Pharmacokinetics (PK)/Safety Study of Atorvastatin in Children With Kawasaki Disease and Coronary Artery Abnormalities
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Purpose
Kawasaki disease (KD) is the leading cause of acquired heart disease in children in the developed world. Despite available treatment, 25% of children in San Diego County appropriately treated for KD develop coronary artery abnormalities that could lead to complications later in life, including heart attack. Although investigators can identify children with KD that have these coronary artery abnormalities, there is no approved additional treatment to decrease coronary artery inflammation and arrest or prevent damage to the coronary arteries. Inflammation and damage to the arterial wall is central to these coronary artery abnormalities. Statins, a class of drugs that is known for lowering cholesterol, have also been shown to decrease inflammation in general as well as at the level of the vessel wall. Therefore, the investigators propose to study the safety of the drug atorvastatin in children with coronary artery abnormalities from KD.
| Condition | Intervention | Phase |
|---|---|---|
|
Kawasaki Disease |
Drug: Atorvastatin |
Phase 1 Phase 2 |
| Study Type: | Interventional |
| Study Design: | Endpoint Classification: Safety Study Intervention Model: Single Group Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Phase I/IIa Study of Pharmacokinetics and Safety of Atorvastatin in Children With Coronary Artery Abnormalities Secondary to Kawasaki Disease |
- Safety of atorvastatin in children with coronary artery abnormalities secondary to Kawasaki disease [ Time Frame: At 6 weeks after initiation of study drug ] [ Designated as safety issue: Yes ]Evaluation of cholesterol, liver functions, and markers of myopathy at the above time points.
- Pharmacokinetics [ Time Frame: 0,1,2,6,12,24 hours at baseline; 2&6 weeks ] [ Designated as safety issue: No ]Blood will be drawn around the first dose at 0,1,2,6,12 and 24 hours and troughs will be drawn at 2 weeks and 6 weeks during the clinic visit.
- Atorvastatin Activity [ Time Frame: Baseline, 2 weeks and 6 weeks ] [ Designated as safety issue: No ]Measures of oxidative stress will be assessed at baseline, 2 weeks and 6 weeks after study enrollment.
| Estimated Enrollment: | 32 |
| Study Start Date: | July 2012 |
| Estimated Study Completion Date: | December 2016 |
| Estimated Primary Completion Date: | June 2016 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Atorvasatin
Atorvastatin dose titration to maximum tolerated dose
|
Drug: Atorvastatin
Atorvastatin dose titration to maximum tolerated dose (once daily for 6 weeks)
Other Name: Lipitor
|
Eligibility| Ages Eligible for Study: | 2 Years to 17 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion criteria:
- Age ≥ 2 years to 17 years old
- Meets clinical criteria for KD according to American Heart Association guidelines (Table 2): Fever (T≥38oC or 100.4oC) ≥ 3 days and ≥ 2 clinical criteria with left anterior descending coronary artery/right coronary artery z-score ≥ 2.5 or an aneurysm (≥ 1.5 x the adjacent segment) of one of the coronary arteries
- Patient presents within the first 20 days after fever onset
- Parent or legal guardian able and willing to provide informed consent and subject willing and able to provide assent when appropriate.
- Post-menarchal females: Negative pregnancy test at screening and willing to use two forms of contraception during the study
- Males engaging in sexual activity that could lead to pregnancy must use a condom.
Exclusion Criteria:
- Use of a statin, fibrate, or niacin within the 3 months prior to enrollment
- Have any chronic disease, except asthma, atopic dermatitis, autism or controlled seizure disorder
- Screening creatine phosphokinase (CK) ≥ 3x upper limit of normal for age
- Patient taking a CYP3A4 inhibitor (ie. cyclosporine or clarithromycin) in the last 7 days
- Patient has a history of allergy to atorvastatin or its derivatives
Contacts and Locations| Contact: Jane C Burns, MD | 858-246-0155 | jcburns@ucsd.edu |
| Contact: Adriana Tremoulet, MD, MAS | 858-246-0012 | atremoulet@ucsd.edu |
| United States, California | |
| University of California San Diego | Recruiting |
| San Diego, California, United States, 92093 | |
| Contact: Adriana H. Tremoulet, MD, MAS 858-246-0012 atremoulet@ucsd.edu | |
| Contact: Jane C. Burns, MD 858-246-0155 jcburns@ucsd.edu | |
| Principal Investigator: Jane C Burns, MD | |
| Sub-Investigator: Adriana H Tremoulet, MD | |
| Principal Investigator: | Jane C Burns, MD | University of California, San Diego |
More Information
No publications provided
| Responsible Party: | Jane C. Burns, Chief, Division of Allergy, Immunology, Rheumatology, University of California, San Diego |
| ClinicalTrials.gov Identifier: | NCT01431105 History of Changes |
| Other Study ID Numbers: | KD-Atorvastatin |
| Study First Received: | September 6, 2011 |
| Last Updated: | February 24, 2013 |
| Health Authority: | United States: Institutional Review Board United States: Food and Drug Administration |
Keywords provided by University of California, San Diego:
|
Kawasaki disease |
Additional relevant MeSH terms:
|
Congenital Abnormalities Mucocutaneous Lymph Node Syndrome Vasculitis Vascular Diseases Cardiovascular Diseases Lymphatic Diseases Skin Diseases, Vascular Skin Diseases Atorvastatin |
Hydroxymethylglutaryl-CoA Reductase Inhibitors Anticholesteremic Agents Hypolipidemic Agents Antimetabolites Molecular Mechanisms of Pharmacological Action Pharmacologic Actions Enzyme Inhibitors Lipid Regulating Agents Therapeutic Uses |
ClinicalTrials.gov processed this record on May 16, 2013