Study on the Composite Endpoint Event of PCSK9 Inhibitor in Patients With Very High Risk of ASCVD and Cancer
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ClinicalTrials.gov Identifier: NCT05976893 |
Recruitment Status :
Not yet recruiting
First Posted : August 4, 2023
Last Update Posted : August 4, 2023
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Condition or disease | Intervention/treatment | Phase |
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ASCVD Atherosclerotic Cardiovascular Disease Proprotein Convertase Subtilisin/Kexin Type 9 Inhibitor Cancer | Drug: Evolocumab Drug: Statin | Phase 4 |
Study Type : | Interventional (Clinical Trial) |
Estimated Enrollment : | 620 participants |
Allocation: | Randomized |
Intervention Model: | Parallel Assignment |
Intervention Model Description: | patients with very high risk of ASCVD and cancer |
Masking: | Single (Outcomes Assessor) |
Primary Purpose: | Treatment |
Official Title: | Study on the Composite Endpoint Event of PCSK9 Inhibitor in Patients With Very High Risk of ASCVD and Cancer |
Estimated Study Start Date : | August 1, 2023 |
Estimated Primary Completion Date : | December 31, 2025 |
Estimated Study Completion Date : | December 31, 2025 |
Arm | Intervention/treatment |
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Experimental: the PCSK9 inhibitor plus statin therapy
Patients with very high risk of ASCVD and cancer are treated with moderate intensity statin daily and evolocumab (420 mg) every 4 weeks throughout the study period.
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Drug: Evolocumab
Evolocuma:420 mg every 4 weeks
Other Name: Repatha Drug: Statin The moderate intensity statins used during the study are one of atorvastatin 10-20mg qd, resuvastatin 5-10mg qd, and xuezhikang 0.6g bid (statin intolerance). |
the statin alone therapy
Patients with very high risk of ASCVD and cancer are treated with moderate intensity statin daily throughout the study period.
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Drug: Statin
The moderate intensity statins used during the study are one of atorvastatin 10-20mg qd, resuvastatin 5-10mg qd, and xuezhikang 0.6g bid (statin intolerance). |
- Major cardiovascular adverse events [ Time Frame: From date of randomization until the date of first documented endpoint or date of completion of follow-up, whichever came first, assessed up to 48 weeks ]Major cardiovascular adverse events include cardiovascular death, recurrent unstable angina, myocardial infarction, stroke, and coronary revascularization
- All cause death [ Time Frame: From date of randomization until the date of first documented endpoint or date of completion of follow-up, whichever came first, assessed up to 48 weeks ]All cause death
- Composite end points [ Time Frame: From date of randomization until the date of first documented endpoint or date of completion of follow-up, whichever came first, assessed up to 48 weeks ]Composite end points include cardiogenic shock, cardiac arrest, malignant arrhythmia, heart failure, Non-coronary revascularization
- The compliance rate of lipid control [ Time Frame: From date of randomization until the date of first documented endpoint or date of completion of follow-up, whichever came first, assessed up to 48 weeks ]Main indicator: LDL-C decreased to below 1.4 mmol/L and decreased by more than 50% from baseline; secondary indicator: non HDL-C<2.2 mmol/L;
- The changes of carotid plaque [ Time Frame: From date of randomization until the date of first documented endpoint or date of completion of follow-up, whichever came first, assessed up to 48 weeks ]By carotid ultrasound
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Ages Eligible for Study: | 18 Years to 80 Years (Adult, Older Adult) |
Sexes Eligible for Study: | All |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Male or female ≥ 18 to ≤ 80 years of age
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Patients with very high risk of ASCVD (with any of the following):
- Documented ASCVD, either clinical or unequivocal on imaging. Documented ASCVD includes previous acute coronary syndrome (ACS), stable angina, coronary revascularization (percutaneous coronary intervention, coronary artery bypass graft, and other arterial revascularization procedures), stroke and transient ischemic attack (TIA), and peripheral arterial disease. Unequivocally documented ASCVD on imaging includes those findings that are known to be predictive of clinical events, such as significant plaque on coronary angiography or computed tomography (CT) scan (multivessel coronary disease with two major epicardial arteries having >50% stenosis), or on carotid ultrasound.
- Diabetes mellitus (DM) with target organ damage, or at least three major risk factors, or early onset of type 1 diabetes mellitus (T1DM) of long duration (>20 years).
- Patients have been diagnosed with cancer through histopathology and have a life expectancy of more than 1 year
- Fasting low-density lipoprotein cholesterol (LDL-C) ≥ 1.8 mmol/L or non-high-density lipoprotein cholesterol (non HDL-C) > 2.6 mmol/L
- Participate voluntarily and sign an informed consent
- Negative serum Pregnancy test (in women with fertility potential)
Exclusion Criteria:
- Pregnant and lactating women
- During the study period and within 3 months of receiving the last dose of the study drug, women with fertility intentions and men unwilling to use effective contraceptive methods
- New York Heart Association (NYHA) class III or IV, or last known left ventricular ejection fraction < 30%
- Uncontrolled hypertension, defined as systolic blood pressure ≥ 180 mmHg and/or diastolic blood pressure ≥ 110 mmHg
- Plan for coronary revascularization or other cardiac surgery in recent (within 3 months after randomization)
- Severe renal insufficiency, defined as estimated glomerular filtration rate (eGRF) < 30ml/min/1.73m2 or Serum creatinine (Scr) > 221 umol/L
- Severe liver dysfunction, defined as an increase in alanine aminotransferase (ALT) or aspartate aminotransferase (AST) more than 3 times above the upper limit of normal
- Have used PCSK9 inhibitors within 3 months before enrollment, or have a history of severe allergic reactions to PCSK9 inhibitors
- Severe infections requiring intravenous antibiotics
- HIV-positive or history of acquired immunodeficiency syndrome (AIDS)
- With cognitive impairment or psychiatric illnesses
- Participating in other trials
To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT05976893
Contact: Xiang Xie, PhD | +869914366892 | xiangxie999@sina.com |
Principal Investigator: | Xiang Xie, PhD | First Affiliated Hospital of Xinjiang Medical University |
Responsible Party: | Xiang Xie, Principal Investigator, Xinjiang Medical University |
ClinicalTrials.gov Identifier: | NCT05976893 |
Other Study ID Numbers: |
PICVDAC |
First Posted: | August 4, 2023 Key Record Dates |
Last Update Posted: | August 4, 2023 |
Last Verified: | July 2023 |
Individual Participant Data (IPD) Sharing Statement: | |
Plan to Share IPD: | No |
Studies a U.S. FDA-regulated Drug Product: | Yes |
Studies a U.S. FDA-regulated Device Product: | No |
Product Manufactured in and Exported from the U.S.: | Yes |
ASCVD cancer PCSK9 |
Cardiovascular Diseases Atherosclerosis Arteriosclerosis Arterial Occlusive Diseases Vascular Diseases Evolocumab PCSK9 Inhibitors Anticholesteremic Agents |
Hypolipidemic Agents Antimetabolites Molecular Mechanisms of Pharmacological Action Serine Proteinase Inhibitors Protease Inhibitors Enzyme Inhibitors Lipid Regulating Agents |