Efficacy of Lapaquistat Acetate Alone or Combined With Rosuvastatin in Subjects With Hypercholesterolemia - Full Text View

Purpose

The purpose of this study is to evaluate lapaquistat acetate, once daily (QD), taken alone or with rosuvastatin on cholesterol levels in treating patients with elevated cholesterol.

Condition	Intervention	Phase
Hypercholesterolemia	Drug: Lapaquistat acetate and rosuvastatin Drug: Rosuvastatin	Phase 3

Study Type:	Interventional
Study Design:	Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor) Primary Purpose: Treatment
Official Title:	A Double-Blind, Randomized Study to Evaluate the Efficacy and Safety of Lapaquistat Acetate 50 mg, 100 mg or Placebo When Coadministered With Rosuvastatin 10 mg or 20 mg in Subjects With Primary Hypercholesterolemia

Resource links provided by NLM:

MedlinePlus related topics: Cholesterol

Drug Information available for: Rosuvastatin calcium Rosuvastatin

U.S. FDA Resources

Further study details as provided by Takeda Global Research & Development Center, Inc.:

Primary Outcome Measures:

Change from Baseline in Low Density Lipoprotein cholesterol [ Time Frame: Week 24 or Final Visit ] [ Designated as safety issue: No ]

Secondary Outcome Measures:

Adverse Events [ Time Frame: Weeks: 2, 4, 8, 12, 16, 20, and 24 or Final Visit ] [ Designated as safety issue: Yes ]
Physical Examination [ Time Frame: Week 24 or Final Visit ] [ Designated as safety issue: Yes ]
Safety Laboratory Tests [ Time Frame: Weeks: 2, 4, 8, 12, 16, 20, and 24 or Final Visit ] [ Designated as safety issue: Yes ]
12- lead Electrocardiogram assessments [ Time Frame: Week 24 or Final Visit ] [ Designated as safety issue: Yes ]
Best Corrected Visual Acuity results [ Time Frame: Week 24 or Final Visit ] [ Designated as safety issue: Yes ]
Vital Signs [ Time Frame: Weeks: 2, 4, 8, 12, 16, 20, and 24 or Final Visit ] [ Designated as safety issue: Yes ]
Change from Baseline in Triglycerides [ Time Frame: Week 24 or Final Visit ] [ Designated as safety issue: No ]
Change from Baseline in Total Cholesterol [ Time Frame: Week 24 or Final Visit ] [ Designated as safety issue: No ]
Change from Baseline in High Density Lipoprotein cholesterol [ Time Frame: Week 24 or Final Visit ] [ Designated as safety issue: No ]
Change from Baseline in Very Low Density Lipoprotein cholesterol [ Time Frame: Week 24 or Final Visit ] [ Designated as safety issue: No ]
Change from Baseline in apolipoprotein A1 [ Time Frame: Week 24 or Final Visit ] [ Designated as safety issue: No ]
Change from Baseline in apolipoprotein B [ Time Frame: Week 24 or Final Visit ] [ Designated as safety issue: No ]
Change from Baseline in non- High Density Lipoprotein cholesterol [ Time Frame: Week 24 or Final Visit ] [ Designated as safety issue: No ]
Change from Baseline in the ratio of Low Density Lipoprotein cholesterol/High Density [ Time Frame: Week 24 or Final Visit ] [ Designated as safety issue: No ]
Change from Baseline in the ratio of Total Cholesterol/High Density Lipoprotein cholesterol [ Time Frame: Week 24 or Final Visit ] [ Designated as safety issue: No ]
Change from Baseline in the ratio of apolipoprotein A1/apolipoprotein B [ Time Frame: Week 24 or Final Visit ] [ Designated as safety issue: No ]
Change from Baseline in high-sensitivity C-reactive protein [ Time Frame: Week 24 or Final Visit ] [ Designated as safety issue: No ]
Percentage of subjects who achieve Low Density Lipoprotein cholesterol concentrations less than 1.81 mmol/L (70 mg/dL) [ Time Frame: Week 24 or Final Visit ] [ Designated as safety issue: No ]
Percentage of subjects who achieve Low Density Lipoprotein cholesterol concentrations less than 2.59 mmol/L (100 mg/dL) [ Time Frame: Week 24 or Final Visit ] [ Designated as safety issue: No ]
Percentage of subjects who achieve Low Density Lipoprotein cholesterol concentrations less than 3.37 mmol/L (130 mg/dL) [ Time Frame: Week 24 or Final Visit ] [ Designated as safety issue: No ]

Enrollment:	415
Study Start Date:	October 2005
Study Completion Date:	April 2007
Primary Completion Date:	April 2007 (Final data collection date for primary outcome measure)

Arms	Assigned Interventions
Experimental: Lapaquistat Acetate 50 mg QD + Rosuvastatin	Drug: Lapaquistat acetate and rosuvastatin Lapaquistat acetate 50 mg, tablets, orally, once daily and stable Rosuvastatin therapy (10 or 20 mg) for up to 24 weeks. Other Names: TAK-475 Crestor
Experimental: Lapaquistat Acetate 100 mg QD + Rosuvastatin	Drug: Lapaquistat acetate and rosuvastatin Lapaquistat acetate 100 mg, tablets, orally, once daily and stable Rosuvastatin therapy (10 or 20 mg) for up to 24 weeks. Other Names: TAK-475 Crestor
Active Comparator: Rosuvastatin	Drug: Rosuvastatin Lapaquistat acetate placebo-matching tablets, orally, once daily and stable Rosuvastatin therapy (10 or 20 mg) for up to 24 weeks. Other Name: Crestor

Detailed Description:

Elevated plasma cholesterol (hypercholesterolemia) and various other plasma lipid imbalances (dyslipidemias) are major risk factors for coronary heart disease. Patients with hypercholesterolemia have elevated low-density lipoprotein cholesterol, which leads to atherosclerotic deposition of cholesterol in the arterial walls. As identified by the National Cholesterol Education Program Adult Treatment Panel III, lowering the low-density lipoprotein cholesterol plasma concentration effectively reduces cardiovascular morbidity and mortality and is essential for the prevention and management of coronary heart disease.

