The purpose of this study is to determine if a new drug, DRL-17822, is safe and effective in elevating high density lipoprotein cholesterol (HDL-C) and reducing low density lipoprotein cholesterol (LDL-C) in people with abnormal cholesterol levels that may put them at risk for heart disease.
Cardiovascular disease is a leading cause of death worldwide. Among cardiovascular disorders, coronary heart disease (CHD) caused by atherosclerosis is the most common cause of morbidity and mortality. Prevention, stabilization and regression of atherosclerotic plaques may have a major impact on reducing the risk of acute coronary events. LDL-C lowering agents, primarily the statins, are the current mainstay in the pharmacologic management of dyslipidemia. However even with stain use, residual CHD risk from dyslipidemia remains. Epidemiologic and observational studies have shown that HDL-C is also a strong independent predictor of CHD, suggesting that raising HDL-C levels might afford clinical benefit in the reduction of cardiovascular risk. Presently only niacin is approved by the FDA for HDL-C elevation and can raise HDL-C levels by 20-30%. However its use can be limited by a high incidence of flushing and, less commonly, by elevation of blood glucose and potential hepatic toxicity. Cholesteryl ester transfer protein (CETP) inhibitors are being explored for their ability to elevate HDL-C. A small molecule CETP inhibitor, torcetrapib, has been demonstrated to elevate HDL-C by 60-100%. However, a large clinical trial (ILLUMINATE) where it increased HDL-C by a mean of 72% compared to baseline was halted as it failed to show benefit. Post-hoc analysis of this study implicated an off-target increase in blood pressure as potentially counteracting any anti-atherosclerotic benefits. Post-hoc subgroup analysis showed that patients in the highest HDL-C quartile had a 57% reduction in the risk of cardiovascular events. Increased blood pressure appears to be specifically related to torcetrapib as two other small molecule CETP inhibitors, anacetrapib and dalcetrapib, have not shown this in clinical trials and have been well tolerated. DRL-17822 has also not shown elevation of blood pressure in either animals or in normal volunteers. This study will investigate the efficacy and tolerability of DRL-17822 as dyslipidemia monotherapy in patients with Type II hyperlipidemia.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
176
DRL-17822 50, 150 or 300 mg or matching placebo once daily after breakfast
Unnamed facility
Genova, Italy
Unnamed facility
Milan, Italy
Unnamed facility
Modena, Italy
Unnamed facility
Palermo, Italy
Percent Change in HDL-C From Baseline
Percent change from baseline in HDL-C after 28 days of treatment in patients with Type II hyperlipidemia
Time frame: 28 days
Safety and Tolerability of DRL-17822
Incidence of treatment-related adverse events
Time frame: 28 days
Changes in Vital Signs Including Blood Pressure
Vital sign abnormalities reported as treatment-emergent AEs
Time frame: 28 days
To Evaluate Trough Levels of DRL-17822 in Plasma
Trough levels of DRL-17822 in plasma after 28 days of treatment
Time frame: 28 days
Changes in CETP Inhibition in Plasma
Percent change from baseline in CETP Inhibition
Time frame: 28 days
Changes in Other Lipids and Apolipoproteins
Change from baseline (LOCF, ITT population)
Time frame: 28 days
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Unnamed facility
Perugia, Italy
Unnamed facility
Gdynia, Poland
Unnamed facility
Gniewkowo, Poland
Unnamed facility
Katowice, Poland
Unnamed facility
Wroclaw, Poland
Unnamed facility
Chernivtsi, Ukraine
...and 2 more locations