Nutraceutical Combination in Patients With Low-grade Systemic Inflammation

Study Overview
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Brief Summary
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The investigators tested if a nutraceutical combination with red yeast rice, berberine and policosanol (NC) can significantly modify inflammation, lipid profile and markers of endothelial injury (endothelial microparticles) in subjects with elevated levels of high-sensitivity C-reactive protein (hsCRP).

Detailed Description
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Will be included in the study 100 subjects with suboptimal LDL cholesterol levels (LDL 100-160 mg / dL) and hsCRP levels> 2 mg / L, divided into two groups of equal numbers, matched by by sex and age, randomized to receive a nutraceutical combination containing red yeast 200 mg, berberine 500 mg and policosanol 10 mg (NC) in combination with a low-cholesterol diet (<200 mg / day) or a low-cholesterol diet only (Standard of Care - SOC). All subjects at the time of inclusion in the study protocol will be prescribed the SOC for a period of 30 days (Lipid Stabilization Period: LSP); After 30 days LSP it will be performed randomization in the two intervention arms: NC + SOC or SOC.

Official Title
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Effect of a Nutraceutical Combination on Endothelial Injury and C-reactive Protein in Patients With Low-grade Systemic Inflammation

Conditions
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Atherosclerosis, Inflammation, Hypercholesterolemia

Intervention / Treatment
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* Dietary Supplement: Nutraceutical Combination
* Other: Standard of Care
* Other: Placebo


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: LDL cholesterol <160 mg/dl (4,14 mmol/l); hsCRP >2 mg/L; Exclusion Criteria: triglycerides >500 mg/dL (5.6 mmol/L); current or previous treatment with lipid-lowering drugs or with other drugs supposed to modify vascular damage and/or repair (antiplatelet, anti-hypertensive and antioxidant drugs); current or previous treatment with hormone replacement therapy for menopause vasomotor symptoms; evidence of liver dysfunction or alanine-aminotransferase (ALT) levels twice above the upper normal limit; creatin-kinase (CK) levels thrice above the upper normal limit history or clinical evidence of previous or current cardiovascular disease; presence of strong cardiovascular risk factors such as: serum creatinine levels >2 mg/dL, diabetes mellitus, uncontrolled systemic arterial hypertension (systolic blood pressure >190 mg/dL or diastolic blood pressure >100 mg/dL); history of cancer in the former 5 years before recruitment; not adequately treated hypothyroidism (TSH levels >1,5 times the upper normal limit); history of malignancy in the previous 5 years before screening; not adequately treated hypothyroidism (TSH levels >1,5 times the upper normal limit); previous or current alcohol or drugs abuse; history or clinical evidence of chronic inflammatory disease such as severe arthritis, systemic lupus erythematosus or chronic inflammatory bowel disease; current or previous use of immunosuppressant agents or long term glucocorticoids history or clinical evidence of any severe concomitant disease which may compromise subject's safety or its possibility to carry out the study.

Ages Eligible for Study
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Minimum Age: 25 Years
Maximum Age: 75 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Placebo Comparator: Standard of Care + Placebo<br>low-cholesterol/low-saturated fat diet and a regular aerobic physical activity schedule + once daily placebo | Other: Standard of Care<br>* low-cholesterol/low-saturated fat diet and regular aerobic physical activity schedule<br>Other: Placebo<br>* placebo<br>|
| Active Comparator: Nutraceutical combination<br>low-cholesterol/low-saturated fat diet and a regular aerobic physical activity schedule + Nutraceutical combination | Dietary Supplement: Nutraceutical Combination<br>* red yeast rice extract 200 mg (equivalent to 3 mg monacolins), policosanol 10 mg, berberine 500 mg, 0.2 mg folic acid, coenzyme Q10 2 mg, and astaxanthin 0.5 mg once daily<br>* Other names: Armolipid Plus, Rottapharm-Madaus;Other: Standard of Care<br>* low-cholesterol/low-saturated fat diet and regular aerobic physical activity schedule<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change from Baseline in LDL cholesterol at 3 months |  | 3 months after treatment randomization | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change from Baseline in Circulating endothelial microparticles at 3 months |  | 3 months after treatment randomization | 
| Change from Baseline in C-reactive protein at 3 months |  | 3 months after treatment randomization | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Cholesterol, C-Reactive Protein, Endothelial Microparticles, Endothelium, Nutraceutical