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Anti-chlamydophila Antibiotic Combination Therapy in the Treatment of Patients With Coronary Heart Disease (ACAC-CHD)

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Know the risks and potential benefits of clinical studies and talk to your health care provider before participating. Read our disclaimer for details. Identifier: NCT03618108
Recruitment Status : Recruiting
First Posted : August 7, 2018
Last Update Posted : February 5, 2020
Centre for Digestive Diseases, Australia
Information provided by (Responsible Party):
Cadrock Pty. Ltd.

Brief Summary:

The purpose of the study is to see whether the antibiotic combination of 100mg doxycycline, 500mg azithromycin and 300mg rifabutin is a safe and effective treatment for coronary artery disease which has not responded to 'standard treatment'.

Coronary artery disease is the process of plaque build up within the walls of the arteries responsible for supplying the heart with oxygen and nutrients. plaque is usually made up of fatty deposits, minerals and various amounts of tissue and white cells which eventually narrows the artery, reducing blood flow to the heart. The resulting damage and build up of fat leads to inflammation of the arterial wall and eventually the arteries narrow. The researchers involved in this study consider that a pathogen called Chlamydophila pneumoniae, which can live inside cells may cause this inflammation of the arterial wall.

The purpose of this study is to see if treatment with this antibiotic combination in patients with CHD is safe and effective in reducing disease severity measured at coronary angiography and improving quality of life. Approximately 60 patients will be involved in this trial. the treatment period is 90 days with a further 90 day follow up period.

Condition or disease Intervention/treatment Phase
Coronary Heart Disease Chlamydophila Pneumoniae Infections Drug: Doxycycline Capsule Drug: Azithromycin Capsule Drug: Rifabutin Oral Capsule Drug: Placebo oral capsule Drug: Placebo Oral Tablet Phase 2

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 60 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Masking Description: Identical placebo capsule dosing
Primary Purpose: Treatment
Official Title: Phase IIa Prospective Study to Evaluate the Safety and Measure Efficacy of Anti-chlamydophila Antibiotic Combination (ACAC) Therapy Comprising 100mg Doxycycline, 500mg Azithromycin and 300mg Rifabutin in the Treatment of Patients With Coronary Heart Disease (CHD)
Actual Study Start Date : April 4, 2018
Estimated Primary Completion Date : December 30, 2020
Estimated Study Completion Date : December 31, 2020

Arm Intervention/treatment
Active Comparator: Active
Subjects will be given oral capsules containing the active comparators 50mg oral capsule doxycycline, 250mg oral capsule azithromycin and 150mg oral capsule rifabutin daily (days 1 to 7). From days 8 to 90 subjects will be given 50mg oral capsule doxycycline, 250mg oral capsule azithromycin and 150mg oral capsule rifabutin twice daily.
Drug: Doxycycline Capsule
doxycycline capsule
Other Name: Vibramycin

Drug: Azithromycin Capsule
azithromycin capsule
Other Name: zithromax

Drug: Rifabutin Oral Capsule
rifabutin capsule
Other Name: mycobutin

Placebo Comparator: Placebo
subjects will be given sugar capsules identical in form and size to the active comparators, 1 capsule of each bottle (3 separate capsules) daily (days 1 to 7), 1 capsule of each bottle (3 separate capsules) twice daily (days 8 to 90).
Drug: Placebo oral capsule
Placebo oral capsule identical in size and form to doxycycline

Drug: Placebo Oral Tablet
Placebo oral capsule identical in size and form to azithromcyin

Drug: Placebo oral capsule
Placebo oral capsule identical in size and form to rifabutin

Primary Outcome Measures :
  1. To evaluate effect of antibiotic therapy through evaluation of fractional flow reserve [ Time Frame: day 90 post initiation of treatment (Visit 3) ]
    to evaluate the effect of antibiotic combination therapy on objective measures of improvement in coronary flow as determined by fractional flow reserve (FFR) in subjects undergoing percutaneous coronary intervention (PCI) with non-critical lesions in non-culprit arteries

Secondary Outcome Measures :
  1. Angiographic stenoses changes [ Time Frame: Day 90 post initiation of treatment (Visit 3) ]
    to evaluate angiographic stenoses changes (QCA) via diagnostic angiography during ACAC trial

  2. Major adverse Clinical events [ Time Frame: day 90 (visit 3) and Day 180 post initiation of treatment ]
    To record major adverse clinical events (MACE), including death, recurrent myocardial infarction, stroke and major bleeding via investigator adverse event reporting

Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.

