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Independent LivingPhase 4STAREENCT02099123

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

A Phase 4 study testing Atorvastatin in people with Independent Living and Disability Free Survival, run by Monash University at 6 sites in Australia.

Active, not recruiting

Under way, not looking for participants. Everyone needed has enrolled. The study is still running.

Official record
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Trial summary

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). Read more about this study

Who is it for?
Ages 70 years and olderHealthy volunteers can take part
What is being tested?
Atorvastatin
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
9,971 participants
Where
6 sitesAustralia
Study dates
Jul 2015to Dec 2025
Phase
Phase 4
Are there results?
Not yet: the study is under way

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 70 years and older
  • All sexes
  • Healthy volunteers accepted
  • Older adult

Who may be able to join

  • 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)

Who cannot join

  • 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),
Show all 11Show fewer
  • 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.

Trial locations and contacts

6 sites in 1 country.

6 sites in 1 country

Australia6 sites
  • South Australia

    Adelaide, Western Australia

  • Queensland

    Brisbane

  • Tasmania

    Hobart, Tasmania

  • Victoria

    Melbourne, Victoria

  • New South Wales

    Newcastle

  • Western Australia

    Perth

Other trials in Australia

About this study

Official title: A Study of STAtins for Reducing Events in the Elderly (STAREE)

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).

Read the detailed description

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.

Being tested
Atorvastatin, Placebo (for Atorvastatin)
Keywords
Survival, Functional Disability, Cardiovascular Disease, Diabetes, Dementia, Cancer
Medical subject headings
Cardiovascular Diseases, Diabetes Mellitus, Dementia, Neoplasms

What participants receive

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

  • AtorvastatinDrug

    Also called Lipitor, , , Cadivast, Caduet, Lorstat, Torvastat, Trovas, Atorachol, Cadatin

    Atorvastatin 20 mg tablet

  • Placebo (for Atorvastatin)Drug

    Also called no other names

    Inactive pill manufactured to mimic Atorvastatin 20 mg tablet

Study groups in NCT02099123
Study groupRoleWhat they receive
AtorvastatinExperimental40 mg atorvastatin (2 x 20 mg atorvastatin), taken orally once daily
Receives: Drug: Atorvastatin
PlaceboPlacebo comparatorPlacebo (2 x 20 mg placebo) taken orally once daily
Receives: Drug: Placebo (for Atorvastatin)

What is being measured

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

  1. Disability free survival - death or development of dementia or development of persistent physical disability

    Defined as survival free of dementia or persistent physical disability (as derived from the endpoints of all-cause mortality, dementia and physical disability)

    Measured: Time from randomisation to a primary endpoint or censoring at the end of study follow-up which is anticipated to be an average 6 years.

  2. Major cardiovascular events

    Defined as the first occurrence of a cardiovascular death or a non-fatal myocardial infarction or stroke or coronary revascularisation

    Measured: Time from randomisation to a primary endpoint or censoring at the end of study follow-up which is anticipated to be an average 6 years.

Secondary outcomes (16)
  1. A composite of cardiovascular death, non-fatal myocardial infarction or non-fatal stroke

    A composite of cardiovascular death, non-fatal myocardial infarction or non-fatal stroke

    Measured: Time from randomisation to a secondary endpoint or censoring at the end of study follow-up which is anticipated to be an average 6 years.

  2. Cardiovascular death

    Fatal cardiovascular events

    Measured: Time from randomisation to a secondary endpoint or censoring at the end of study follow-up which is anticipated to be an average 6 years.

  3. Fatal and Non-fatal Mycocardial infarction

    Fatal and non-fatal

    Measured: Time from randomisation to a secondary endpoint or censoring at the end of study follow-up which is anticipated to be an average 6 years.

  4. Hospitalisations

    Hospitalisation reasons and length of stay

    Measured: Time from randomisation to a secondary endpoint or censoring at the end of study follow-up which is anticipated to be an average 6 years.

  5. Fatal and Non-fatal Cancer

    Fatal and Non-fatal Cancer (excluding non-melanoma skin cancer)

    Measured: Time from randomisation to a secondary endpoint or censoring at the end of study follow-up which is anticipated to be an average 6 years.

  6. Other cognitive impairment

    Cognitive decline as assessed using cognitive tests excluding depression

    Measured: Time from randomisation to a secondary endpoint or censoring at the end of study follow-up which is anticipated to be an average 6 years.

