Chloroquine to Treat People With Metabolic Syndrome Aim2 (ARCH-MS)

This study is ongoing, but not recruiting participants.
Sponsor:
Collaborator:
Information provided by (Responsible Party):
Washington University School of Medicine
ClinicalTrials.gov Identifier:
NCT00455325
First received: March 30, 2007
Last updated: December 24, 2013
Last verified: December 2013
  Purpose

Metabolic syndrome consists of a group of co-occuring conditions that increase an individual's risk of developing heart disease, stroke, and diabetes. The purpose of this study is to evaluate the short-term effectiveness of chloroquine, a protein-activation medication, at improving metabolic syndrome.


Condition Intervention Phase
Metabolic Syndrome X
Overweight
Hypertension
Dyslipidemias
Prediabetic State
Drug: Placebo Comparator Limb 1
Drug: Chloroquine
Phase 2

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Crossover Assignment
Masking: Single Blind (Subject)
Primary Purpose: Treatment
Official Title: Genotoxic Stress, Atherosclerosis, and Metabolic Syndrome-AIM 2

Resource links provided by NLM:


Further study details as provided by Washington University School of Medicine:

Primary Outcome Measures:
  • Insulin sensitivity [ Time Frame: Measured with a hyperinsulinemic clamp every 8 - 10 weeks ] [ Designated as safety issue: No ]

Enrollment: 35
Study Start Date: March 2007
Estimated Study Completion Date: January 2014
Estimated Primary Completion Date: January 2014 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Placebo Comparator: Placebo Comparator Limb 1
Chloroquine placebo one tablet daily for 3 weeks
Drug: Placebo Comparator Limb 1
1 chloroquine placebo tablet for 3 weeks; euglycemic clamp procedure; 24 hour Ambulatory Blood Pressure; Oral Glucose tolerance Test; serum collection; 24 hour urine collection; collection of peripheral blood mononuclear cells
Other Name: Placebo
Active Comparator: Chloroquine Limb 2
80mg chloroquine or placebo tablet weekly for Weeks 1-3
Drug: Chloroquine
80mg chloroquine or placebo tablet weekly for Weeks 1-3;euglycemic clamp procedure; 24 hour Ambulatory Blood Pressure; Oral Glucose tolerance Test; serum collection; 24 hour urine collection; collection of peripheral blood mononuclear cells
Other Name: Aralen
Active Comparator: Chloroquine Limb 3
80mg tablet daily for 3 weeks
Drug: Chloroquine
80mg tablet daily for 3 weeks; euglycemic clamp procedure; 24 hour Ambulatory Blood Pressure; Oral Glucose tolerance Test; serum collection; 24 hour urine collection; collection of peripheral blood mononuclear cells
Other Name: Aralen
Active Comparator: Chloroquine Limb 4
250mg tablet daily for 3 weeks
Drug: Chloroquine
250mg tablet daily for 3 weeks; euglycemic clamp procedure; 24 hour Ambulatory Blood Pressure; Oral Glucose tolerance Test; serum collection; 24 hour urine collection; collection of peripheral blood mononuclear cells
Other Name: Aralen

Detailed Description:

Metabolic syndrome is one of the most common disorders in industrialized countries. It consists of abnormal serum lipids, glucose intolerance, elevated blood pressure, and central obesity in the setting of insulin resistance. The syndrome substantially increases the risk of developing diabetes and vascular disease, but there is no clear unifying approach to treat this disorder. In animals, activation of the protein ataxia telangiectasia mutated (ATM) using the antimalarial drug chloroquine improves features of metabolic syndrome and decreases atherosclerosis, a build-up of fatty plaque within arteries. The purpose of this study is to evaluate the effectiveness of short-term treatment with low doses of chloroquine as a way of managing metabolic syndrome.

Participants in this study will initially receive placebo for 3 weeks, followed by increasing doses of chloroquine in 3-week intervals. There will be a period of no active treatment for 5 to 7 weeks between each arm. At the end of each 3-week period, participants will be admitted to the research center and will undergo insulin sensitivity testing with the hyperinsulinemic euglycemic clamp procedure. In addition, blood will be collected and blood pressure will be measured.

