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REVEAL: Randomized EValuation of the Effects of Anacetrapib Through Lipid-modification (REVEAL)

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.
 
ClinicalTrials.gov Identifier: NCT01252953
Recruitment Status : Active, not recruiting
First Posted : December 3, 2010
Results First Posted : May 4, 2018
Last Update Posted : March 14, 2022
Sponsor:
Collaborator:
Merck Sharp & Dohme LLC
Information provided by (Responsible Party):
University of Oxford

Brief Summary:
The Randomized EValuation of the Effects of Anacetrapib Through Lipid-modification (REVEAL) trial aims to determine whether lipid modification with anacetrapib 100mg daily reduces the risk of coronary death, myocardial infarction (MI) or coronary revascularization (collectively known as major coronary events) in patients with circulatory problems who have their Low-density Lipoprotein (LDL) cholesterol level treated with a statin.

Condition or disease Intervention/treatment Phase
Atherosclerotic Cardiovascular Disease Drug: Anacetrapib Drug: Placebo anacetrapib Phase 3

Detailed Description:

Sub-study: Does anacetrapib as a CETP inhibitor lead to mobilization of stem cells and enhance myocardial function via neoangiogenesis and tissue regeneration?

Following the main on-treatment part of the study, there was a further period of at least 2 years during which participants were followed-up by telephone, off treatment.

All participants stopped study treatment prior to February 2017 (results for the main-trial have been reported) and direct participant follow-up was completed in April 2019.

In the UK we will continue to collect information on health outcomes via central data registries and NHS sources for many years.

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 30449 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary Purpose: Prevention
Official Title: REVEAL: Randomized EValuation of the Effects of Anacetrapib Through Lipid-modification. A Large-scale, Randomized Placebo-controlled Trial of the Clinical Effects of Anacetrapib Among People With Established Vascular Disease
Study Start Date : June 2011
Actual Primary Completion Date : January 31, 2017
Estimated Study Completion Date : January 31, 2037

Arm Intervention/treatment
Experimental: Anacetrapib Drug: Anacetrapib
tablet, 100mg daily

Placebo Comparator: Placebo anacetrapib Drug: Placebo anacetrapib
tablet, 1 tablet daily




Primary Outcome Measures :
  1. Number of Participants With Major Coronary Event [ Time Frame: Randomized treatment phase during median follow-up period of 4.1years ]

    Primary assessment involves an intention-to-treat comparison among all randomized participants of the effects of allocation to anacetrapib versus placebo on major coronary events (defined as the occurrence of coronary death, myocardial infarction or coronary revascularization procedure) during the scheduled treatment period.

    Data reported is for the first major coronary event.



Secondary Outcome Measures :
  1. Number of Participants With Major Atherosclerotic Event [ Time Frame: Randomized treatment phase during median follow-up period of 4.1years ]

    Major atherosclerotic events (defined as coronary death, myocardial infarction or presumed ischaemic stroke; the key secondary outcome).

    Secondary assessments involve intention-to-treat comparisons among all randomized participants of the effects of allocation to anacetrapib versus placebo during the scheduled treatment period.


  2. Number of Participants With Presumed Ischaemic Stroke [ Time Frame: Randomized treatment phase during median follow-up period of 4.1years ]

    Presumed ischaemic stroke (i.e. not known to be haemorrhagic).

    Secondary assessments involve intention-to-treat comparisons among all randomized participants of the effects of allocation to anacetrapib versus placebo during the scheduled treatment period.


  3. Number of Participants With Major Vascular Event [ Time Frame: Randomized treatment phase during median follow-up period of 4.1years ]

    Major vascular events (defined as coronary death, myocardial infarction, coronary revascularization or presumed ischaemic stroke).

    Secondary assessments involve intention-to-treat comparisons among all randomized participants of the effects of allocation to anacetrapib versus placebo during the scheduled treatment period




Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.


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Ages Eligible for Study:   50 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Patients must be aged at least 50 at the time of initial invitation, and at least one of the following inclusion criteria must be satisfied:

    • History of MI; or
    • Cerebrovascular atherosclerotic disease (i.e. history of presumed ischaemic stroke or carotid revascularization); or
    • Peripheral arterial disease (i.e. history of non-coronary revascularization, including aortic aneurysm repair or graft); or
    • Diabetes mellitus with other evidence of symptomatic coronary heart disease (i.e. treatment or hospitalization for angina, or a history of coronary revascularization or acute coronary syndrome).

