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HypercholesterolemiaPhase 3NCT00143676

Efficacy of Lapaquistat Acetate and Atorvastatin on Blood Cholesterol Levels in Subjects With Primary Hypercholesterolemia

A Phase 3 study testing Lapaquistat acetate and atorvastatin and Atorvastatin in people with Hypercholesterolemia, run by Takeda at 78 sites in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
Search all trials

Trial summary

The purpose of this study is to determine the efficacy of lapaquistat acetate, once daily (QD), on lowering cholesterol in subjects already taking atorvastatin. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Hypercholesterolemia
What is being tested?
Lapaquistat acetate and atorvastatin and Atorvastatin
Type of treatment
Pill or oral medicine
Could I receive a placebo?
No, everyone receives an active treatment
How many people
448 participants
Where
78 sitesUnited States
Study dates
Aug 2005to Aug 2006
Phase
Phase 3
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Female subjects of childbearing potential must not be pregnant as determined by a negative serum human chorionic gonadotropin, lactating, or planning on becoming pregnant, and agrees to use acceptable forms of contraception during the study.
  • Must have a mean low density lipoprotein cholesterol value greater than or equal to 2.590 mmol/L (100 mg/dL) for 2 consecutive samples
  • Must have a mean triglyceride value less than or equal to 4.516 mmol/L (400 mg/dL) for 2 consecutive samples.
  • Has taken a stable dose of atorvastatin (10 to 40 mg)
  • Has clinical laboratory evaluations within reference range for the testing laboratory.
  • Is willing and able to continue to comply with a standardized low-cholesterol diet.

Who cannot join

  • Has an alanine aminotransferase or aspartate aminotransferase level greater than 1.5 times the upper limit of normal, active liver disease or jaundice.
  • Has a serum creatinine level greater than 135 μmol/L (1.5 mg/dL).
  • Has a creatine phosphokinase level greater than 3 times the upper limit of normal
  • Has diabetes with a hemoglobin A1c level greater than 8% at Visit 1.
  • Has a history of cancer in remission for less than 5 years prior to the first dose of study drug.
  • Has an endocrine disorder, such as Cushing's syndrome, hyperthyroidism, or inappropriately treated hypothyroidism, affecting lipid metabolism.
Show all 18Show fewer
  • Has a history of myocardial infarction, unstable angina, transient ischemic attacks, cerebrovascular accident, percutaneous coronary intervention, or coronary or peripheral arterial surgery.
  • Has a positive hepatitis B surface antigen, or hepatitis C virus antibody, as determined by medical history and/or the subject's verbal report.
  • Has a positive human immunodeficiency virus status or was taking antiretroviral medications as determined by medical history and/or the subject's verbal report.
  • Has had exposure to lapaquistat acetate in other studies, was participating in another investigational study, or had participated in an investigational study within the past 30 days or, for drugs with a long half-life, within a period of less than 5 times the drug's half-life.
  • Has a known hypersensitivity or history of adverse reaction to atorvastatin.
  • Has a history or presence of clinically significant food allergy that would prevent adherence to the recommended diet.
  • Has a known homozygous familial hypercholesterolemia or known type III hyperlipoproteinemia.
  • Has fibromyalgia, myopathy, rhabdomyolysis, or unexplained muscle pain.
  • Has uncontrolled hypertension
  • Has inflammatory bowel disease or any other malabsorption syndrome or has had gastric bypass or any other surgical procedure for weight loss.
  • Has a history of drug abuse or a history of alcohol abuse within the past 2 years.
  • Has any other serious disease or condition that might reduce life expectancy, impair successful management according to the protocol, or make the subject an unsuitable candidate to receive study drug.

Trial locations and contacts

78 sites in 1 country.

