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TerminatedNCT01308203Updated Sep 21, 2023

Lipid Efficacy of the Extended Release Niacin/Laropiprant Combination in Patients With Cardiovascular Disease

A Phase 4 interventional study of Extended release niacin/laropiprant and placebo in Coronary Artery Disease and Dyslipidemias, sponsored by Daniel A. Siniawski. Terminated at 1 site in Argentina. Open to participants aged 21 Years to 75 Years. Per ClinicalTrials.gov, last updated 2023-09-21.

Sponsored by Daniel A. Siniawski · Phase 4, Interventional, and Treatment

Why this study was terminated
Merck has decided to discontinue all studies with extended-release niacin/laropiprant.because the HPS2-THRIVE did not meet its primary endpoint
Phase
Phase 4
Study type
Interventional
Enrollment
32
Allocation
Randomized
Ages
21 Years to 75 Years
Sex
All
01

Study summary

  • Clinical studies with statins have shown that patients that suffered a cardiovascular event have a high residual risk. Residual risk decreases with the attaining of progressive lower LDL-C levels.
  • In patients treated with statins, HDL-C level is an independent inverse predictor of subsequent CV and coronary plaque progression, even when LDL-C levels are less than 70 mg/dL.
  • Therefore the purpose on this study is to assess the lipid efficacy on lipid profile and effects on HDL-C metabolism and function of the extended release niacin/laropiprant combination added to usual therapy in very high risk patients with cardiovascular disease and low HDL-C that did not achieve the optional very low LDL-C or non-HDL-C goals
Read the detailed description

During the screening period, patients will be pre-selected from medical records of patients that met the inclusion criteria. Patients who fulfilled the eligibility criteria will be invited to participate in the study by signing the consent form. After consenting, a screening blood sample test will be taken to determine TC, HDL-C, TG, LDL-C, non-HDL-C (the difference between TC and HDL-C), ALT, AST, CK, hemoglobin A1c (HbA1c), uric acid and TSH in the local laboratory. Patients who have HDL-C, LDL-C and/or non-HDL-C within inclusion criteria and had none of the biochemical exclusion criteria will be randomized one week after the screening blood test. Further blood samples will be obtained at baseline, 4 weeks (± 2 days), 12 weeks (± 2 days), 16 weeks (± 2 days) and 24 weeks (± 2 days). The blood samples will be centrifuged a 2000 rpm and a tube with blood serum will be sent to the local laboratory for measuring plasma levels of TC, HDL-C, TG, LDL-C, ALT, AST, CK, fasting glucose, HbA1c, creatinine, uric acid, ApoB, ApoA, Lp(a), high sensibility-C Reactive Protein (hs-CRP) and HDL-C sub-fractions (baseline, weeks 12 and 24). ALT, AST, CK, fasting glucose, creatinine and uric acid will be measured at weeks 4 and 16. A second tube will be frozen in -70ºC refrigerator an will be sent to the Department of Clinical Biochemistry of the Faculty of Pharmacy and Biochemistry from the University of Buenos Aires (Argentina) to determine: paraoxonase 1/arylesterase activity (PON1), soluble cell adhesion molecule level (ICAM-1), tumor necrosis factor-α (TNF-α), lipoprotein-associated phospholipase A2 (Lp-PLA2) and cholesterol ester transfer protein (CETP) activity. A third tube will be frozen in -70ºC refrigerator an will be sent to the Cardiovascular Research Center of the Faculty of Medical Sciences from the University of La Plata (Argentina) to determine ex vivo cellular cholesterol efflux capacity.

A unique patient number will be provided by the randomization coordinating centre from the Hospital Italiano de Buenos Aires.

Randomized patient will received a bottle of 35 pills with 1g ERN/20mg LRPT or placebo. At week 4 (± 2 days), after randomization the patient will be assessed in the outpatient clinic. Patients with good tolerance to the study medication will receive four bottles of 35 pills with 1g ERN/20mg LRPT or placebo. At week 12 (± 2 days), patients will be assessed in the outpatient clinic patients and will be crossed over to placebo or active medication. Patients will receive a bottle of 35 pills with 1g ERN/20mg LRPT or placebo. At week 16 (± 2 days), patients with good tolerance to the study medication will receive four bottles of 35 pills with 1g ERN/20mg LRPT or placebo.

02

Conditions studied

  • Coronary Artery Disease
  • Dyslipidemias
03

In context

Cardiovascular Diseases

4,904 studies on the registry are indexed under Cardiovascular Diseases; 919 are open to participants now.

This study's enrollment of 32 is below the median of 100 across 2,738 interventional studies indexed under Cardiovascular Diseases.

