The purpose of this study is to compare changes in cholesterol levels in patients with elevated blood cholesterol with administration of lapaquistat acetate, once daily (QD), and fenofibrate.
Elevated plasma cholesterol (hypercholesterolemia) and various other plasma lipid imbalances (dyslipidemias) are major risk factors for coronary heart disease. It has been established that lowering the low-density lipoprotein cholesterol plasma concentration effectively reduces cardiovascular morbidity and mortality. As a result of this finding, the National Cholesterol Education Program Adult Treatment Panel III identifies control of low-density lipoprotein cholesterol as essential in 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 Adult Treatment Panel III-recommended levels of low-density lipoprotein cholesterol reduction, making it necessary to increase the dose or add an additional treatment. This in turn may result in decreased tolerability and potential safety concerns. At higher doses, statins are associated with various myopathies ranging from rare occurrences of rhabdomyolysis and myositis to more frequent symptoms of muscle weakness, cramps, or pain; these can occur with mild or no increases in creatine kinase. Statin use also is associated with increases in liver transaminase levels. These tolerability and safety concerns may contribute to the high discontinuation rates of statins and their prescription at low, and often ineffective, doses. TAK-475 (lapaquistat acetate) inhibits the cholesterol synthesis pathway at a different step than statins (acting on squalene synthase rather than 3-hydroxy-3-methylglutaryl coenzyme A); it does not reduce concentrations of isoprenylated intermediates believed to be responsible for the myopathies associated with statin use. This study was conducted to determine whether lapaquistat acetate with fenofibrate has the potential to be more effective than fenofibrate by itself in lowering low-density lipoprotein cholesterol.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
213
Lapaquistat acetate 100 mg, tablets, orally, once daily and fenofibrate 145 mg, tablets, orally, once daily for up to 12 weeks.
Lapaquistat acetate placebo-matching tablets, orally, once daily and fenofibrate 145 mg, tablets, orally, once daily for up to 12 weeks.
Unnamed facility
Percent change from Baseline in direct fasting plasma low-density lipoprotein cholesterol.
Time frame: Week 12 or Final Visit.
Change from baseline in calculated low-density lipoprotein cholesterol.
Time frame: Week 12 or Final Visit.
Change from baseline in non- high-density lipoprotein cholesterol.
Time frame: Week 12 or Final Visit.
Change from baseline in total cholesterol.
Time frame: Week 12 or Final Visit.
Change from baseline in apolipoprotein B.
Time frame: Week 12 or Final Visit.
Change from baseline in triglycerides.
Time frame: Week 12 or Final Visit.
Change from baseline in high-density lipoprotein cholesterol.
Time frame: Week 12 or Final Visit.
Change from baseline in apolipoprotein A1.
Time frame: Week 12 or Final Visit.
Change from baseline in very-low-density lipoprotein cholesterol.
Time frame: Week 12 or Final Visit.
Change from baseline in derived ratios including total cholesterol/high-density lipoprotein cholesterol, low-density lipoprotein cholesterol/high-density lipoprotein cholesterol, and apolipoprotein B/ apolipoprotein Al.
Time frame: Week 12 or Final Visit.
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Huntsville, Alabama, United States
Unnamed facility
Sierra Vista, Arizona, United States
Unnamed facility
Beverly Hills, California, United States
Unnamed facility
Long Beach, California, United States
Unnamed facility
Spring Valley, California, United States
Unnamed facility
Colorado Springs, Colorado, United States
Unnamed facility
Golden, Colorado, United States
Unnamed facility
Waterbury, Connecticut, United States
Unnamed facility
Jacksonville, Florida, United States
Unnamed facility
Kissimmee, Florida, United States
...and 26 more locations
Change from baseline in high-sensitivity C-reactive protein.
Time frame: Week 12 or Final Visit.
Percentage of Subjects Achieving Target Direct low-density lipoprotein cholesterol Levels.
Time frame: Week 12 or Final Visit.