E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
The aim of this study is to validate MRI as a screening tool for detection of early signs of heart disease. Those thought to be at the highest risk of developing cardiovascular disease will be randomised to statin/placebo intervention for 18 months to 2 years. At the end of the study they will undergo a repeat MRI and blood tests to detect any changes. |
|
MedDRA Classification |
E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
1) To screen an at-risk Tayside population for early signs of heart disease using Magnetic Resonance Imaging (MRI), as measured by left ventricular mass and gadolinium detected silent infarct.
2) To assess the effects of statin/placebo therapy on Left Ventricular Mass (LVM) in a cohort of 800 subjects.
|
|
E.2.2 | Secondary objectives of the trial |
1) To validate the MRI screening technique, which is known to be relatively non-invasive and safe, as a sensitive and specific measure of vascular risk.
2) Assessment of Brain Natriuretic Peptide (BNP) and other vascular markers along with MRI measured LVM as marker of future Cardiovascular events (CVEs).
|
|
E.2.3 | Trial contains a sub-study | Yes |
E.2.3.1 | Full title, date and version of each sub-study and their related objectives |
Genetic sub-study- For research Healthforce- Lifestlye intervention |
|
E.3 | Principal inclusion criteria |
1. Males and Female equal to or over 40 years of age. 2. Not requiring statin therapy by virtue of presence of CVD or CVD risk based on SIGN 97 Guideline.
|
|
E.4 | Principal exclusion criteria |
1. Pregnancy, breast-feeding or women of child-bearing potential not using adequate contraception 2. Known primary muscle disease 3. Known atherosclerotic disease eg: i. previous episodes of confirmed Acute Coronary Syndrome (ACS), unstable angina; myocardial infarction with or without ST elevation; or stable CHD/CVD deemed to require statin therapy on clinical grounds, including: ii. Previous amputation due to severe peripheral vascular disease or severe peripheral arterial disease, iii. Previous central or peripheral revascularisation procedure (including coronary angioplasty, coronary artery bypass graft surgery, peripheral arterial graft surgery) iv. Hypertension. v. Heart failure. vi. Significant dysrhythmia or angina requiring hospitalisation in the 6 months preceding potential study entry vii. Previous cerebrovascular accident 4. Other accepted indication for statin therapy according to the investigators’ current clinical practice including: i. Known familial hyperlipidaemia requiring drug therapy ii. Known diabetes (if we detect risk more than 20%, patient will be referred to his GP for proper treatment). iii. Those above the treatment cut off point using the Coronary Risk SIGN 97 Guidline. 5. Known hypersensitivity or intolerance to statins. 6. Significant biochemical abnormalities such as: Active liver disease or hepatic dysfunction with AST or ALT >2x upper limit of normal (ULN) 7. Participation in another clinical trial (other than observational trials and registries) concurrently or within 30 days prior to screening for entry into this study. 8. Other serious illness or significant abnormalities that may compromise the subject's safety or successful participation in the study. 9. Any illness which in the doctor’s opinion means that the subject is unable to give informed consent. 10. Known alcohol abuse. 11. Taking any of the following medications: i. Use of OTC statins (other HMG-CoA reductase inhibitors). ii. Drugs known to be associated with rhabdomyolysis in combination with HMG-CoA reductase inhibitors (e.g. cyclosporin, erythromycin, azo anti-fungals, protease inhibitors and all macrolides) iii. Drugs (other than beta-blockers, diuretics, ACE inhibitors, other anti-hypertensive agents, oral hypoglycaemic agents and thyroxine replacement therapy) known to affect lipid levels, that interact with the study medications, or that may affect clinical laboratory parameters (such as isotretinoin). iv. Lipid-regulating drugs: probucol, fibrates and derivatives, bile acid sequestering resins. Subjects currently taking a lipid-altering drug may be considered for screening after a 4-week wash-out period except in the case of probucol where medication must have been discontinued for at least 6 months. 12. Drinking more than two glasses of grapefruit juice per day
|
|
E.5 End points |
E.5.1 | Primary end point(s) |
Primary criterion of efficacy: The primary criterion will be the difference in Left ventricular mass after 2 years in those receiving statins to those who did not in the Index group
Secondary criteria efficacy: 1. Other measures of MRI and CVEs in the Index group (gadolinium enhanced infarcts, atheroma burden) 2. CV mortality and Events at 18m - 2 years in the Index group based on ISD Records, and General Practitioner Records, defined as the first occurrence, over the duration of follow-up of the following: - Myocardial Infarction (fatal and non fatal) - Hospitalisation for Angina - Requirement for endovascular procedure eg angioplasty, stent, by-pass grafting (in any vascular bed) - Stroke - Sudden Death - All cause mortality - Safety: Safety outcomes, including myositis, and other adverse events will be examined throughout the study
|
|
E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | Yes |
E.6.3 | Therapy | No |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | No |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | Yes |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | Information not present in EudraCT |
E.8.1.3 | Single blind | Information not present in EudraCT |
E.8.1.4 | Double blind | Yes |
E.8.1.5 | Parallel group | Yes |
E.8.1.6 | Cross over | Information not present in EudraCT |
E.8.1.7 | Other | Information not present in EudraCT |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | Information not present in EudraCT |
E.8.2.2 | Placebo | Yes |
E.8.2.3 | Other | Information not present in EudraCT |
E.8.3 |
The trial involves single site in the Member State concerned
| Yes |
E.8.4 | The trial involves multiple sites in the Member State concerned | No |
E.8.4.1 | Number of sites anticipated in Member State concerned | 1 |
E.8.5 | The trial involves multiple Member States | No |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | No |
E.8.6.2 | Trial being conducted completely outside of the EEA | Information not present in EudraCT |
E.8.7 | Trial has a data monitoring committee | Yes |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
| |
E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 4 |
E.8.9.1 | In the Member State concerned months | |
E.8.9.1 | In the Member State concerned days | |