Lipid-lowering Therapies in Vietnamese Chronic Kidney Disease Population

NCT ID: NCT03543774

Last Updated: 2019-08-13

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

30 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-06-15

Study Completion Date

2020-10-15

Brief Summary

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This study aims to determine the mechanisms underlying dyslipidemia in chronic kidney disease (CKD) and effect of lipid-lowering therapies in patients with CKD via parameters of lipid, oxidative stress, tryptophan delegation as well as renal function and side effects. Thirty 3,4 CKD patients with low-density lipoprotein (LDL) \> 100 mg/mL (2,59mmol/l), randomly receive three different LDL lipid-lowering therapies: Simvastatin (40 mg/day) or ezetimibe/simvastatin combination (10/20 mg/day or 10/40 mg/day).

Detailed Description

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The prevalence of chronic kidney disease (CKD) in Vietnamese population is increasing along with hypertension and diabetes. In CKD patient, cardiovascular disease (CVD) is the leading cause of mortality. The lipidemic disorder is one of the CV risk factors in CKD but it was not fully concerned in Viet Nam.

Hypocholesterolemia therapy has shown many benefits; however, its effects on OS and endothelial function are still not fully evidenced.

In clinical practice, physicians always concern the effects and safety before giving the prescription. However, despite the high frequency of statin treatment, only 1/3 of CKD patients achieved the LDL-C goal. Whether high-dose of statins mono-therapy is more effective in LDL-C lowering is still unclear, but are associated with a high rate of hepatotoxicity, myopathy.

Lowering LDL-C with statin mono-therapy and statin/ezetimibe combination reduces the risk of CVD in population without kidney disease. Which Cholesterol-lowering therapies are suitable for stage 3,4 CKD patients in term of e-GFR reduction and side effects? There is no data related to this field in the Vietnamese CKD population.

Thus, more advanced lipid-lowering therapies and a better understanding of the mechanism is needed for treatment strategy of hyperlipidemia in Vietnamese patients with CKD.

Conditions

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Hypercholesterolemia Chronic Kidney Diseases

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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simvastatin treatment

Group Type ACTIVE_COMPARATOR

Simvastatin 40mg

Intervention Type DRUG

Simvastatin mono-therapy at the dose of 40 mg/day for 12 months

EZE/simvastatin 10/20 mg treatment

Group Type SHAM_COMPARATOR

Ezetimibe/simvastatin 10/20 mg/day

Intervention Type DRUG

Ezetimibe/simvastatin combined therapy at the dose of 10/20 mg/day for 12 months

EZE/simvastatin 10/40 mg treatment

Group Type SHAM_COMPARATOR

Ezetimibe/simvastatin 10/40 mg/day

Intervention Type DRUG

Ezetimibe/simvastatin combined therapy at the dose of 10/40 mg/day for 12 months

Interventions

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Simvastatin 40mg

Simvastatin mono-therapy at the dose of 40 mg/day for 12 months

Intervention Type DRUG

Ezetimibe/simvastatin 10/20 mg/day

Ezetimibe/simvastatin combined therapy at the dose of 10/20 mg/day for 12 months

Intervention Type DRUG

Ezetimibe/simvastatin 10/40 mg/day

Ezetimibe/simvastatin combined therapy at the dose of 10/40 mg/day for 12 months

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Ages Eligible for Study:

* ≥ 50 years old but not treated with chronic dialysis or kidney transplantation
* In adults aged 18-49 years with CKD but not treated with chronic dialysis or kidney transplantation, statin treatment in people with one or more of the following: known coronary disease (myocardial infarction or coronary revascularization); diabetes mellitus; prior ischemic stroke; estimated 10-year incidence of coronary death or non-fatal myocardial infarction \> 10%.
* CKD in the 3,4 stage: (e-GFR: 15-60 ml/min/1.73 m2)
* CKD proteinuria (defined as Creatinine clearance \>20 ml/min/1.73 m2 combines with urinary protein excretion rate \>300mg/24 h)
* LDL cholesterol concentration \> 100 mg/dl (2,59 mmol/l)

Exclusion Criteria

In adults with dialysis-dependent CKD

* Heart failure (New York Heart Association class III or more)
* Previous or concomitant treatment with corticoids, statin, immunosuppressive agents, vitamin B6, B12, folate.
* Pregnancy
* Patients who do not agree to participate the research
* Patients are unable to understand the purposes and the risks of the study
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Università degli Studi di Sassari

OTHER

Sponsor Role collaborator

Hue University of Medicine and Pharmacy

OTHER

Sponsor Role lead

Responsible Party

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Duong Thi Ngoc Lan

Principal Investigator, Physician, Master degree

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Duong Thi Ngoc Lan, Master

Role: PRINCIPAL_INVESTIGATOR

Hue University of Medicine and Pharmacy

Locations

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Hue University of Medicine and Pharmacy

Huế, Thừa Thiên Huế Province, Vietnam

Site Status RECRUITING

Countries

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Vietnam

Central Contacts

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Duong Thi Ngoc Lan, Master

Role: CONTACT

084-903572535

Ciriaco Carru, Professor

Role: CONTACT

0039-3204299322

Facility Contacts

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Nguyen Thanh Thao

Role: primary

84.234.3822873

Nguyen Thanh Thao

Role: backup

84.234.3822873

References

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Tunnicliffe DJ, Palmer SC, Cashmore BA, Saglimbene VM, Krishnasamy R, Lambert K, Johnson DW, Craig JC, Strippoli GF. HMG CoA reductase inhibitors (statins) for people with chronic kidney disease not requiring dialysis. Cochrane Database Syst Rev. 2023 Nov 29;11(11):CD007784. doi: 10.1002/14651858.CD007784.pub3.

Reference Type DERIVED
PMID: 38018702 (View on PubMed)

Provided Documents

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Document Type: Study Protocol

View Document

Document Type: Statistical Analysis Plan

View Document

Document Type: Informed Consent Form

View Document

Related Links

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https://www.jstage.jst.go.jp/article/jat/22/12/22_29264/_pdf/-char/en

A Trial of Pitavastatin Versus Rosuvastatin for Dyslipidemia in Chronic Kidney Disease

http://jasn.asnjournals.org/content/25/8/1825.long

Effects of lowering LDL cholesterol on progression of kidney disease

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3534534/

Ezetimibe and simvastatin for the prevention of cardiovascular events in predialysis chronic kidney disease patients: a review

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3145073/

The effects of lowering LDL cholesterol with simvastatin plus ezetimibe in patients with chronic kidney disease (Study of Heart and Renal Protection): a randomised placebo-controlled trial.

Other Identifiers

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HueUMP

Identifier Type: -

Identifier Source: org_study_id

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