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| Name | Class |
|---|---|
| Korea Otsuka Pharmaceutical Co., Ltd. | INDUSTRY |
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The purpose of this study is to evaluate the additional effect of probucol or concomitant administration of cilostazol and probucol on mean carotid artery intima-media thickness (mean IMT) at year 1, 2, and 3.
Hyperlipidemic patients who are currently receiving HMGCoA reductase inhibitors(Statins) will be randomized Group A(Control), Group B(Probucol only added group) or Group C(Probucol and cilostazol added group) . Randomization will be done by the minimization method, controlling for the following factors: Country(Korea vs China) and max IMT (≥2.0mm vs.<2.0mm).
Group A : HMGCoA reductase inhibitor continued
Group B : HMGCoA reductase inhibitor continued + Probucol 250 mg PO, BID
Group C : HMGCoA reductase inhibitor continued + Probucol 250 mg PO, BID +Cilostazol 100 mg PO, BID
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Group A | Placebo Comparator | HMGCoA reductase inhibitor continued |
|
| Group B | Active Comparator | HMGCoA reductase inhibitor continued + Probucol 250 mg PO, BID |
|
| Group C | Active Comparator | HMGCoA reductase inhibitor continued + Probucol 250 mg PO, BID + Cilostazol 100 mg PO, BID |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| HMG-CoA Reductase Inhibitor | Drug | During the study period, HMGCoA reductase inhibitor is continuously administered to the patients. Dosage regimen: following the package insert of each HMGCoA reductase inhibitor |
| Measure | Description | Time Frame |
|---|---|---|
| Difference of Carotid artery IMT (mean IMT) between screening and treatment completion(3 years after) or discontinuation | For primary endpoint of Carotid artery IMT, t-test will be conducted for the mean IMT and variation by treatment arm(Group A vs B, Group A vs C). The 2-sided significance level is 5%. Morever, Mantel - Haenszel method can be accepted considering stratification factor or Sub-analysis can be done by each stratum in case of categorical variables. | Baseline(screening), 3years |
| Measure | Description | Time Frame |
|---|---|---|
| Time from enrollment date to the onset of composite cerebrovascular events |
Kaplan-Meier method will be conducted for the time from enrollment date to the onset of composite cerebrovascular and cardiovascular events by treatment arm(Group A vs B, Group A vs C). Overall survival curves and progression-free survival curves are estimated per treatment arm. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Byung-Hee Oh, M.D. | Seoul National University Hospital | Study Chair |
| Cheol Ho Kim, M.D. | Seoul National University Bundang Hospital | Principal Investigator |
| Sang-Hyun Kim, M.D. | SMG-SNU Boramae Medical Center | Principal Investigator |
| Moo-Hyun Kim, M.D. | Dong-A medical center | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Dong-A Medical Center | Seogu | Busan | 602-715 | South Korea | ||
| Samsung Medical Center |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 7997016 | Result | Manzato E. Scandinavian simvastatin study (4S). Lancet. 1994 Dec 24-31;344(8939-8940):1767; author reply 1767-8. No abstract available. | |
| 9892586 | Result | Plehn JF, Davis BR, Sacks FM, Rouleau JL, Pfeffer MA, Bernstein V, Cuddy TE, Moye LA, Piller LB, Rutherford J, Simpson LM, Braunwald E. Reduction of stroke incidence after myocardial infarction with pravastatin: the Cholesterol and Recurrent Events (CARE) study. The Care Investigators. Circulation. 1999 Jan 19;99(2):216-23. doi: 10.1161/01.cir.99.2.216. |
