Fenofibrate and Omega-3 Fatty Acid Modulation of Endotoxemia (FFAME)

The purpose of this study is to better understand the anti-inflammatory benefits of two prescription medicines that are currently used to help people with cholesterol problems.

Fish oil, from eating certain kinds of fish and from supplement pills, has been used to help control cholesterol and reduce inflammation (the body's response to injury or sickness). Lovaza® is the brand name for prescription strength fish oil pills. In this study, we will be looking at how Lovaza® works to help reduce inflammation in healthy volunteers.

Tricor® is the brand name for prescription fenofibrate pills. Fenofibrate is a prescription medicine that many doctors give to people with high triglyceride (fat in the blood) levels. In this study, we will be looking at how Tricor® works to help reduce inflammation in healthy volunteers.

Endotoxin or lipopolysaccharide (LPS) is a small part of bacteria (that is no longer living) that can cause many of the effects similar to bacterial infections in humans. However, it can be administered in very small amounts to produce a mild immune response much the same as a 'flu' like illness. Within 1 ½ -3 hours after giving LPS by vein, a response consisting of fever, chills, headache, nausea and vomiting and generalized aches and pains will occur which lasts up to 6-8 hours. In addition to the flu like symptoms, the response causes temporary changes in cholesterol, triglycerides and blood sugar. Different people respond differently to LPS. We are using LPS in this study to bring on a temporary inflammatory response in the body and to compare the responses of people who receive Lovaza® or Tricor® to the responses of people who receive a placebo (pill that does not contain medicine).

• Drug: Fenofibrate tablets
  One 145 mg tablet taken once daily, in the evening, with food, for 6 to 8 weeks
• Drug: Placebo
  Two placebo capsules taken twice daily, morning and evening, with food and one placebo gel capsule taken once daily, in the evening, with food, for 6 to 8 weeks
• Drug: Lovaza
  900 mg/day: One 900 mg capsule taken once daily, morning or evening; or 3,600 mg/day: Two 900 mg capsules taken twice daily, morning and evening; All capsules to be taken with food, for 6 to 8 weeks.

• Experimental: Tricor (145 mg/day)
  Participants will be given 1 Tricor 145mg and 4 fish oil placebos - supplies of study drug will be provided to last 8 weeks.
  Intervention: Drug: Fenofibrate tablets
• Placebo Comparator: Placebo
  Participants will be given 5 placebo pills (4 fish oil placebo and 1 Fenofibrate placebo) - supplies of study drug will be provided to last 8 weeks.
  Intervention: Drug: Placebo
• Experimental: Lovaza (900 mg/day)
  Participants will be given 1 Lovaza capsule, 3 Fish oil placebo capsules, and 1 Fenofibrate placebo - supplies of study drug will be provided to last 8 weeks.
  Intervention: Drug: Lovaza
• Experimental: Lovaza (3,600 mg/day)
  Participants will be given 4 Lovaza capsules and 1 Fenofibrate placebo - supplies of study drug will be provided to last 8 weeks.
  Intervention: Drug: Lovaza

Inclusion Criteria:

• Men and non-pregnant/lactating women between the ages of 18 and 45.
• BMI ≥18 and ≤30
• Participants who are able to give written informed consent and willing to comply with all study-related procedures.

Exclusion Criteria:

• Known clinically manifest atherosclerotic cardiovascular disease, including coronary disease, cerebrovascular disease, or peripheral vascular disease
• History of diabetes mellitus
• Fasting glucose >126mg/dL at screening
• History of a non-skin malignancy within the previous 5 years
• Renal insufficiency as defined by creatinine outside of lab defined normal range or eGFR <60 ml/Kg/min at Screening Visit
• History of liver disease or abnormal LFTs (AST, ALT, Alk. Phos., GGT > 1.5x ULN; bilirubin > 2x ULN) at Screening Visit
• Men who are unwilling to limit alcohol consumption to < 14 alcoholic drinks per week or < 4 alcoholic drinks per occasion (AMA / NIAAA criteria for "at risk" usage levels) while participating in the study
• Women who are unwilling to limit alcohol consumption to < 7 alcoholic drinks per week or < 3 alcoholic drinks per occasion (AMA / NIAAA criteria for "at risk" usage levels) while participating in the study
• Total white blood cell count less than or equal to 3.0 THO/uL
• Hemoglobin less than 11.0 g/dL
• Any major active rheumatologic, pulmonary, or dermatologic disease or inflammatory condition or minor active infection
• Self-reported history of HIV positive
• First degree family history of premature cardiovascular disease event (father or brother if diagnosed at before 55 years of age; mother or sister if diagnosed before 65 years of age)
• Patients who have undergone any organ transplant
• Individuals who currently use tobacco products or have done so in the previous 30 days
• Treatment with aspirin, NSAIDs, COX-2 inhibitors, steroids or any immunomodulatory therapy 2 weeks prior to the Screening Visit
• Treatment with statins, fibrates or niacin 4 weeks prior to the Screening Visit.
• Current daily use of Vitamin C > 1000 mg, Beta carotene > 1000 IU, vitamin A > 5000 IU, vitamin E > 400 IU, and selenium > 200 mcg
• Participants who are unwilling to eliminate omega-3 fatty acid (EPA + DHA) supplements and/or fortified food, or have their usual intake of high omega-3 fish (tuna and other non-fried fish) be > 3 to 4 servings per month as assessed by a simple screening questionnaire
• Positive urine pregnancy test result.
• Participation in another clinical trial within the previous 6 weeks prior to the Screening Visit.
• Poorly controlled blood pressure (BP > 160/110) or on any anti-hypertensive medications.
• A diagnosis of metabolic syndrome using updated 2004 NCEP ATPIII criteria.
• Any medical condition or abnormal laboratory value that is judged clinically significant by an investigator

• National Heart, Lung, and Blood Institute (NHLBI)
• GlaxoSmithKline