78 sites in 1 country

United States78 sites
  • Study site

    Allentown, Pennsylvania

  • Study site

    Altoona, Pennsylvania

  • Study site

    Anaheim, California

  • Study site

    Arkansas City, Kansas

  • Study site

    Arlington Heights, Illinois

  • Study site

    Auburn, Maine

  • Study site

    Birmingham, Alabama

  • Study site

    Bloomington, Indiana

  • Study site

    Carmichael, California

  • Study site

    Charleston, South Carolina

  • Study site

    Chattanooga, Tennessee

  • Study site

    Chicago, Illinois

  • Study site

    Chula Vista, California

  • Study site

    Cincinnati, Ohio

  • Study site

    Clearwater, Florida

  • Study site

    Corpus Christi, Texas

  • Study site

    Dallas, Texas

  • Study site

    Daytona Beach, Florida

  • Study site

    Downingtown, Pennsylvania

  • Study site

    Edina, Minnesota

  • Study site

    Edison, New Jersey

  • Study site

    Escondido, California

  • Study site

    Euless, Texas

  • Study site

    Evansville, Indiana

  • Study site

    Golden, Colorado

  • Study site

    Hickory, North Carolina

  • Study site

    Hollywood, Florida

  • Study site

    Honolulu, Hawaii

  • Study site

    Indianapolis, Indiana

  • Study site

    Jacksonville, Florida

  • Study site

    Jonesboro, Arkansas

  • Study site

    Jupiter, Florida

  • Study site

    Kansas City, Kansas

  • Study site

    Kissimmee, Florida

  • Study site

    Las Vegas, Nevada

  • Study site

    Livonia, Michigan

  • Study site

    Louisville, Kentucky

  • Study site

    Madison, Wisconsin

  • Study site

    Margate City, New Jersey

  • Study site

    Medford, Oregon

  • Study site

    Miami, Florida

  • Study site

    Morristown, Tennessee

  • Study site

    Mt. Pleasant, South Carolina

  • Study site

    New Hyde Park, New York

  • Study site

    New Port Richey, Florida

  • Study site

    Norfolk, Virginia

  • Study site

    Northport, Alabama

  • Study site

    Ocala, Florida

  • Study site

    Ogden, Utah

  • Study site

    Omaha, Nebraska

  • Study site

    Overland Park, Kansas

  • Study site

    Pembroke Pines, Florida

  • Study site

    Peoria, Illinois

  • Study site

    Pismo Beach, California

  • Study site

    Portland, Oregon

  • Study site

    Raleigh, North Carolina

  • Study site

    Renton, Washington

  • Study site

    Richmond, Virginia

  • Study site

    Rochester, New York

  • Study site

    Salt Lake City, Utah

  • Study site

    San Antonio, Texas

  • Study site

    Santa Rosa, California

  • Study site

    Searcy, Arkansas

  • Study site

    Sellerville, Pennsylvania

  • Study site

    Sierra Vista, Arizona

  • Study site

    Simpsonville, South Carolina

  • Study site

    Statesville, North Carolina

  • Study site

    Syracuse, New York

  • Study site

    The Colony, Texas

  • Study site

    Tipton, Pennsylvania

  • Study site

    Tucson, Arizona

  • Study site

    Tulsa, Oklahoma

  • Study site

    Warwick, Rhode Island

  • Study site

    Waterbury, Connecticut

  • Study site

    Waterloo, Iowa

  • Study site

    West Palm Beach, Florida

  • Study site

    Wichita, Kansas

  • Study site

    Winston-Salem, North Carolina

Other trials in United States

About this study

Official title: A Double-blind, Randomized Placebo-controlled Study to Evaluate the Efficacy and Safety of TAK-475 50 mg, 100 mg, or Placebo When Co-administered With Atorvastatin (10 mg to 40 mg) in Subjects With Primary Hypercholesterolemia

The purpose of this study is to determine the efficacy of lapaquistat acetate, once daily (QD), on lowering cholesterol in subjects already taking atorvastatin.

Read the detailed description

According to the World Health Organization, CHD is now the leading cause of death worldwide. In 2001, CHD caused 7.2 million deaths and estimates for 2020 indicate that annual CHD deaths will increase to 11.1 million. These statistics suggest that improved options are needed to treat hypercholesterolemia and dyslipidemia.