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| ID | Term |
|---|---|
| D006949 | Hyperlipidemias |
| ID | Term |
|---|---|
| D050171 | Dyslipidemias |
| D052439 | Lipid Metabolism Disorders |
| D008659 | Metabolic Diseases |
| D009750 | Nutritional and Metabolic Diseases |
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| ID | Term |
|---|---|
| D019161 | Hydroxymethylglutaryl-CoA Reductase Inhibitors |
| D011341 | Probucol |
| D000077407 | Cilostazol |
| ID | Term |
|---|---|
| D000924 | Anticholesteremic Agents |
| D000960 | Hypolipidemic Agents |
| D000963 | Antimetabolites |
| D045504 | Molecular Mechanisms of Pharmacological Action |
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| Probucol | Drug | In addition to the continued HMGCoA reductase inhibitor treatment, probucol is administered. Dosage regimen: probucol 250-mg tablet, oral administration twice daily with meal(breakfast and dinner) |
|
|
| Cilostazol | Drug | In addition to the continued HMGCoA reductase inhibitor treatment, probucol and cilostazol are administered. Dosage regimen: probucol 250-mg tablet, oral administration twice daily with meal(breakfast and dinner) Cilostazol 100-mg tablet, twice daily by the oral route |
|
|
| enrollment date, onset date(during study period, 3years) |
| Number of composite cerebrovascular and cardiovascular events(including intervention) |
For the number of composite cerebrovascular and cardiovascular events (including intervention) t-test will be done by treatment arm(Group A vs B, Group A vs C). | enrollment date, onset date(during study period, 3years) |
| The change of Biomarkers(1) | Metabolic index: Lipid profile (TC, LDL-C, HDL-C, TG) | enrollment date ,onset date(during study period, 3years) |
| The change of Biomarkers(2) | Inflammatory index: High sensitive C-reactive protein (hsCRP) | enrollment date ,onset date(during study period, 3years) |
| The change of Biomarkers(3) | Oxidation index:oxidized LDL The change of biomarkers, t-test will be done by treatment arm(Group A vs B, Group A vs C). | enrollment date ,onset date(during study period, 3years) |
| Seoul |
| Gangnam-Gu |
| 135-710 |
| South Korea |
| Seoul National University Bundang Hospital | Seongnam-si | Gyeonggi-do | 463-707 | South Korea |
| Seoul National University Hospital | Seoul | 110-744 | South Korea |
| Boramae Medical Center | Seoul | 156-707 | South Korea |
| 9841303 | Result | Long-Term Intervention with Pravastatin in Ischaemic Disease (LIPID) Study Group. Prevention of cardiovascular events and death with pravastatin in patients with coronary heart disease and a broad range of initial cholesterol levels. N Engl J Med. 1998 Nov 5;339(19):1349-57. doi: 10.1056/NEJM199811053391902. |
| 5450842 | Result | Barnhart JW, Sefranka JA, McIntosh DD. Hypocholesterolemic effect of 4,4'-(isopropylidenedithio)-bis(2,6-di-t-butylphenol) (probucol). Am J Clin Nutr. 1970 Sep;23(9):1229-33. doi: 10.1093/ajcn/23.9.1229. No abstract available. |
| 6946776 | Result | Tomikawa M, Nakayasu T, Tawara K, Abiko Y. Effect of probucol on serum lipoprotein levels in normal and dyslipoproteinemic mice. Atherosclerosis. 1981 Oct;40(2):101-13. doi: 10.1016/0021-9150(81)90029-0. |
| 3959347 | Result | Tawara K, Tomikawa M, Abiko Y. Mode of action of probucol in reducing serum cholesterol in mice. Jpn J Pharmacol. 1986 Jan;40(1):123-33. doi: 10.1254/jjp.40.123. |
