High cholesterol is one of the major controllable risk factor for coronary heart disease. It is well demonstrated that drugs that reduce the intestinal absorption of cholesterol or block the synthesis of cholesterol or the association of both, can reduce cholesterol and reduce rate of cardiovascular events. The trial will evaluate natural alternative to this drug approach testing the effects of a combination of phytosterol, a nutritional that reduce cholesterol absorption, and fermented red rice, a nutritional that reduce the synthesis of cholesterol. Subjects with sub optimal blood cholesterol levels, matching all the inclusion criteria and none of the exclusion criteria, will be treated for 8 weeks with a nutraceutical combination of phytosterols and fermented red rice and will have to maintain, during the entire duration of the study, the Mediterranean-style diet provided. The study will evaluate as primary objective the changes in LDL cholesterol blood levels and more in general the modulation of lipid profile and of others clinical parameters as well as the tolerability.
The study is made up of four visits distributed over a 10-weeks period: V 1 (day -14) - Screening: After providing written informed consent, tests will be run in order to check the subject's eligibility for the study. Subjects will also be given suggestions regarding their diet (a Mediterranean-style diet is to be maintained for the entire duration of the study). V2 (baseline) and Day 0 (randomization): After confirmation of the subject's eligibility \[LDL-C and Triglycerides (TG) criteria confirmed with blood test results\], eligible subjects will be randomized within 3 days to one of the two treatment groups. During this visit an endothelial reactivity test will be performed. V3 (28 ±3 days after Day 0) - Intermediate: Blood will be drawn for tests and compliance with treatment will be assessed. V4 (28 ± 3 days after Visit 3) - End of study: Blood tests and an endothelial reactivity test will be performed and treatment compliance will be assessed. Weight, waist circumference, Index of Central Obesity (ICO) and Body Mass Index (BMI), Hepatic Steatosis Index (HSI) and Lipid Accumulation Product (LAP) will be measured/calculated at each visit, height at Visit 1. Heart rate and blood pressure will be measured at each visit. Adverse events (AEs) will be collected throughout the study starting from the Informed consent signature. The study will be monitored according to the details specified in the Monitoring Plan. The monitor will have the responsibility of reviewing the ongoing study with the Investigator to verify adherence to the protocol and to deal with any problems. Case Report Form (CRF) will be checked for completeness and consistency with the source data and special attention will be dedicated to patient enrolment, obtaining signed informed consent, occurrence of AEs, product accountability, and accurate recording of variables. The confidentiality of study related documents shall be maintained at all times. The Investigator agrees to allow access to all study materials needed for the proper review of study conduct. An independent quality audit/inspection at the study site may take place at any time during or after the study. The independent audit/inspection can be carried out by the Sponsor's independent Quality Assurance (QA), by a Health Authorities or an Ethics Committee (EC).
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Enrollment
88
One tablet per os per day to be taken in the evening from randomization (day 0) to the end of the trial (day 56 +/- 3)
One tablet per os per day to be taken in the evening from randomization (day 0) to the end of the trial (day 56 +/- 3)
Policlinico S.Orsola - Malpighi Medicina Interna Borghi
Bologna, Italy
Change in Blood LDL Cholesterol Level
Mean change in blood LDL cholesterol level from randomization (day 0) to V4 (week 8)
Time frame: From randomization (day 0) to V4 (week 8) for a total of 56 +/- 3 days of treatment
Change in Total Blood Cholesterol Level
Mean change in total blood LDL cholesterol level from randomization (day 0) to V4 (week 8)
Time frame: From randomization (day 0) to V4 (week 8) for a total of 56 +/- 3 days of treatment
Change in Blood HDL Cholesterol Level
Mean change in blood HDL cholesterol level from randomization (day 0) to V4 (week 8)
Time frame: From randomization (day 0) to V4 (week 8) for a total of 56 +/- 3 days of treatment
Change in Blood Non-HDL Cholesterol Level
Mean change in blood non-HDL cholesterol level from randomization (day 0) to V4 (week 8)
Time frame: From randomization (day 0) to V4 (week 8) for a total of 56 +/- 3 days of treatment
Change in Blood Triglycerides Level
Mean change in blood triglycerides level from randomization (day 0) to V4 (week 8)
Time frame: From randomization (day 0) to V4 (week 8) for a total of 56 +/- 3 days of treatment
Change in Blood Apolipoprotein B Level
Mean change in blood apolipoprotein B level from randomization (day 0) to V4 (week 8)
Time frame: From randomization (day 0) to V4 (week 8) for a total of 56 +/- 3 days of treatment
Change in Total Cholesterol/HDL Cholesterol Ratio
Mean change in total cholesterol/HDL cholesterol ratio from randomization (day 0) to V4 (week 8)
Time frame: From randomization (day 0) to V4 (week 8) for a total of 56 +/- 3 days of treatment
Change in Total LDL Cholesterol/HDL Cholesterol Ratio
Mean change in LDL/HDL cholesterol ratio from randomization (day 0) to V4 (week 8)
Time frame: From randomization (day 0) to V4 (week 8) for a total of 56 +/- 3 days of treatment
Change in Pulse Volume (PV) Waveform (Endothelial Reactivity)
Mean change in Pulse Volume (PV) waveform from randomization (day 0) to V4 (week 8). PV unit of measurement is a percent change in the PV waveform area, comparing waveforms during and before hyperemia through the equation √PV2/PV1 that relates PV at baseline (PV1) and PV during hyperemia (PV2).
Time frame: From randomization (day 0) to V4 (week 8) for a total of 56 +/- 3 days of treatment
Change in Glycemia
Mean change in Glycemia from randomization (day 0) to V4 (week 8)
Time frame: From randomization (day 0) to V4 (week 8) for a total of 56 +/- 3 days of treatment
Change in Aspartate Aminotransferase (AST)
Mean change in aspartate aminotransferase from randomization (day 0) to V4 (week 8)
Time frame: From randomization (day 0) to V4 (week 8) for a total of 56 +/- 3 days of treatment
Change in Alanine Aminotransferase (ALT)
Mean change in aspartate aminotransferase from randomization (day 0) to V4 (week 8)
Time frame: From randomization (day 0) to V4 (week 8) for a total of 56 +/- 3 days of treatment
Change in Gamma Glutamyl Transpeptidase (GGT)
Mean change gamma glutamyl transpeptidase (GGT) from randomization (day 0) to V4 (week 8)
Time frame: From randomization (day 0) to V4 (week 8) for a total of 56 +/- 3 days of treatment
Change in Serum Creatinine
Mean change in Serum Creatinine values from randomization (day 0) to V4 (week 8)
Time frame: From randomization (day 0) to V4 (week 8) for a total of 56 +/- 3 days of treatment
Change in Serum Uric Acid
Mean change in Serum uric acid values from randomization (day 0) to V4 (week 8)
Time frame: From randomization (day 0) to V4 (week 8) for a total of 56 +/- 3 days of treatment
Change in Creatine Phosphokinase (CPK)
Mean change in creatine phosphokinase (CPK) from randomization (day 0) to V4 (week 8)
Time frame: From randomization (day 0) to V4 (week 8) for a total of 56 +/- 3 days of treatment
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