Currently, 3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitors (statins) are the first-line monotherapies prescribed to reduce low-density lipoprotein cholesterol, after diet and therapeutic lifestyle change. However, low doses of statins often fail to produce the ATP III-recommended levels of low-density lipoprotein cholesterol reduction, making it necessary to increase the dose or add an additional treatment. Dose increases of statins in turn may result in decreased tolerability and potential safety concerns which contribute to the high discontinuation rates of statins and their prescription at low, and often ineffective, doses.

The purpose of this study is to determine whether administration of lapaquistat acetate co-administered with rosuvastatin will be more efficacious in lowering low-density lipoprotein cholesterol, compared to lapaquistat or rosuvastatin alone. Total participation time in this study is anticipated to be 24 weeks.

Eligibility

Ages Eligible for Study:	18 Years and older
Genders Eligible for Study:	Both
Accepts Healthy Volunteers:	No

Criteria

Inclusion Criteria:

Woman of childbearing potential can not to be pregnant, lactating, not planning on becoming pregnant, and agree to use acceptable forms of contraception throughout the course of the study.
Prior to Randomization, has a low-density lipoprotein cholesterol level mean greater than or equal to 3.37 mmol/L and less than or equal to 5.70 mmol/L.
Prior to Randomization, has a mean triglyceride level less than or equal to 4.52 mmol/L (400 mg/dL).
Has clinical laboratory evaluations including clinical chemistry, hematology, and urinalysis within the defined reference range.
Participant is taking a stable dose of rosuvastatin (10 or 20 mg) for at least 4 weeks prior to Screening.

Exclusion Criteria:

Has an alanine aminotransferase or aspartate aminotransferase level of greater than 1.5 times the upper limit of normal, active liver disease or jaundice.
Has a serum creatinine of greater than 133 μmol/L.
Has a creatine kinase greater than 3 times the upper limit of normal.
Has type 1 or 2 diabetes mellitus.
Has a previous history of cancer that had been in remission for less than 5 years prior to the first dose of study medication.
Has an endocrine disorder, such as Cushing syndrome, hyperthyroidism, or inappropriately treated hypothyroidism, affecting lipid metabolism.
Has a history of myocardial infarction, angina pectoris, transient ischemic attacks, cerebrovascular accident, peripheral vascular disease, abdominal aortic aneurysm, coronary revascularization or multiple factors that conferred a 10-year risk for coronary heart disease greater than 20% based on Framingham risk scoring.
Has a positive hepatitis B surface antigen, or antibody to hepatitis C virus, as determined by medical history and/or subject's verbal report.
Has a positive human immunodeficiency virus status or was taking antiretroviral medications, as determined by medical history.
Has 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.
The subject had a known hypersensitivity or history of adverse reaction rosuvastatin.
Has a history or presence of clinically significant food allergy that would prevent adherence to the recommended diet.
Has a known heterozygous or homozygous familial hypercholesterolemia or known Type III hyperlipoproteinemia (familial dysbetalipoproteinemia).
Has fibromyalgia, myopathy, rhabdomyolysis or unexplained muscle pain.
Has uncontrolled hypertension
Has inflammatory bowel disease, any other malabsorption syndrome, or had gastric bypass or any other surgical procedure for weight loss.
Is unwilling or unable, in the opinion of the investigator, to comply with the protocol or scheduled appointments.
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 reduced life expectancy, impaired successful management according to the protocol, or make the participant an unsuitable candidate to receive study medication.

Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT00249912

Show 92 Study Locations

Sponsors and Collaborators

Takeda Global Research & Development Center, Inc.

Investigators

Study Director:

Medical Director

Takeda Global Research & Development Center, Inc.

More Information

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. Epub 2011 Apr 25.

Responsible Party:	Takeda Global Research & Development Center, Inc.
ClinicalTrials.gov Identifier:	NCT00249912 History of Changes
Other Study ID Numbers:	01-05-TL-475-022, U1111-1122-8106
Study First Received:	November 4, 2005
Last Updated:	May 23, 2012
Health Authority:	United States: Food and Drug Administration Canada: Health Canada

Keywords provided by Takeda Global Research & Development Center, Inc.:

Hyperlipidemia
Drug Therapy

Additional relevant MeSH terms:

Hypercholesterolemia
Hyperlipidemias
Dyslipidemias
Lipid Metabolism Disorders
Metabolic Diseases
Rosuvastatin
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Anticholesteremic Agents

Hypolipidemic Agents
Antimetabolites
Molecular Mechanisms of Pharmacological Action
Pharmacologic Actions
Enzyme Inhibitors
Lipid Regulating Agents
Therapeutic Uses

ClinicalTrials.gov processed this record on May 21, 2013