Safety & Effectiveness on Vascular Structure and Function of ACZ885 in Atherosclerosis and Either T2DM or IGT Patients

Novartis Pharmaceuticals189 enrolled

Overview

This study will evaluate the effect of ACZ885 on vascular function in patients with documented atherosclerotic disease and T2DM or IGT.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

TRIPLE

Enrollment

189

Conditions

Diabetes Mellitus, Type 2 Atherosclerosis Prediabetic State

Interventions

ACZ885DRUG

ACZ885 150 mg was administered subcutaneously once a month for 12 months.

PlaceboDRUG

Matching placebo to ACZ885 was administered subcutaneously once a month for 12 months.

Eligibility

Sex: ALLMin age: 18 YearsMax age: 74 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Patients with known atherosclerotic disease and documented diagnosis of T2DM for ≤ 14 years OR IGT * HbA1c between 6.0% and 10.0% * On stable statin therapy or statin intolerant * Patients who are eligible and able to participate in the study Exclusion Criteria: * Contraindications to MRI * NYHA class IV Heart Failure * NYHA class I - III heart failure with acute exacerbation in 3 months prior to screening * Patients with type 1 diabetes * Acute infections * HsCRP \> 30 mg/dL * Aortic aneurysm ≥5cm Other protocol-defined inclusion/exclusion criteria may apply

Locations (9)

Novartis Investigative Site

New York, New York, United States

Novartis Investigative Site

Cincinnati, Ohio, United States

Novartis Investigative Site

Montreal, Quebec, Canada

Novartis Investigative Site

Mainz, Germany

Outcomes

Primary Outcomes

Number of Participants With Adverse Events, Serious Adverse Events and Death

Participants were monitored for adverse events, serious adverse events and death throughout the study.

Time frame: 12 months

Change From Baseline in Aortic Distensibility

Two axial, ECG-gated, steady state free precession (SSFP) 'cine' images were acquired during breath-hold to determine aortic distensibility. The first image was obtained at the level of the right pulmonary artery through the ascending and proximal descending aorta and the second through the distal aorta below the diaphragm. Imaging of the aorta also enabled evaluation of the plaque burden and additional vascular function measures.

Time frame: baseline, 3 months, 12 months

Change From Baseline in Plaque Burden (Aortic Vessel Wall Area and Carotid Vessel Wall Area)

For assessment of atherosclerotic plaque burden of the aorta, vessel wall images of the aorta were acquired with an ECG gated double-inversion recovery (black blood) fast spin echo sequence applied breath-holding. Using an oblique sagittal image of the aorta as a pilot, serial axial images were acquired to cover a section of the descending thoracic aorta. The midpoint of the right pulmonary artery in cross section was used as the anatomical reference for the first slice in baseline and follow-up scans. For assessment of the atherosclerotic plaque burden in the carotids, vessel wall images were acquired with an axial ECG gated PD (proton density) weighted black blood sequence. The carotid bifurcation was used as the anatomical reference for all three imaging time points (baseline, 12 weeks, 48 weeks) with axial slice planes acquired below the bifurcation region. The mean values reported here for the carotid are reported for the proximal common carotid region.

Time frame: baseline, 3 months, 12 months

Secondary Outcomes

Change From Baseline in Pulse Wave Velocity and Pulse Wave Velocity Error

Utilizing the SphygmoCor Device, ECG leads placed at the carotid and femoral arteries provided the measure of the pulse wave at that particular arterial location. The distance between the two vascular beds divided by the pulse wave time shift provided a measure of the pulse wave velocity.

Data from ClinicalTrials.gov

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Novartis Investigative Site

Neuss, Germany

Novartis Investigative Site

Ulm, Germany

Novartis Investigative Site

Jerusalem, Israel

Novartis Investigative Site

Oxford, UK, United Kingdom

Novartis Investigative Site

London, United Kingdom

Time frame: baseline, 3 months, 12 months

Change From Baseline in Plaque Composition

During the carotid MRI acquisition, in addition to the PD weighted ECG gated double inversion fast spin echo sequences T1 and T2 weighted sequences were acquired. In combination with the PD weighted images, the multi-contrast images were analyzed to determine regions of interest with contrast patterns consistent with the presence of necrotic lipid core, calcification and fibrous tissue in participants who had complex carotid plaque present in the bifurcation region.

Time frame: baseline, 3 months, 12 months

Change From Baseline in Aortic Strain

Arterial strain was computed directly from the cine SSFP images and the change in lumen diameters over the cardiac cycle. The value was independent of pulse pressure and is unitless ratio derived from the maximum to minimum lumen diameters diastole and systole, respectively..

Time frame: baseline, 3 months, 12 months

Change From Baseline in High Sensitivity C-reactive Protein (hsCRP)

Blood samples were collected to analyze hsCRP.

Time frame: baseline, 3 months, 12 months

Change From Baseline in Fasting Plasma Glucose

Blood samples were collected to analyze fasting plasma glucose.

Time frame: baseline, 3 months, 12 months

Change From Baseline in Hemoglobin A1c (HbA1c)

Blood samples were collected to analyze HbA1c.

Time frame: baseline, 3 months, 12 months

Change From Baseline in 2 Hour Glucose Post Oral Glucose Tolerance Test (OGTT)

Blood samples were collected to analyze the 2 hour glucose post OGTT.

Time frame: baseline, 3 months, 12 months

Change From Baseline in Beta Cell Function (HOMA-B)

Blood samples were collected to analyze beta cell function. Beta cell function was calculated by the Homeostasis Model Assessments (of beta cell function (HOMA-B) as follows: HOMA-B: The product of 20 and basal insulin (µU/mL) levels divided by the value of basal glucose (mmol/L) concentrations minus 3.5 \[i.e., HOMA-B = 20\*basal insulin/(basal glucose-3.5)\].

Time frame: baseline, 3 months, 12 months

Change From Baseline Insulin Resistance (HOMA-IR)

Blood samples were collected to analyze insulin resistance. Insulin resistance was calculated by the Homeostasis Model Assessments of insulin resistance (HOMA-IR)) as follows: HOMA-IR: The product of basal glucose (mmol/L) and insulin (µU/mL) levels divided by 22.5 \[i.e., HOMA-IR = basal glucose\*basal insulin/22.5\].

Time frame: baseline, 3 months, 12 months

Pharmacokinetics: ACZ885 Serum Concentrations

Blood samples were collected to analyze the ACZ885 serum concentrations.

Time frame: pre-dose, 0.167 day post dose 1, 7 days post dose 1, 14 days post dose 1, every 30 days post each dose from doses 1 through 12, 60 days post dose 12, 90 days post dose 12