The balance among cholesterol synthesis, dietary intake, and degradation is normally adequate to maintain healthy cholesterol plasma levels. However, in patients with hypercholesterolemia, elevated low-density lipoprotein cholesterol leads to atherosclerotic deposition of cholesterol in the arterial walls. Consequently, in this population it has been established that lowering low-density lipoprotein cholesterol plasma concentrations effectively reduces cardiovascular morbidity and mortality. The National Cholesterol Education Program Adult Treatment Panel III has therefore identified control of low-density lipoprotein cholesterol as essential in the prevention and management of CHD. Additional lipid risk factors designated by National Cholesterol Education Program Adult Treatment Panel III include elevated triglycerides, elevated non-high-density lipoprotein cholesterol (atherogenic lipoproteins), and low levels of high-density lipoprotein cholesterol. Lipoproteins rich in triglycerides, such as very-low-density lipoprotein cholesterol, appear to contribute to atherosclerosis, whereas the apparent protective effect of high-density lipoprotein cholesterol, which is likely related to high-density lipoprotein cholesterol-facilitated transport of cholesterol away from atherosclerotic deposits, may be limited at low high-density lipoprotein cholesterol concentrations.

Initial dietary and lifestyle measures taken to control dyslipidemia are often inadequate, and most patients require pharmacologic intervention. Currently, 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins) are the first-line monotherapies most often prescribed to reduce low-density lipoprotein cholesterol, after diet and therapeutic lifestyle change. However, with statin monotherapy, many patients fail to reach National Cholesterol Education Program Adult Treatment Panel III recommended levels of low-density lipoprotein cholesterol reduction. As a result, the statin dosage must be increased or an additional treatment added to achieve treatment goals. Increasing the statin dosage may result in decreased tolerability and potential safety concerns, contributing to the high discontinuation rates of statins and their prescription at low and often ineffective doses. Further, although the effectiveness of increasing the dose varies among the statins, in general, doubling of the dose above the minimum effective dose has been found to decrease serum low-density lipoprotein cholesterol by only an additional 6 percent.

TGRD is developing an orally active squalene synthase inhibitor, TAK-475 (lapaquistat acetate) for the treatment of dyslipidemia. Lapaquistat acetate inhibits the biosynthesis of cholesterol by inhibiting the enzyme squalene synthase, which catalyzes the conversion of farnesyl diphosphate to squalene-a precursor in the final steps of cholesterol production.

This study will assess the effects of co-administration of lapaquistat acetate with atorvastatin, the most commonly prescribed statin in the United States, on LDL-C and associated lipid variables in subjects with hypercholesterolemia. Study Participation is anticipated to be up to 24 weeks.

Being tested
Lapaquistat acetate and atorvastatin, Atorvastatin
Keywords
Hyperlipidemia, Dyslipidemia, Drug Therapy
Medical subject headings
Hypercholesterolemia, Hyperlipidemias, Dyslipidemias

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Lapaquistat acetate and atorvastatinDrug

    Also called Lapaquistat, Lipitor, TAK-475

    Lapaquistat acetate 50 mg, tablets, orally, once daily and Atorvastatin 10 mg to 40 mg stable dose for up to 24 weeks.

  • Lapaquistat acetate and atorvastatinDrug

    Also called Lapaquistat, Lipitor, TAK475

    Lapaquistat acetate 100 mg, tablets, orally, once daily and Atorvastatin 10 mg to 40 mg stable dose for up to 24 weeks.

  • AtorvastatinDrug

    Also called Lipitor

    Lapaquistat acetate placebo-matching tablets, orally, once daily and Atorvastatin 10 mg to 40 mg stable dose for up to 24 weeks.