Browse Cardiovascular Diseases studies →

Lead sponsor

This is the only study on the registry with Daniel A. Siniawski as lead sponsor.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
21 Years to 75 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Men between 21 and 75 years old.
  • Very high risk patients (according NCEP-ATP III definition) with coronary heart disease (CHD) or peripheral arterial disease (PAD), documented by an angiographic study.
  • Clinical stability.
  • Low HDL-C plasma levels: \< 40 mg/dL in men or \<50 mg/dL in women in the screening and lead-in blood sample tests.
  • LDL-C plasma levels between 70-100 mg/dL or non-HDL-C between 100-130 mg/dL if TG were > 200 mg/dL in the screening and lead-in blood sample tests.
  • Statin based-treatment with or without ezetimibe in a stable dose in last 8 weeks.
  • Women must be postmenopausal for at least 2 years and ≤ 75 years old.

Exclusion criteria

Exclusion Criteria:

  • Coronary event o arterial revascularization in the past 6 months.
  • Uncontrolled diabetes mellitus (HbA1C > 8%).
  • Acute crisis, history of gout or uric acid > 9 mg/dL.
  • Thyroid stimulating hormone (TSH) outside the central laboratory's normal reference range.
  • Renal insufficiency (creatinine > 1.5 mg/dL).
  • Baseline alanine aminotransferase (ALT) and/or aspartate aminotransferase (AST) levels > 1.5 UNL.
  • Baseline creatine kinase (CK) > 2 UNL.
  • Triglycerides plasma level ≥ 500 mg/dL.
  • Active fibrate therapy.
  • Age > 75 years old.
05

Study design

Phase
Phase 4
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Crossover assignment
Masking
Double (Participant, Investigator)
Enrollment
32 participants (actual)

Study arms

  • Experimental
    Extended release niacin /laropiprant

    The patients will be randomized to one of two arms. The intervention is with the extended release niacin laropiprant combination, that is an add on of the usual medication that the primary care physician gave them to treat their lipid disorder (statin, ezetimibe or the combination of both).

    Drug: Extended release niacin/laropiprant

  • Placebo comparator
    placebo

    The patients will received placebo added to the usual therapy their primary care physician gave them to treat their lipid disorder (statin, ezetimibe or the combination of both).

    Drug: placebo

Interventions

  • DrugExtended release niacin/laropiprant

    Randomized patient will received 1 tablet of 1g ERN/20 mg LRPT for the first 4 weeks of treatment. At week 4 (± 2 days)the patient will be assessed in the outpatient clinic. Patients with good tolerance to the study medication will receive 2 tablets of 1 g ERN/20 mg LRPT that should be taken together for the next 8 weeks. At week 12 (± 2 days), patients will be assessed in the outpatient clinic patients and will be crossed over to placebo.

  • Drugplacebo

    Randomized patient will received 1 oral 1 g tablet of placebo for the first 4 weeks of treatment. At week 4 (± 2 days), after randomization the patient will be assessed in the outpatient clinic. Patients with good tolerance to the study medication will receive 2 oral 1 g tablets of placebo that should be taken together for the next 8 weeks. At week 12 (± 2 days), patients will be assessed in the outpatient clinic patients and will be crossed over to active medication.

06

What researchers measure

Primary outcomes

  1. Nominal change from baseline in low density lipoprotein- cholesterol (LDL-C) at 12 weeks of treatment with the extended release niacin /laropiprant combination added to usual therapy.

    Will be calculated by the Friedewald equation. With plasma triglycerides levels \>400 mg/dL, LDL-C will be measured by an homogeneous method.

    Time frame: Week -1, baseline (week 0), week (12 ± 2 days) and week 24 (± 2days).

Secondary outcomes

  1. Efficacy on other lipid variables: high density lipoprotein-cholesterol (HDL-C), triglycerides, total cholesterol (TC), TC/HDL-C ratio, apolipoprotein B (ApoB), apolipoprotein A1 (ApoA), ApoB/ApoA ratio and lipoprotein (a) [Lp(a)].

    TC: enzymatic method. HDL-C: homogeneous direct method. Lp(a),ApoA and ApoB: nephelometric method, using an Immage immunochemistry system (Beckman Coulter).

    Time frame: Baseline (week 0), week 12 (± 2 days) and week (24 ± 2 days).

07

Study locations

1 site
  • Hospital Italiano de Buenos Aires
    Buenos Aires, C1181ACH, Argentina
08

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Sep 21, 2023, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
09

Registry details

Key details

Study ID
NCT01308203
Lead sponsor
Daniel A. Siniawski
Collaborators
Merck Sharp & Dohme LLC
Responsible party
Daniel A. Siniawski (Associated Medical Doctor, Hospital Italiano de Buenos Aires) — Sponsor-investigator
First posted
Mar 4, 2011
Start date
Oct 2011
Primary completion
Jan 2013
Completion
Jan 2013
Last update
Sep 21, 2023

Oversight

Data monitoring committee
No
View the source record on ClinicalTrials.gov ↗

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This study is terminated, as verified in Sep 2023. You cannot join it, but the record below documents what was studied.

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