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Trial registered on ANZCTR
Registration number
ACTRN12610000671066
Ethics application status
Not yet submitted
Date submitted
16/08/2010
Date registered
16/08/2010
Date last updated
16/08/2010
Type of registration
Prospectively registered
Titles & IDs
Public title
Fenofibrate effects on endothelial progenitor cell (EPC) number and function
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Scientific title
Fenofibrate effects on endothelial progenitor cell (EPC) number and function in patients with recent diagnosis of type 2 diabetes mellitus (T2DM).
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Secondary ID [1]
252452
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Nil
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Type 2 Diabetes mellitus
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Hypercholesterolemia/dyslipidemia
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Condition category
Condition code
Cardiovascular
258131
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0
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Diseases of the vasculature and circulation including the lymphatic system
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Metabolic and Endocrine
258132
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0
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Diabetes
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Commencement of fenofibrate 145mg tablets orally as a single dose daily for 6 weeks. At the end of the 6 week period, half the subjects selected randomly will receive additional atorvastatin 40mg daily taken orally and the other half will continue with fenofibrate 145mg only for a further 6 weeks . At the end of the 12 week treatment period, all intervention treatment will be ceased and subjects analysed 6 weeks later.
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Intervention code [1]
257018
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Treatment: Drugs
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Comparator / control treatment
Patients on treatment will act as controls with assesment of EPC number/function at baseline, and subsequent comparison of patients on fenofibrate only versus combination of fenofibrate plus atorvatstain.
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Control group
Active
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Outcomes
Primary outcome [1]
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Change in EPC number using flow cytometric analysis.
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Assessment method [1]
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Timepoint [1]
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Assessments done at baseline, 6, 12 and at 18 weeks.
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Primary outcome [2]
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EPC function using standardized colony forming unit assays and by in vitro angiogenesis assays using Matrigel. Serum angiogenic factors will be quantified by Enzyme Linked Immunosorbent Assay (ELISA).
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Assessment method [2]
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Timepoint [2]
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Assessments done at baseline, 6, 12 and at 18 weeks.
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Secondary outcome [1]
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Nil
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Assessment method [1]
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Timepoint [1]
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N/A
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Eligibility
Key inclusion criteria
1)Recently diagnosed type 2 diabetes mellitus in adults.
2) No previous recent exposure to or any current definite indication for statins or fibrates
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
1) Age less than 18 years
2) Pregnant women(based on urine Beta Human Choriogonadotrophin test (HCG))
3) Cognitively impaired, homeless people or others considered unlikely to comply.
4) Acute myocardial infarction within the last 3 months
5) Anemia with Hemoglobin < 110 mg/dl
6) Significant renal impairment (estimated Glomerular Filtration Rate<60 ml/min/1.73m^2)
7) Active liver disease
8) Clinical gallbladder disease
9)Known hypersensitivity to statin or fibrate therapy
10) Severe hypertriglyceridaemia and/or pancreatitis requiring fibrate therapy
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
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Who is / are masked / blinded?
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Intervention assignment
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Other design features
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Phase
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
1/10/2010
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
22
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
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Funding & Sponsors
Funding source category [1]
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University
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Name [1]
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National Health and Medical Research Council, Clinical Trials Centre, University of Sydney
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Address [1]
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Locked Bag 77, Camperdown NSW 1450
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Country [1]
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Australia
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Primary sponsor type
Individual
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Name
Prof Anthony Keech
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Address
Locked Bag 77, Camperdown NSW 1450
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
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Country [1]
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Other collaborator category [1]
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Individual
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Name [1]
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Dr Martin Ng
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Address [1]
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Heart Research Institute, 7 Eliza Street Newtown, NSW 2042
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Country [1]
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Australia
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Other collaborator category [2]
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Individual
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Name [2]
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Prof Roland Stocker
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Address [2]
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Room 253, Medical Foundation Building, K25, 92-94 Parramatta Rd, Camperdown, NSW 2050
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Country [2]
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Australia
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Other collaborator category [3]
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Individual
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Name [3]
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Dr Kushwin Rajamani
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Address [3]
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Locked Bag 77, Camperdown NSW 1450
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Country [3]
251443
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Australia
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Other collaborator category [4]
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Individual
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Name [4]
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Dr Linda Hoffman
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Address [4]
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Room 154, Medical Foundation Building, K25, 92-94 Parramatta Rd, Camperdown, NSW 2050
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Country [4]
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Australia
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Ethics approval
Ethics application status
Not yet submitted
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Ethics committee name [1]
259496
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Ethics committee address [1]
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Ethics committee country [1]
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Date submitted for ethics approval [1]
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30/06/2010
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Approval date [1]
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Ethics approval number [1]
259496
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X10-0192
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Summary
Brief summary
BACKGROUND AND SCIENTIFIC BASIS Coronary artery disease is an important cause of morbidity and mortality worldwide. Although much is known about the mechanism of myocardial infarction and its associated risk factors, many patients develop myocardial infarction in the absence of known risk factors. Two possible explanations for this are impaired angiogenesis (new blood vessel formation) and impaired endothelial (blood vessel lining) reparative processes in this group of patients. Endothelial progenitor cells (EPC) are thought to be involved in these two processes by: 1) incorporating into new vessels, or 2) coordinating the reparative process. Fenofibrate is a lipid-lowering agent, used in the setting of hypercholesterolemia, particularly among patients with coronary artery disease and diabetes. It has well documented beneficial effects by reducing myocardial infarction. In practice, it is commonly used when patients are intolerant of statins (another cholesterol lowering agent), or in combination with statins. Interest in fenofibrate has increased with recent observations of reduced diabetic microvascular complications. Little is known about EPCs and their function. It has been recently shown that EPCs derived from bone marrow circulate in the peripheral blood and can facilitate the formation of new blood vessels in tissues that are not getting enough blood supply, thereby helping to increase the blood supply to the affected tissue (Asahara T et al Science. 1997;275:964, Urbich C. Circ Res. 2004;95:343). Moreover, patients with coronary artery disease who have high blood levels of EPCs have a better prognosis than those with low EPC levels, possibly due to the beneficial reparative effects of these cells (Werner N. N Engl J Med 2005;353:999). It is unknown if the clinical outcomes of fenofibrate are partly related to EPC levels and function. Statins have been shown to have a positive effect on EPC number and function when used alone. Their effects in combination with fenofibrate have not been evaluated. HYPOTHESIS The central hypotheses of this project are that: 1) EPC levels are increased by fenofibrate 2) EPC levels are higher in those with vascular disease, 3) Fenofibrate augments EPC differentiation and function and 4) Effects of fenofibrate on EPC s occur with and without combination statin therapy. AIMS 1.To determine the number of EPC s after fenofibrate treatment. 2.To investigate if fenofibrate augments EPC function and number. 3.To see the additional benefit of statins on EPC number and function. POTENTIAL SIGNIFICANCE This study will be one of the preliminary studies in man, to identify if fenofibrate has a positive effect on EPCs, and provide an understanding of the clinical effects observed. This will have implications in understanding the role of EPCs in the pathogenesis of vascular diseases, as well as in the development of novel treatment strategies for reducing the impact of vascular disease and myocardial infarction.
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Trial website
Nil
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Address
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Dr Kushwin Rajamani
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Address
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Locked Bag 77,
Camperdown NSW 1450
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Country
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Australia
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Phone
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+61 413540679
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Dr Kushwin Rajamani
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Address
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Locked Bag 77,
Camperdown NSW 1450
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Country
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Australia
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Phone
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+61 413540679
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Fax
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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