The Fenofibrate and Metformin for Atherogenic Dyslipidemia (FAMA) Study
Information source: University of Pennsylvania
Information obtained from ClinicalTrials.gov on June 20, 2008
Link to the current ClinicalTrials.gov record.
Condition(s) targeted: Metabolic Syndrome X
Intervention: Study drugs: Metformin and fenofibrate (Drug); Study Drug: Metformin (Drug); Study Drug: fenofibrate (Drug); Metformin and Fenofibrate placebo (Drug)
Phase: Phase 2
Status: Active, not recruiting
Sponsored by: University of Pennsylvania Official(s) and/or principal investigator(s):
Frederick F. Samaha, M.D., Principal Investigator, Affiliation: University of Pennsylvania
Summary
Patients with metabolic syndrome, insulin resistance, and elevated triglycerides of 150 mg/dl
or higher will be randomized to one of four groups: 1) placebo; 2) metformin; 3) fenofibrate;
or 4) combined metformin and fenofibrate for a period of 12 weeks after titration to target
dose. We are interested in the effects of these therapies on triglyceride levels, HDL-C,
insulin resistance, and markers of inflammation.
Clinical Details
Official title: The Fenofibrate and Metformin for Atherogenic Dyslipidemia (FAMA) Study
Study design: Diagnostic, Randomized, Double Blind (Subject, Investigator), Placebo Control, Parallel Assignment, Safety/Efficacy Study
Primary outcome: triglyceride levels
Secondary outcome: HDL-C, Resistin, insulin resistance
Eligibility
Minimum age: 18 Years.
Maximum age: 75 Years.
Gender(s): Both.
Criteria:
Inclusion Criteria:
Subjects between the ages of 18 and 75 with both of the following risk factors:
1. Fasting triglycerides >= 150 mg/dl (but less than 800 mg/dl)
2. Glucose of 140 to 199 mg/dl, 2 hours after a 75 gm oral glucose load, a fasting HOMA
level in the upper quartile (> 2. 68), or a plasma triglyceride to high density
lipoprotein cholesterol concentration > 3. 0
And at least one of the following three:
1. Central obesity (waist size > 40 inches in men or >35 inches in women)
2. A systolic blood Pressure of >130 mmHg and/or a diastolic blood pressure of >85 mmHg
and/or taking an antihypertensive medication.
3. HDL < 40 mg/dl for men or < 50 mg/dl for women
Exclusion Criteria:
1. Blood pressure > 180/95 mmHg (subjects may be re-screened after adequate blood
pressure control has been obtained)
2. Women who are pregnant or lactating, or who are of child-bearing potential and not
using an acceptable method of birth control.
3. Chronic renal insufficiency (serum creatinine >1. 5 mg/dl in men and > 1. 4 mg/dl in
women
4. Any active liver disease or abnormal LFTs (>2x upper limit normal)(12)
5. Active infection, malignancy or chronic inflammatory disorder
6. Concomitant use of niacin, a bile acid sequestrant, or ezetimibe. If it is deemed safe
by the patient's primary physician and by the principal investigator, patients may be
screened for enrollment upon stopping these medications for at least 2 weeks.
7. Subjects on statins will need to be on less than maximal dose (e. g. < 80 mg per day
for simvastatin or atorvastatin). Subjects will also need to have been on a stable
dose of statin therapy for at least 1 month prior to enrollment and continue their
currently prescribed statin at the same dose throughout the study. If it is deemed
safe by the patient's primary physician and by the principal investigator, patients on
maximal statin therapy (usually 80 mg/day) may reduce their dose of statin therapy to
a sub maximal dose (usually 40 mg/day) for 4 weeks prior to screening for enrollment.
8. History of lactic acidosis(12)
9. Expected need for use of intravenous radiographic contrast during the study
10. More than moderate alcohol use (> 14 drinks per week)
11. Moderate to severe left ventricular dysfunction (ejection fraction <45%)
12. Decompensated heart failure or decompensated lung disease that has resulted in hypoxia
or reduced peripheral perfusion within the past year regardless of left ventricular
ejection fraction (thus patients with underlying heart disease, coronary artery
disease, mild left ventricular dysfunction (ejection fraction > 45%), or lung disease
that has been stable for at least one year will be eligible to participate)
13. Creatinine kinase (CK) levels ≥ 2. 5 ULN or history of statin-induced myopathy.
Patients with a CK level more than 2. 5 times the upper limit of normal may undergo
repeat testing up to two more times before being excluded (since vigorous physical
activity can often elevate CK levels, and this would not increase the risk of
myopathy).
14. Participation in an investigational drug study within 6 weeks prior to the screening
visit
15. Surgery within the previous 30 days
16. Concomitant use of ketoconazole, itraconazole, cyclosporin A, erythromycin, or
Clarithromycin.
17. Hemoglobin < 10 mg/dl, active use of coumadin, history of bleeding disorder, or
abnormal clotting time (protime >14. 6 seconds and aPTT > 37. 0)
18. Septic shock
19. Acute coronary syndrome or stroke within 3 months prior to study
20. Serious or unstable medical or psychological conditions that, in the opinion of the
investigator, would compromise the subject's safety or successful participation in the
study
Locations and Contacts
University of Pennsylvania, Philadelphia, Pennsylvania 19104, United States
Additional Information
Starting date: August 2005
Ending date: November 2008
Last updated: January 8, 2008
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