| 3475709 | Result | Kita T, Nagano Y, Yokode M, Ishii K, Kume N, Ooshima A, Yoshida H, Kawai C. Probucol prevents the progression of atherosclerosis in Watanabe heritable hyperlipidemic rabbit, an animal model for familial hypercholesterolemia. Proc Natl Acad Sci U S A. 1987 Aug;84(16):5928-31. doi: 10.1073/pnas.84.16.5928. |
| 9134376 | Result | Ishigami M, Yamashita S, Sakai N, Hirano K, Arai T, Maruyama T, Takami S, Koyama M, Kameda-Takemura K, Matsuzawa Y. High-density lipoproteins from probucol-treated patients have increased capacity to promote cholesterol efflux from mouse peritoneal macrophages loaded with acetylated low-density lipoproteins. Eur J Clin Invest. 1997 Apr;27(4):285-92. doi: 10.1046/j.1365-2362.1997.1040657.x. |
| 10323786 | Result | Rinninger F, Wang N, Ramakrishnan R, Jiang XC, Tall AR. Probucol enhances selective uptake of HDL-associated cholesteryl esters in vitro by a scavenger receptor B-I-dependent mechanism. Arterioscler Thromb Vasc Biol. 1999 May;19(5):1325-32. doi: 10.1161/01.atv.19.5.1325. |
| 3394656 | Result | Matsuzawa Y, Yamashita S, Funahashi T, Yamamoto A, Tarui S. Selective reduction of cholesterol in HDL2 fraction by probucol in familial hypercholesterolemia and hyperHDL2 cholesterolemia with abnormal cholesteryl ester transfer. Am J Cardiol. 1988 Jul 25;62(3):66B-72B. doi: 10.1016/s0002-9149(88)80055-9. |
| 11009277 | Result | Daida H, Kuwabara Y, Yokoi H, Nishikawa H, Takatsu F, Nakata Y, Kutsumi Y, Oshima S, Nishiyama S, Ishiwata S, Kato K, Nishimura S, Miyauchi K, Kanoh T, Yamaguchi H. Effect of probucol on repeat revascularization rate after percutaneous transluminal coronary angioplasty (from the Probucol Angioplasty Restenosis Trial [PART]). Am J Cardiol. 2000 Sep 1;86(5):550-2, A9. doi: 10.1016/s0002-9149(00)01013-4. |
| 9241125 | Result | Tardif JC, Cote G, Lesperance J, Bourassa M, Lambert J, Doucet S, Bilodeau L, Nattel S, de Guise P. Probucol and multivitamins in the prevention of restenosis after coronary angioplasty. Multivitamins and Probucol Study Group. N Engl J Med. 1997 Aug 7;337(6):365-72. doi: 10.1056/NEJM199708073370601. |
| 7830729 | Result | Anderson TJ, Meredith IT, Yeung AC, Frei B, Selwyn AP, Ganz P. The effect of cholesterol-lowering and antioxidant therapy on endothelium-dependent coronary vasomotion. N Engl J Med. 1995 Feb 23;332(8):488-93. doi: 10.1056/NEJM199502233320802. |
| 11849859 | Result | Sawayama Y, Shimizu C, Maeda N, Tatsukawa M, Kinukawa N, Koyanagi S, Kashiwagi S, Hayashi J. Effects of probucol and pravastatin on common carotid atherosclerosis in patients with asymptomatic hypercholesterolemia. Fukuoka Atherosclerosis Trial (FAST). J Am Coll Cardiol. 2002 Feb 20;39(4):610-6. doi: 10.1016/s0735-1097(01)01783-1. |
| 19060422 | Result | Yamashita S, Bujo H, Arai H, Harada-Shiba M, Matsui S, Fukushima M, Saito Y, Kita T, Matsuzawa Y. Long-term probucol treatment prevents secondary cardiovascular events: a cohort study of patients with heterozygous familial hypercholesterolemia in Japan. J Atheroscler Thromb. 2008 Dec;15(6):292-303. doi: 10.5551/jat.e610. Epub 2008 Dec 6. |
| 12652104 | Result | Bots ML, Grobbee DE. Intima media thickness as a surrogate marker for generalised atherosclerosis. Cardiovasc Drugs Ther. 2002 Jul;16(4):341-51. doi: 10.1023/a:1021738111273. |
| 7863988 | Result | Crouse JR 3rd, Byington RP, Bond MG, Espeland MA, Craven TE, Sprinkle JW, McGovern ME, Furberg CD. Pravastatin, Lipids, and Atherosclerosis in the Carotid Arteries (PLAC-II). Am J Cardiol. 1995 Mar 1;75(7):455-9. doi: 10.1016/s0002-9149(99)80580-3. |