Study groups in NCT00143676
Study groupRoleWhat they receive
Lapaquistat Acetate 50 mg QD + AtorvastatinExperimentalNot described
Receives: Drug: Lapaquistat acetate and atorvastatin
Lapaquistat Acetate 100 mg QD + AtorvastatinExperimentalNot described
Receives: Drug: Lapaquistat acetate and atorvastatin
AtorvastatinActive comparatorNot described
Receives: Drug: Atorvastatin

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change from Baseline in Low Density Lipoprotein cholesterol

    Measured: Week 24 or Final Visit

Secondary outcomes (20)
  1. Adverse Events

    Measured: Weeks: 2, 4, 8, 12, 16, 20, and 24 or Final Visit

  2. Physical Examination

    Measured: Week 24 or Final Visit

  3. Safety Laboratory Tests

    Measured: Weeks: 2, 4, 8, 12, 16, 20, and 24 or Final Visit

  4. Electrocardiogram assessments

    Measured: Week 24 or Final Visit

  5. Best Corrected Visual Acuity results

    Measured: Week 24 or Final Visit

  6. Vital Signs

    Measured: Weeks: 2, 4, 8, 12, 16, 20, and 24 or Final Visit

  7. Change from Baseline in Triglycerides

    Measured: Week 24 or Final Visit

  8. Change from Baseline in Total Cholesterol

    Measured: Week 24 or Final Visit

  9. Change from Baseline in High Density Lipoprotein cholesterol

    Measured: Week 24 or Final Visit

  10. Change from Baseline in Very Low Density Lipoprotein cholesterol

    Measured: Week 24 or Final Visit

  11. Change from Baseline in apolipoprotein A1

    Measured: Week 24 or Final Visit

  12. Change from Baseline in apolipoprotein B

    Measured: Week 24 or Final Visit

  13. Change from Baseline in non- High Density Lipoprotein cholesterol

    Measured: Week 24 or Final Visit

  14. Change from Baseline in the ratio of Low Density Lipoprotein cholesterol/High Density Lipoprotein cholesterol

    Measured: Week 24 or Final Visit

  15. Change from Baseline in the ratio of Total Cholesterol/High Density Lipoprotein cholesterol

    Measured: Week 24 or Final Visit

  16. Change from Baseline in the ratio of apolipoprotein A1/apolipoprotein B

    Measured: Week 24 or Final Visit

  17. Change from Baseline in high-sensitivity C-reactive protein

    Measured: Week 24 or Final Visit

  18. Percentage of subjects who achieve Low Density Lipoprotein cholesterol concentrations less than 1.813 mmol/L (70 mg/dL)

    Measured: Week 24 or Final Visit

  19. Percentage of subjects who achieve Low Density Lipoprotein cholesterol concentrations less than 2.590 mmol/L (100 mg/dL)

    Measured: Week 24 or Final Visit

  20. Percentage of subjects who achieve Low Density Lipoprotein cholesterol concentrations less than 3.367 mmol/L (130 mg/dL)

    Measured: Week 24 or Final Visit

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted2 Sep 2005 (estimated)
  2. Study startAug 2005
  3. Primary completionAug 2006
  4. Study completionAug 2006

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
448 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT00143676
Sponsor's protocol ID
01-04-TL-475-009
Other IDs
U1111-1122-7783
Status last verified
May 2012
First submitted
31 Aug 2005
Last updated
24 May 2012
Results posted
No
Data monitoring committee
No

Publications

  • Stein EA, Bays H, O'Brien D, Pedicano J, Piper E, Spezzi A. Lapaquistat acetate: development of a squalene synthase inhibitor for the treatment of hypercholesterolemia. Circulation. 2011 May 10;123(18):1974-85. doi: 10.1161/CIRCULATIONAHA.110.975284. Epub 2011 Apr 25.

    PubMed 21518985

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Lapaquistat acetate and atorvastatin and Atorvastatin in people with Hypercholesterolemia, run by Takeda at 78 sites in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 6 inclusion and 18 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 24 May 2012. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 78 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change from Baseline in Low Density Lipoprotein cholesterol (time frame: Week 24 or Final Visit). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT00143676, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 24 May 2012.

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