Clinical trial NCT00519714: A Study to Evaluate the Lipid Regulating Effects of 1-Methylnicotinamide (1-MNA)
Official title: A Randomized, Double-Blind, Placebo-Controlled, Dose-Ranging, Multi-Center Study to Evaluate the Lipid Regulating Effects of 1-Methylnicotinamide (1-MNA)
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: PHASE2
PHASE3
Conditions: Hypertriglyceridemia
Lead sponsor: Montreal Heart Institute
Sponsor class: OTHER
Collaborators: name: Commonwealth Medical Clinic
name: Institut de Recherches Cliniques de Montreal
name: Clinique des maladies lipidiques de Québec
name: Centre de médecine genique communautaire
name: Omnispec clinical research Inc
name: Manna Research
name: St. Jerome Medical Research Inc.
name: Royal Victoria Hospital, Canada
name: Hotel Dieu Hospital
name: St Michael's Hospital Health Center
name: Cambridge Cardiac Care Centre
name: Maritime Research Center
name: Rhodin Recherche Clinique
name: Queen Elizabeth II Health Sciences Centre
name: First Line Medical Ltd
name: Diabetes Research, Vancouver General Hosp
name: The Allin Clinic
name: St Paul's Hospital Healthy Heart Clinical Trial
name: The Clinical Trials Centre
name: Recherche Invascor Inc
name: MSHJ Research Associates
name: Dr.Kim W Tan
First posted: 2007-08-23
Enrollment: 195
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: A randomized, double-blind, placebo-controlled, dose-ranging, multi-center study. Following a 6-8 week placebo and dietary-controlled baseline period, approximately 195 men and women with either hypertriglyceridemia or mixed hyperlipidemia with serum triglycerides (TG) \> 200 mg/dl (2.26 mmol/l) will be randomized to receive either placebo, 30 mg 1-MNA or 90 mg 1-MNA three times daily for twelve weeks. Lipid and ancillary exploratory parameters will be evaluated at screening, during the baseline period, upon randomisation and throughout the 12-week active treatment period. Additionally, blood samples will be drawn at randomisation and at clinic visits during the active treatment period for sparse sampling population pharmacokinetic assessments. All blood samples for lipid assessments and glucose measurements will be collected following a 12-hour fast. Safety and tolerability will be assessed throughout the trial through the evaluation of physical exams, ECGs, routine hematology and blood chemistry testing, and adverse events.


Eligibility criteria: Inclusion Criteria:

* Patients at least 18 years of age at the time of informed consent (women of childbearing potential must be practicing adequate contraception)
* Patients with mean serum TG \> 200 mg/dl (2.26 mmol/l) and \< 700 mg/dl (7.91 mmol/l) as measured at 2 sequential visits during the dietary controlled baseline period (Visits 2 and 3 or Visits 3 and 3a) and having lower level within 25% of upper level (higher value minus lower value)/higher value \< 0.25)
* Patients willing and able to sign an informed consent form and follow the protocol

Exclusion Criteria:

* Patients who are pregnant or nursing
* Patients with evidence of hepatic (ALT or AST greater than 1.5 ULN, bilirubin greater than 1.5 ULN, or cirrhosis) or renal dysfunction (serum creatinine greater than 140 μmol/l, or nephrotic syndrome) as measured during the baseline phase
* Patients with uncontrolled diabetes mellitus (fasting glucose level above 11 mmol/l or HbA1C above 10%) as measured during the baseline phase
* Patients with hypothyroidism that is not treated or not stable for at least 6 months prior to study entry
* Patients with uncontrolled hypertension (systolic blood pressure above 160 mm Hg and/or diastolic blood pressure above 110 mm Hg)
* Patients with systolic blood pressure above 140 mm Hg AND three or more of the following cardiovascular risk factors:

  * Current cigarette smoker
  * HDL-C \< 40 mg/dL (1.04 mmol/L)
  * Coronary heart disease in male first degree relative \< 55 years of age
  * Coronary heart disease in female first degree relative \< 65 years of age
  * Male age 45 years or older
  * Female age 55 years or older
* Patients with known hyperuricemia or with a history of gout
* Patients with an active peptic ulcer
* Patients with known coronary artery disease, cerebrovascular disease or peripheral arterial disease that has previously required PCI or surgical intervention
* Patients with known intolerance or allergy to niacin
* Patients consuming more than 10 alcoholic drinks per week
* Patients with a history of drug abuse
* Patients receiving any lipid modifying agent within 4 weeks of entry into the baseline period
* Patients participating in another clinical trial within 30 days of entry into the baseline period
* Patients considered to be non-compliant to study medication (\< 80% study medication) or diet during the placebo-baseline phase
* Patients for whom the investigator determines that the study would not be appropriate

Primary outcomes:
measure: The percent change in total serum Triglycerides from baseline to end of study
timeFrame: 12 weeks
Secondary outcomes:
measure: The percent change in total cholesterol, low-density lipoprotein cholesterol, very low-density lipoprotein cholesterol, high-density lipoprotein cholesterol , total apolipoprotein B , apolipoprotein A1 and TG/HDL-C ratio from baseline to end of study.
timeFrame: One year
Other outcomes:
Locations:
city: Montreal
country: Canada
facility: Institut de Cardiologie de Montreal
state: Quebec
Study officials:
affiliation: Montreal Heart Institute
name: Jean-Claude Tardif, MD
role: PRINCIPAL_INVESTIGATOR
References: