Site Status

Queensland

Brisbane, , Australia

Site Status

New South Wales

Newcastle, , Australia

Site Status

Western Australia

Perth, , Australia

Site Status

Countries

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Australia

References

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Zoungas S, Moran C, Curtis AJ, Spark S, Flanagan Z, Beilin L, Chong TT, Cloud GC, Hopper I, Kost A, McNeil JJ, Nicholls SJ, Reid CM, Ryan J, Tonkin AM, Ward S, Wierzbicki AS, Wolfe R, Zhou Z, Nelson MR; STAREE investigator group. Baseline Characteristics of Participants in STAREE: A Randomized Trial for Primary Prevention of Cardiovascular Disease Events and Prolongation of Disability-Free Survival in Older People. J Am Heart Assoc. 2024 Nov 19;13(22):e036357. doi: 10.1161/JAHA.124.036357. Epub 2024 Nov 15.

Reference Type DERIVED
PMID: 39548016 (View on PubMed)

Zoungas S, Curtis A, Spark S, Wolfe R, McNeil JJ, Beilin L, Chong TT, Cloud G, Hopper I, Kost A, Nelson M, Nicholls SJ, Reid CM, Ryan J, Tonkin A, Ward SA, Wierzbicki A; STAREE investigator group. Statins for extension of disability-free survival and primary prevention of cardiovascular events among older people: protocol for a randomised controlled trial in primary care (STAREE trial). BMJ Open. 2023 Apr 3;13(4):e069915. doi: 10.1136/bmjopen-2022-069915.

Reference Type DERIVED
PMID: 37012015 (View on PubMed)

Rozing MP, Westendorp RGJ. Altered cardiovascular risk pattern of LDL cholesterol in older adults. Curr Opin Lipidol. 2023 Feb 1;34(1):22-26. doi: 10.1097/MOL.0000000000000859. Epub 2022 Nov 16.

Reference Type DERIVED
PMID: 36413436 (View on PubMed)

Other Identifiers

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NHMRC 1068146

Identifier Type: -

Identifier Source: org_study_id

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