Exclusion Criteria:

  • None of the following must be satisfied:

    • Acute MI, acute coronary syndrome or stroke within 4 weeks prior to Screening Visit or during Run-in (but such individuals may be entered later, if appropriate);
    • Planned coronary revascularization procedure within the next 6 months (such individuals may be entered later, if appropriate);
    • Definite history of chronic liver disease, or abnormal liver function (i.e. alanine transaminase (ALT) >2x the upper limit of normal (ULN)). Note: Individuals with a history of acute hepatitis are eligible provided this ALT limit is not exceeded;
    • Severe renal insufficiency (i.e. creatinine >200 µmol/L [2.3 mg/dL], dialysis or functioning renal transplant);
    • Evidence of active inflammatory muscle disease (e.g. dermatomyositis, polymyositis), or creatine kinase (CK) >3x ULN;
    • Previous significant adverse reaction to a statin or anacetrapib;
    • Current treatment with any of the following lipid-lowering treatments:

      (i) a regimen considered to produce substantially greater LDL cholesterol reduction than atorvastatin 80 mg daily for individuals in non-Asian countries or 20 mg daily for those in North East Asia; or (ii) fibric acid derivative ("fibrate", including gemfibrozil); or (iii) niacin (nicotinic acid) at doses above 100 mg daily

    • Concurrent treatment with a medication that is contraindicated with anacetrapib or atorvastatin:

      (i) any potent CYP3A4 inhibitor, such as:

      1. macrolide antibiotics (erythromycin, clarithromycin, telithromycin);
      2. systemic imidazole or triazole antifungals (e.g. itraconazole, posaconazole);
      3. protease inhibitors (e.g. atazanavir);
      4. nefazodone

        (ii) ciclosporin

        (iii) daptomycin

        (iv) systemic use of fusidic acid

        Note: Individuals who are taking such drugs temporarily may be re-screened when they discontinue them, if considered appropriate;

    • Known to be poorly compliant with clinic visits or prescribed medication;
    • Medical history that might limit the individual's ability to take trial treatments for the duration of the study (e.g. severe respiratory disease; history of cancer or evidence of spread within last 5 years, other than non-melanoma skin cancer; or recent history of alcohol or substance misuse);
    • Women of child-bearing potential (unless using adequate contraception);
    • Current participation in a clinical trial with an unlicensed drug or device.

Individuals will also be excluded at the Screening visit if it is considered unlikely that they will achieve total cholesterol <3.5 mmol/L (135 mg/dL) on the highest atorvastatin dose available in their region (atorvastatin 80 mg daily in non-Asian countries or 20 mg daily in North East Asia).

In addition, individuals will be excluded at the Randomization visit if any of the following are true:

  • Total cholesterol above 4 mmol/L [155 mg/dL]
  • Non-compliant with run-in treatment (<90% scheduled run-in medication taken)
  • Individual is no longer willing to be randomized into the 4-5 year trial
  • The individual's doctor is of the view that their patient should not be randomized.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT01252953


Locations
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United Kingdom
CTSU, University of Oxford
Oxford, Oxfordshire, United Kingdom, OX3 7LF
Sponsors and Collaborators
University of Oxford
Merck Sharp & Dohme LLC
Investigators
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Principal Investigator: Martin Landray University of Oxford
Principal Investigator: Louise Bowman University of Oxford
  Study Documents (Full-Text)

Documents provided by University of Oxford:
Study Protocol  [PDF] January 11, 2016
Statistical Analysis Plan  [PDF] May 12, 2017

Additional Information:
Publications of Results:
Other Publications:
Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
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Responsible Party: University of Oxford
ClinicalTrials.gov Identifier: NCT01252953    
Other Study ID Numbers: CTSUREVEAL1
48678192 ( Registry Identifier: ISRCTN )
2010-023467-18 ( EudraCT Number )
First Posted: December 3, 2010    Key Record Dates
Results First Posted: May 4, 2018
Last Update Posted: March 14, 2022
Last Verified: March 2022
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: Yes
Plan Description: Proposals for substudies must be approved by the Steering Committee. Procedures for accessing the data for this study are available on: https://www.ndph.ox.ac.uk/data-access.
Supporting Materials: Study Protocol
Statistical Analysis Plan (SAP)
Access Criteria: See URL
URL: https://www.ndph.ox.ac.uk/data-access
Keywords provided by University of Oxford:
vascular disease
lipids
cholesteryl ester transfer protein (CETP) inhibition
anacetrapib
Additional relevant MeSH terms:
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Anacetrapib
Cardiovascular Diseases
Atherosclerosis
Vascular Diseases
Arteriosclerosis
Arterial Occlusive Diseases
Oxazolidinones
Anticholesteremic Agents
Hypolipidemic Agents
Antimetabolites
Molecular Mechanisms of Pharmacological Action
Lipid Regulating Agents
Anti-Infective Agents
Protein Synthesis Inhibitors
Enzyme Inhibitors