| 9626835 | Result | de Groot E, Jukema JW, Montauban van Swijndregt AD, Zwinderman AH, Ackerstaff RG, van der Steen AF, Bom N, Lie KI, Bruschke AV. B-mode ultrasound assessment of pravastatin treatment effect on carotid and femoral artery walls and its correlations with coronary arteriographic findings: a report of the Regression Growth Evaluation Statin Study (REGRESS). J Am Coll Cardiol. 1998 Jun;31(7):1561-7. doi: 10.1016/s0735-1097(98)00170-3. |
| 9603532 | Result | MacMahon S, Sharpe N, Gamble G, Hart H, Scott J, Simes J, White H. Effects of lowering average of below-average cholesterol levels on the progression of carotid atherosclerosis: results of the LIPID Atherosclerosis Substudy. LIPID Trial Research Group. Circulation. 1998 May 12;97(18):1784-90. doi: 10.1161/01.cir.97.18.1784. |
| 12379573 | Result | Taylor AJ, Kent SM, Flaherty PJ, Coyle LC, Markwood TT, Vernalis MN. ARBITER: Arterial Biology for the Investigation of the Treatment Effects of Reducing Cholesterol: a randomized trial comparing the effects of atorvastatin and pravastatin on carotid intima medial thickness. Circulation. 2002 Oct 15;106(16):2055-60. doi: 10.1161/01.cir.0000034508.55617.65. |
| 9436818 | Result | Baldassarre D, Franceschini G, Peruzzotti G, Brusoni B, Sirtori CR. Clinical evaluation of probucol in hypercholesteremia: individual lipoprotein responses and inhibitory effect on carotid atherosclerosis progression. J Cardiovasc Pharmacol. 1997 Dec;30(6):784-9. doi: 10.1097/00005344-199712000-00013. |
| 9848888 | Result | Elam MB, Heckman J, Crouse JR, Hunninghake DB, Herd JA, Davidson M, Gordon IL, Bortey EB, Forbes WP. Effect of the novel antiplatelet agent cilostazol on plasma lipoproteins in patients with intermittent claudication. Arterioscler Thromb Vasc Biol. 1998 Dec;18(12):1942-7. doi: 10.1161/01.atv.18.12.1942. |
| 18404599 | Result | Yoshikawa T, Mitani K, Kotosai K, Nozako M, Miyakoda G, Yabuuchi Y. Antiatherogenic effects of cilostazol and probucol alone, and in combination in low density lipoprotein receptor-deficient mice fed with a high fat diet. Horm Metab Res. 2008 Jul;40(7):473-8. doi: 10.1055/s-2008-1065348. Epub 2008 Apr 10. |
| 19967051 | Result | Park SY, Lee JH, Shin HK, Kim CD, Lee WS, Rhim BY, Shin YW, Hong KW. Synergistic efficacy of concurrent treatment with cilostazol and probucol on the suppression of reactive oxygen species and inflammatory markers in cultured human coronary artery endothelial cells. Korean J Physiol Pharmacol. 2008 Aug;12(4):165-70. doi: 10.4196/kjpp.2008.12.4.165. Epub 2008 Aug 31. |
| 11558482 | Result | Smilde TJ, van Wissen S, Wollersheim H, Trip MD, Kastelein JJ, Stalenhoef AF. Effect of aggressive versus conventional lipid lowering on atherosclerosis progression in familial hypercholesterolaemia (ASAP): a prospective, randomised, double-blind trial. Lancet. 2001 Feb 24;357(9256):577-81. doi: 10.1016/s0140-6736(00)04053-8. |
| D020228 | Pharmacologic Actions |
| D020164 | Chemical Actions and Uses |
| D004791 | Enzyme Inhibitors |
| D057847 | Lipid Regulating Agents |
| D045506 | Therapeutic Uses |
| D010636 | Phenols |
| D001555 | Benzene Derivatives |
| D006841 | Hydrocarbons, Aromatic |
| D006844 | Hydrocarbons, Cyclic |
| D006838 | Hydrocarbons |
| D009930 | Organic Chemicals |
| D013777 | Tetrazoles |
| D001393 | Azoles |
| D006573 | Heterocyclic Compounds, 1-Ring |
| D006571 | Heterocyclic Compounds |
| D011804 | Quinolines |
| D006574 | Heterocyclic Compounds, 2-Ring |
| D000072471 | Heterocyclic Compounds, Fused-Ring |