Official Title

A Prospective, Open Label Comparison of Ezetimibe, Niacin, and Colestipol as Adjunct Therapy in Lipid Reduction
  • Phase

    Phase 4
  • Study Type

    Interventional
  • Study Participants

    30
To compare LDL reduction compared to baseline in patients using maximum tolerated HMG CoA Reductase inhibitor (statin) therapy with adjunctive therapy with ezetimibe, colestipol, or niacin. The patient's cardiovascular risks are assessed to determine if National Cholesterol Education Program's Adult Treatment Panel III (NCEP ATP III) guidelines for low density lipoprotein (LDL) reduction were achieved between the three groups. Secondary measures examine the safety issues with liver function test (LFT) monitoring and rhabdomyolysis. High-density lipoproteins (HDL) elevations are monitored between the three groups to determine efficacy as a secondary outcome.
: Patients with hyperlipidemia who sign consent and who are currently at maximum tolerated dose of a statin and are not meeting NCEP ATPIII treatment goals for LDL cholesterol are enrolled in 12-week open label, prospective trial. Patients are randomized into one of three groups to receive ezetimibe, niacin, or colestipol in addition to current statin therapy. Patients are titrated as tolerated to therapeutic doses of study medications (ezetimibe 10mg/day, niacin 1500mg/day, and colestipol 20gm/day). At baseline, informed consent; a laboratory admission profile (Chem20); weight; height; blood pressure; concomitant medications; cholesterol medication history; and grapefruit juice consumption data are gathered. At weeks 6 and 12, patients have their cholesterol panels and liver function tests assessed. Patients are also interviewed regarding side effects (including rhabdomyolysis), tolerance, changes in concomitant medications, and grapefruit juice consumption, along with weight and blood pressure measurements.
Study Started
May 31
2005
Primary Completion
Jan 31
2008
Study Completion
Jan 31
2008
Results Posted
Aug 12
2014
Estimate
Last Update
Aug 12
2014
Estimate

Drug Niacin

Drug Colestipol

Drug Ezetimibe

  • Other names: Zetia

Statin with Niacin Active Comparator

Niacin dose range of 500-1500mg (average 888mg)

Statin with Colestipol Active Comparator

Colestipol dose range 5-15gm (average 9.5gm)

Statin with Ezitimibe Active Comparator

Ezitimibe 10mg (average 10mg)

Criteria

Inclusion Criteria:

Veterans eligible for treatment at the Tuscaloosa VA Medical Center
50 years of age
Male or female
Any race or ethnic group
Signed informed consent
Hyperlipidemia despite current maximum tolerated dose of an HMG CoA Reductase inhibitor (statin) for > 6 weeks
Currently not meeting NCEP ATPIII treatment goals for LDL cholesterol

Exclusion Criteria:

Known hypersensitivity or intolerance to ezetimibe, niacin, or colestipol
Previous failed adequate trial of adjunctive ezetimibe, niacin, or colestipol
Consumes more than 8oz. grapefruit juice daily
Significant medical condition that would impact safety evaluations (i.e. significantly elevated LFT, hepatitis, severe dermatitis, uncontrolled diabetes, severe GI disease, fibromyalgia, renal failure, recent CVA or MI, pancreatitis, etc.)
Receiving medications that would be contraindicated to use in combination with ezetimibe, niacin, or colestipol

Summary

Niacin

Colestipol

Ezetimibe

All Events

Event Type Organ System Event Term Niacin Colestipol Ezetimibe

LDL Goal Attainment

Each participant had his LDL goal calculated based on the NCEP ATPIII guidelines.

Niacin

6.0
participants

Colestipol

6.0
participants

Ezetimibe

9.0
participants

LFT Elevation

Niacin

1.0
participants

Colestipol

1.0
participants

Ezetimibe

2.0
participants

Incidents of Rhabdomyolysis

Niacin

Colestipol

Ezetimibe

Change in HDL From Baseline to 12 Weeks.

Niacin

12 weeks

43.0
mg/dl (Mean)
Standard Deviation: 11.62

baseline

42.33
mg/dl (Mean)
Standard Deviation: 11.20

Colestipol

12 weeks

37.56
mg/dl (Mean)
Standard Deviation: 7.83

baseline

39.22
mg/dl (Mean)
Standard Deviation: 14.22

Ezetimibe

12 weeks

34.7
mg/dl (Mean)
Standard Deviation: 10.39

baseline

32.9
mg/dl (Mean)
Standard Deviation: 5.15

Total

30
Participants

Age, Customized

Region of Enrollment

Sex: Female, Male

Overall Study

Niacin

Colestipol

Ezetimibe

Drop/Withdrawal Reasons

Niacin

Colestipol