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Ages Eligible for Study:   18 Years to 80 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  1. Males and females (without childbearing potential as evidenced by hysterectomy, tubal ligation or at least one year post-menopause) aged 18 to 80 years inclusive.
  2. Ability to provide written informed consent to participate in the study.
  3. Subjects with documented recent acute coronary syndrome (ACS) or evidence of myocardial ischemia.
  4. Subjects who have a culprit lesion suitable for PCI, and a non-critical lesion in another vessel suitable for staged PCI with an FFR of <0.80, for subjects undergoing diagnostic angiography and FFR without ad hoc PCI.
  5. No serious co-morbidities, which might interfere with the subject's ability to enter the study.
  6. Able to communicate effectively with the study team and to comply with the protocol.

Exclusion Criteria:

  1. Females that are of child bearing potential
  2. Subjects without a non-culprit lesion considered appropriate to plan a staged PCI.
  3. Clinically significant haematologic, hepatic, metabolic, renal, rheumatologic, anaphylactic reactions, neurological or psychiatric disease.
  4. Clinical evidence of any other disease, which might interfere with the subject's ability to enter the trial.
  5. Concomitant administration of medications that may interfere with treatment as assessed by the Investigator, including allergy to any component of the therapy.
  6. Concomitant administration of any medication prohibited for use during this study (e.g. colchicine)
  7. Male subjects consuming greater than 60g alcohol per day, or female subjects consuming greater than 40g alcohol per day.
  8. Evidence of any recent history of, or current recreational drug abuse.
  9. Serious adverse reaction or hypersensitivity to therapeutic drugs.
  10. Unable and to comply with the study requirements.
  11. Subjects who have been involved in an experimental drug protocol within the past four weeks.

If a subject becomes pregnant during the course of the study, they will be immediately withdrawn and treated in the way least likely to harm both subject and foetus.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT03618108

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Contact: Annabel Clancy +61 2 9370 0005
Contact: Krystle Kyriakou +61 2 8738 3495

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Australia, New South Wales
Liverpool hospital Recruiting
Liverpool, New South Wales, Australia, 2170
Contact: John French    +612 8738 3495   
Contact: Krystle Kyriakou    +612 8738 3495   
Principal Investigator: John French         
Principal Investigator: Henry Newman         
Sub-Investigator: Rohan Rajaratnam         
Sub-Investigator: Craig Juergens         
Sub-Investigator: David Taylor         
Sub-Investigator: Sidney Lo         
Sub-Investigator: Oliver Gibbs         
Sub-Investigator: Kalaeb Asrress         
Sub-Investigator: Amir Faour         
Sponsors and Collaborators
Cadrock Pty. Ltd.
Centre for Digestive Diseases, Australia
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Principal Investigator: Thomas Borody Centre for Digestive Diseases
Principal Investigator: John French Liverpool Hospital
  Study Documents (Full-Text)

Documents provided by Cadrock Pty. Ltd.:

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Responsible Party: Cadrock Pty. Ltd. Identifier: NCT03618108    
Other Study ID Numbers: NC10/C01
First Posted: August 7, 2018    Key Record Dates
Last Update Posted: February 5, 2020
Last Verified: February 2020

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Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No
Product Manufactured in and Exported from the U.S.: No
Additional relevant MeSH terms:
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Chlamydial Pneumonia
Heart Diseases
Coronary Disease
Coronary Artery Disease
Myocardial Ischemia
Cardiovascular Diseases
Lung Diseases
Respiratory Tract Diseases
Respiratory Tract Infections
Vascular Diseases
Arterial Occlusive Diseases
Chlamydia Infections
Chlamydiaceae Infections
Gram-Negative Bacterial Infections
Bacterial Infections
Chlamydophila Infections
Pneumonia, Bacterial
Anti-Bacterial Agents
Anti-Infective Agents
Antibiotics, Antitubercular
Antitubercular Agents
Antiprotozoal Agents
Antiparasitic Agents