Lp-PLA2, Progenitor Cells and Coronary Atherosclerosis in Humans AIM III

This study has been completed.
National Heart, Lung, and Blood Institute (NHLBI)
National Institute on Aging (NIA)
Information provided by (Responsible Party):
Amir Lerman, Mayo Clinic
ClinicalTrials.gov Identifier:
First received: February 9, 2010
Last updated: January 7, 2016
Last verified: September 2015
AIM III is a prospective, randomized, double-blinded, placebo controlled trial. The study is directly connected to IRB 08-008161 as a specific aim of the National Institute of Health (NIH) grant. Participants may either consent to and qualify for AIM I and AIM II (IRB 08-008161) or have a cardiac catheterization with acetylcholine testing in the Cardiac Catheterization Laboratory at Mayo Clinic in Rochester MN to be considered for this study.

Condition Intervention Phase
Endothelial Dysfunction
Drug: darapladib
Drug: placebo
Phase 3

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Single Group Assignment
Masking: Double Blind (Subject, Caregiver, Investigator)
Primary Purpose: Treatment
Official Title: Lp-PLA2, Progenitor Cells and Coronary Atherosclerosis in Humans AIM III

Resource links provided by NLM:

Further study details as provided by Mayo Clinic:

Primary Outcome Measures:
  • The dual primary endpoints will the pre-treatment and post-treatment difference in % change CAD (Ach)and % change CBF (Ach). [ Time Frame: six months ] [ Designated as safety issue: No ]

Enrollment: 64
Study Start Date: February 2010
Study Completion Date: November 2015
Primary Completion Date: November 2015 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Darapladib
1:1 randomization drug or placebo
Drug: darapladib
darapladib, tablet, 160 mg, by mouth, one time daily, 6 month duration
Placebo Comparator: Sugar Pill
1:1 randomization placebo or darapladib
Drug: placebo
placebo, by mouth, once daily for six months

Detailed Description:
The main goal of AIM III is to assess and quantify the effect of long-term administration of darapladib 160 mg once a day, a selective, reversible, orally active inhibitor of plasma and vascular Lp-PLA2, on coronary endothelial function, progression of coronary atherosclerosis as determined by IVUS, and atherosclerosis in patients with early atherosclerosis. Patients with evidence of coronary endothelial dysfunction, as determined by intracoronary administration of acetylcholine during angiography and IVUS, will be followed for 6 months during once daily dosing of darapladib. Coronary endothelial function is determined by the changes in coronary artery diameter and coronary blood flow response to the intracoronary administration of acetylcholine and adenosine. The patients will be followed in clinic 6 months. They will have follow-up angiography, assessment of endothelial function, and IVUS during the six month visit.

Ages Eligible for Study:   18 Years to 85 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  1. Patients undergoing coronary angiography including endothelial function testing with the medication acetylcholine in the cardiac catheterization laboratory at Mayo Clinic. Patients may be enrolled in AIM I and AIM II IRB 08-008161 :Lp-PLA2, Progenitor Cells and Atherosclerosis in Humans".
  2. Male or female aged at least 18 years, inclusive, at screening. Female subjects must be post-menopausal or using a highly effective method for avoidance of pregnancy. The decision to include or exclude women of childbearing potential may be made at the discretion of the investigator in accordance with local practice in relation to adequate contraception.
  3. Age greater than 18 up to age 85

Exclusion Criteria:

  1. Current severe heart failure New York Heart Association class III or IV with ejection fraction less than 40%
  2. Unstable angina
  3. Myocardial infarction or angioplasty within 6 months prior to entry into the study
  4. Planned coronary revascularization (PCI or CABG)
  5. Planned major surgical procedure
  6. Patients with segments with endothelial dysfunction of less than 10 mm in length or complete occlusion will be excluded.
  7. Angiographic exclusion criteria include left main disease with greater than 30% stenosis on angiogram, luminal diameter of the study vessel less than 2.5 mm, severe tortuousity of the study vessel, or any other relevant anatomical reasons that the investigator deems inappropriate for the study.
  8. Current liver disease, known hepatic or biliary abnormalities (with the exception of Gilbert's syndrome or asymptomatic gallstones) or evidence of abnormal liver function tests (total bilirubin or alkaline phosphatase > 1.5 x upper limit of normal (UNL); or ALT or AST > 2.5 x UNL or other hepatic abnormalities that in the opinion of the investigator would preclude the subject from participation in the study.
  9. Chronic or acute kidney disease with serum creatinine greater than or equal to 2 mg/dL or estimated glomerular filtration rate <40 mL/min/1.73m2, renal transplant status, history of contrast nephropathy,
  10. Poorly controlled hypertension despite lifestyle modifications and pharmacotherapy. (systolic BP >160 mm Hg and/or diastolic BP >110 mm Hg),
  11. Poorly controlled diabetes mellitus (HbA1c >10%),
  12. Current or within 1 month use of any form of corticosteroids,
  13. Severe asthma that is poorly controlled on pharmacotherapy
  14. History of anaphylaxis, anaphylactoid (resembling anaphylaxis) reactions
  15. Current life-threatening conditions other than vascular disease, alcohol or drug abuse within the last 6 months
  16. Malignancy within the past 5 years,
  17. Positive pregnancy test (all female subjects of childbearing potential must have a urine β-human chorionic gonadotropin [hCG] pregnancy test performed at Screening and/or within 7 days prior to randomization) or is known to be pregnant or lactating.
  18. Current or planned chronic administration of strong oral or injectable cytochrome P-450 isoenzyme 3A4 (CYP3A4) inhibitors.
  19. Subjects with both parents of Japanese, Chinese, or Korean ancestry must have a blood sample collected for assessment of Lp-PLA2 activity by the central laboratory prior to randomization. Those with Lp-PLA2 activity ≤10 nmol/min/mL will be excluded from participation in the study.
  20. Previous exposure to darapladib (SB-480848).
  21. Use of an investigational device or investigational drug within 30 days or 5 half-lives (whichever is longer) preceding the first dose of the study medication, or any subject the investigator deems unsuitable for the study
  22. Patients who require treatment with positive inotropic agents other than digoxin during the study
  23. Patients with cerebrovascular accident within 6 months prior to entry into the study
  24. Significant endocrine, hepatic or renal disorders
  25. Local or systemic infectious disease within 4 weeks prior to entry into study
  26. Mental instability
  27. Federal Medical Center inmates
  28. Hemoglobin less than 12 mg/dL
  Contacts and Locations
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Please refer to this study by its ClinicalTrials.gov identifier: NCT01067339

United States, Minnesota
Mayo Clinic
Rochester, Minnesota, United States, 55905
Sponsors and Collaborators
Mayo Clinic
National Heart, Lung, and Blood Institute (NHLBI)
National Institute on Aging (NIA)
Principal Investigator: Amir Lerman, MD Mayo Clinic
  More Information

Responsible Party: Amir Lerman, Professor of Medicine, Mayo Clinic
ClinicalTrials.gov Identifier: NCT01067339     History of Changes
Other Study ID Numbers: 10-000044  5R01HL092954  5R01AG031750 
Study First Received: February 9, 2010
Last Updated: January 7, 2016
Health Authority: United States: Food and Drug Administration

Keywords provided by Mayo Clinic:
coronary endothelial dysfunction
coronary vasospasm

Additional relevant MeSH terms:
Coronary Artery Disease
Myocardial Ischemia
Arterial Occlusive Diseases
Cardiovascular Diseases
Coronary Disease
Heart Diseases
Vascular Diseases
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action
Phospholipase A2 Inhibitors

ClinicalTrials.gov processed this record on May 26, 2016