  7. Quality of life measured by the Short Form Health Survey (SF-36)

    Quality of life (measured by the Short Form Health Survey (SF-36) administered at every second year of follow-up).

    Measured: Time from randomisation to a secondary endpoint or censoring at the end of study follow-up which is anticipated to be an average 6 years.

  8. Cost-effectiveness of statin

    Cost-effectiveness of statin

    Measured: Time from randomisation to a secondary endpoint or censoring at the end of study follow-up which is anticipated to be an average 6 years.

  9. Fatal and Non-fatal Stroke

    Fatal and Non-fatal Stroke can be a) haemorrhagic or b) thromboembolic

    Measured: Time from randomisation to a secondary endpoint or censoring at the end of study follow-up which is anticipated to be an average 6 years.

  10. Approved need for permanent residential care

    ACAS report

    Measured: Time from randomisation to a secondary endpoint or censoring at the end of study follow-up which is anticipated to be an average 6 years.

  11. Dementia

    All-cause dementia (COWAT, Stroop test, Trail Making Test, HVLT-R, SDMT, ADAS-Cog, Lurian overlapping figures) or external diagnosis

    Measured: Time from randomisation to a secondary endpoint or censoring at the end of study follow-up which is anticipated to be an average 6 years.

  12. Persistent physical disability

    KATZ-ADL administered every 6 months or external diagnosis

    Measured: Time from randomisation to a secondary endpoint or censoring at the end of study follow-up which is anticipated to be an average 6 years.

  13. All cause death

    All cause death

    Measured: Time from randomisation to a secondary endpoint or censoring at the end of study follow-up which is anticipated to be an average 6 years.

  14. Heart failure

    Heart failure

    Measured: Time from randomisation to a secondary endpoint or censoring at the end of study follow-up which is anticipated to be an average 6 years.

  15. Atrial fibrillation

    Atrial fibrillation

    Measured: Time from randomisation to a secondary endpoint or censoring at the end of study follow-up which is anticipated to be an average 6 years.

  16. Revascularisation procedure

    Revascularisation procedure including coronary revascularisation

    Measured: Time from randomisation to a secondary endpoint or censoring at the end of study follow-up which is anticipated to be an average 6 years.

Timeline

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

  1. First posted28 Mar 2014 (estimated)
  2. Study startJul 2015
  3. Primary completionDec 2025 (estimated)
  4. Study completionDec 2025 (estimated)

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 4
Primary purpose
Prevention
Allocation
Randomised
Intervention model
Parallel groups
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
9,971 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02099123
Sponsor's protocol ID
NHMRC 1068146
Acronym
STAREE
Status last verified
Nov 2024
First submitted
25 Mar 2014
Last updated
21 Nov 2024
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No: On completion of the trial, and after publication of the primary and secondary outcomes of the study, requests for access to de-identified data (to be provided through a secure online environment) may be submitted to the researchers located at the School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia

Publications

  • Zoungas S, Wolfe R, Moran C, Nicholls SJ, Cloud GC, Reid CM, Tauonkin AM, Beilin L, Wierzbicki AS, Chong TT, Broder JC, Curtis AJ, Flanagan Z, Hopper I, Ryan J, Spark S, McNeil JJ, Nelson MR; STAREE Investigators. Atorvastatin, Cardiovascular Events, and Disability-free Survival in Older Adults. N Engl J Med. 2026 Aug 29. doi: 10.1056/NEJMoa2607314. Online ahead of print.

    PubMed 42670961
  • 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.

    PubMed 39548016
  • 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.

    PubMed 37012015
  • 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.

    PubMed 36413436

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing Atorvastatin in people with Independent Living and Disability Free Survival, run by Monash University at 6 sites in Australia.

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 2 inclusion and 11 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: under way, not looking for participants, as of the sponsor's last update on 21 Nov 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 6 sites in Australia. 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. Some participants in this study may receive a placebo. 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 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.

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

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

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?

Disability free survival - death or development of dementia or development of persistent physical disability (time frame: Time from randomisation to a primary endpoint or censoring at the end of study follow-up which is anticipated to be an average 6 years.). The study lists 2 primary outcomes in all. 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 NCT02099123, which also lists 4 linked publications.

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 21 Nov 2024.

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