Comparison of Pitavastatin Plus Ezetimibe Versus High-Intensity Statin Therapy on Risk of New-Onset Diabetes Mellitus

NCT ID: NCT06767774

Last Updated: 2025-04-27

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

RECRUITING

Clinical Phase

PHASE4

Total Enrollment

2000 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-04-25

Study Completion Date

2030-01-31

Brief Summary

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The AVOID-DM trial is a multicenter, prospective, randomized study comparing the risk of new-onset diabetes mellitus (DM) between two cholesterol-lowering strategies in patients with prediabetes and established atherosclerotic cardiovascular disease (ASCVD). The study evaluates pitavastatin plus ezetimibe combination therapy versus high-intensity statin monotherapy (rosuvastatin 20 mg). Enrolling 2,000 non-diabetic participants with ASCVD, subjects are randomized 1:1 into the two treatment arms. The primary outcome is the incidence of new-onset DM over a follow-up period of up to 36 months. Secondary outcomes include cardiovascular events, changes in LDL cholesterol, fasting glucose, HbA1c, and insulin resistance. This trial hypothesizes that the combination therapy will achieve LDL targets with a lower risk of new-onset DM compared to high-intensity statin monotherapy.

Detailed Description

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Conditions

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ASCVD Diabetes Statin

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Study Groups

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Combination therapy

fixed dose single-pill combination of pitavastatin 4mg plus ezetimibe 10mg

Group Type EXPERIMENTAL

Combination therapy

Intervention Type DRUG

* pitavastatin 4mg
* ezetimibe 10mg

High intensity statin monotherapy

Rosuvastatin 20mg

Group Type ACTIVE_COMPARATOR

High intensity statin monotherapy

Intervention Type DRUG

rosuvastatin 20mg

Interventions

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Combination therapy

* pitavastatin 4mg
* ezetimibe 10mg

Intervention Type DRUG

High intensity statin monotherapy

rosuvastatin 20mg

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Age Requirement:

* Patients aged 18 years or older.

Glycemic Status:

* Patients who are not taking oral hypoglycemic agents (OHAs) and meet all of the following criteria:

* Fasting glucose less than 126 mg/dL.\*
* HbA1c less than 6.5%.
* Plasma glucose less than 200 mg/dL after 2 hours during a 75 g oral glucose tolerance test (OGTT).\*Note: For fasting glucose, two measurements of 126 mg/dL or greater within 3 months are required for a diagnosis of diabetes.

Cardiovascular Disease:

* Patients with established atherosclerotic cardiovascular disease, defined as having at least one of the following:

* Coronary Heart Disease (CHD):

* Documented history of myocardial infarction (MI).
* History of coronary revascularization.

* 50% stenosis of a major epicardial coronary artery confirmed by cardiac catheterization, computed tomography (CT), or coronary angiography.
* Cerebrovascular Disease:

\>History of stroke of atherosclerotic origin.
* History of carotid revascularization.

\>≥50% stenosis of the carotid artery confirmed by X-ray angiography, magnetic resonance (MR) angiography, CT angiography, or Doppler ultrasound.
* Symptomatic Peripheral Arterial Disease (PAD):

\>Intermittent claudication with an ankle-brachial index (ABI) of 0.90 at rest.
* Intermittent claudication with ≥50% stenosis of a peripheral artery (excluding the carotid artery) confirmed by X-ray angiography, MR angiography, CT angiography, or Doppler ultrasound.
* History of revascularization of peripheral arteries (excluding carotid arteries).
* Lower extremity amputation at or above the ankle due to atherosclerotic disease (excluding trauma or osteomyelitis).

Dietary Requirements:

* Patients must be on a stable diet prior to randomization and able to adhere to the National Cholesterol Education Program (NCEP) Therapeutic Lifestyle Change (TLC) diet or an equivalent throughout the study.

Informed Consent:

* Subjects or their legal representatives must provide written informed consent to the study protocol and clinical follow-up schedule.
* An informed consent form approved by the institutional review board (IRB)/ethics committee of the study site must be signed.

Exclusion Criteria

* Patient is pregnant or breastfeeding or of childbearing potential.
* Requires concomitant administration of strong inhibitors of CYP3A4 (itraconazole, ketoconazole, protease inhibitors, erythromycin, clarithromycin, telithromycin, and nefazodone) or CYP2C9 (relative contraindication not dependent on CYP450 statins).
* Chronic kidney disease (eGFR \< 30 ml/min/1.73m²) or dialysis-dependent renal failure.
* Uncontrolled hypothyroidism.
* Personal or family history of an inherited muscle disorder.
* History of statin-induced muscle toxicity.
* Alcohol-dependent person.
* Hypersensitivity to statins and ezetimibe.
* Hemodynamic instability at the time of enrollment: cardiogenic shock, refractory ventricular arrhythmia, or congestive heart failure (New York Heart Association class IV) at randomization.
* History of hemorrhagic stroke or intracranial hemorrhage, TIA, or ischemic stroke within the past 6 months.
* Planned surgery requiring discontinuation of statins or ezetimibe within 6 months of randomization.
* Current treatment for active cancer.
* Clinically significant abnormal findings identified at the screening visit, physical examination, laboratory tests, or electrocardiogram that, in the investigator's judgment, may interfere with safe completion of the study.
* Liver disease or biliary obstruction, elevated liver enzymes (ALT or AST \> the upper limit of normal) or elevated total bilirubin (total bilirubin \> 2 times the upper limit of normal) at screening.
* Life expectancy for noncardiac or cardiac causes \< 1 year.
* Unwillingness or inability to comply with the procedures described in this protocol.
* Previously diagnosed with diabetes mellitus and compliant with lifestyle modification and taking oral hypoglycemic agents (OHAs) or insulin.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Daewon Pharmaceutical Co., Ltd.

INDUSTRY

Sponsor Role collaborator

Samjin Pharmaceutical Co., Ltd.

INDUSTRY

Sponsor Role collaborator

Korea University Anam Hospital

OTHER

Sponsor Role lead

Responsible Party

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Dr. Cheol Woong Yu

Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Korea University Anam Hospital

Seoul, , South Korea

Site Status RECRUITING

Countries

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South Korea

Central Contacts

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Cheol Woong Yu

Role: CONTACT

+82-2-920-5445

Facility Contacts

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Korea Hospital

Role: primary

References

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Other Identifiers

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AVOIDM

Identifier Type: -

Identifier Source: org_study_id

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