  Eligibility

Ages Eligible for Study:   18 Years to 60 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Diagnosis of metabolic syndrome, as determined by at least three of the following five criteria:

    1. Elevated fasting triglyceride levels greater than or equal to 150 mg/dL
    2. Low HDL cholesterol levels: less than 50 mg/dL for women and less than 40 mg/dL for men
    3. Hypertension (=>130/85 mm Hg =<160/100 mm Hg) untreated; or hypertension controlled (=<150/90 mm Hg) on a stable medication regimen for 4 weeks prior to baseline visit.
    4. Increased waist circumference: greater than 35 inches in women and greater than 40 inches in men
    5. Elevated fasting glucose levels =<100 mg/dL but =>126 mg/dL
  • Subjects may be on a stable doses of a statin drug for at least 3 months
  • Subjects may be on a stable doses of L-thyroxine for at least 3 months
  • Willing to use acceptable form of birth control (e.g., hormonal birth control, double barrier methods)

Exclusion Criteria:

  • Prior travel treatment with chloroquine or hydroxychloroquine as follows:

    1. any exposure in the past 2 years,
    2. >30 days of therapy if exposure was between 2 and 5 years ago,
    3. >90 days of therapy if exposure was between 5 and 10 years ago,
    4. >6 months of therapy if exposure was 10 to 20 years ago,
    5. >1 year of therapy if exposure was 20 to 30 years ago,
    6. No limit if last exposure was >30 years ago, ex. during the Vietnam conflict.
  • Morbid obesity (body mass index [BMI] greater than 45)
  • Coronary artery disease or other vascular disease
  • History of stroke
  • Chronic kidney insufficiency (i.e.,estimated glomerular filtration rate (eGFR) less than 60 ml/min/1.73m2)
  • Diabetes
  • Seizure disorder
  • History of psoriasis
  • Blood disorders, including anemia (i.e., hemoglobin levels less than 13 g/dL in men and less than 12 g/dL in women)
  • Current malignancy or active treatment for recurrence prevention, example tamoxifen. Cancer considered to be cured, either as a result of surgery or other treatment is not exclusionary.
  • Asthma requiring daily beta agonist therapy or intermittent oral steroids is exclusionary. Inhaled steroids are acceptable. Obstructive sleep apnea will be allowed if Continuous Positive Airway Pressure (CPAP) or other therapy has been stable for 6 months. Other active respiratory diseases are excluded.
  • Liver disease, or liver function test results greater than twice the normal value
  • Active infection, including HIV
  • Serious illness requiring ongoing medical care or medication
  • Treatment with atypical anti-psychotic medication. Treatment with any other medication for psychiatric illness, unless on a stable dose for 6 weeks prior to enrollment. Patients with unstable psychiatric disorders are excluded per the decision of the study MD regardless of medication history.
  • Taking any of the following lipid lowering medications: niacin, fibrates, and greater than 1 gm fish oils
  • Uncontrolled hypertension (BP >150/90) at enrollment.
  • Need for daily over the counter medications, or currently taking cimetidine or >1000 IU vitamin E daily and unwilling to reduce or discontinue the use of vitamin E or discontinue cimetidine for the duration of the study. Persons taking >1000 IU of vitamin E should reduce the dose 30 days prior to randomization.
  • Pregnant, breastfeeding, or intending to become pregnant
  • Glucose-6-phosphate dehydrogenase (G6PD) deficiency
  • Retinal disease (in particular, drusen or pigmentary changes at the macula); any ocular disease that interferes with the eye examination (e.g., cataracts)
  • Auditory disease or hearing loss; persons with total, irreversible hearing loss can be enrolled.
  • Participation in another clinical trial within past 30 days prior to screening and 60 days prior to randomization. Questionnaire or observational studies are not exclusionary.
  Contacts and Locations
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Please refer to this study by its ClinicalTrials.gov identifier: NCT00455325

Locations
United States, Missouri
Washington University in St. Louis
St. Louis, Missouri, United States, 63110
Sponsors and Collaborators
Washington University School of Medicine
Investigators
Principal Investigator: Clay F. Semenkovich, MD Washington University School of Medicine
  More Information

Additional Information:
Publications:
Additional publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
Responsible Party: Washington University School of Medicine
ClinicalTrials.gov Identifier: NCT00455325     History of Changes
Other Study ID Numbers: 395, P50HL083762
Study First Received: March 30, 2007
Last Updated: December 24, 2013
Health Authority: United States: Federal Government

Keywords provided by Washington University School of Medicine:
Insulin Resistance
Atherosclerosis
Metabolic Syndrome

Additional relevant MeSH terms:
Hypertension
Metabolic Syndrome X
Overweight
Atherosclerosis
Dyslipidemias
Syndrome
Prediabetic State
Vascular Diseases
Cardiovascular Diseases
Insulin Resistance
Hyperinsulinism
Glucose Metabolism Disorders
Metabolic Diseases
Body Weight
Signs and Symptoms
Arteriosclerosis
Arterial Occlusive Diseases
Lipid Metabolism Disorders
Disease
Pathologic Processes
Diabetes Mellitus
Endocrine System Diseases
Chloroquine
Chloroquine diphosphate
Amebicides
Antiprotozoal Agents
Antiparasitic Agents
Anti-Infective Agents
Therapeutic Uses
Pharmacologic Actions

ClinicalTrials.gov processed this record on October 02, 2014