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The VALDIATE-D Study

Information source: Brigham and Women's Hospital
ClinicalTrials.gov processed this data on August 23, 2015
Link to the current ClinicalTrials.gov record.

Condition(s) targeted: Type 2 Diabetes; Obesity

Intervention: Calcitriol and Lisinopril (Drug); Placebo (Drug)

Phase: N/A

Status: Recruiting

Sponsored by: Brigham and Women's Hospital

Official(s) and/or principal investigator(s):
Anand Vaidya, MD, MMSc, Principal Investigator, Affiliation: Brigham and Women's Hospital, Harvard Medical School

Overall contact:
Molly Connors, Phone: 617-732-5186

Summary

The purpose of this study is to evaluate whether vitamin D receptor agonist therapy lowers renin-angiotensin system activity.

Clinical Details

Official title: Evaluating Hormonal Mechanisms for Vitamin D Receptor Agonist Therapy in Diabetes: The VALIDATE-D Study

Study design: Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Investigator), Primary Purpose: Prevention

Primary outcome: Circulating RAS activity after calcitriol/placebo therapy

Secondary outcome:

Renal-vascular tissue RAS activity after calcitriol/placebo therapy

Renal-vascular RAS activity and urien protein after calcitriol/lisinopril therapy

Adiponectin levels

Adipose-tissue RAS measures

Detailed description: This study aims to evaluate whether vitamin D receptor agonist therapy (calcitriol) in diabetes lowers renin-angiotensin system (RAS) activity in a manner similar to an ACE inhibitor. This is a physiology study, focused on evaluating hormonal changes in the circulating and tissue RAS when compared to placebo. Subjects with type 2 diabetes and obesity and normal kidney function will undergo evaluation of their circulating and renal-vascular RAS activity and urinary protein at baseline, after withdrawing interfering medications, while on a controlled electrolyte diet, and in controlled posture settings. They will then randomly receive a study medication (calcitriol or placebo) for 3 weeks followed by a re-assessment of their RAS parameters. The main outcomes that will be evaluated following calcitriol/placebo include measures of the circulating RAS (primary), as well as measures of the renal-vascular RAS, urine protein, adipocytokine levels, and adipose-tissue RAS activity (secondary) In an extension phase, Lisinopril will be added to the study drug for another 2 weeks followed by another assessment of the primary and secondary outcome parameters, and subjects will continue lisinopril+study drug for 3 additional months for one final assessment of RAS parameters and urinary protein.

Eligibility

Minimum age: 18 Years. Maximum age: 70 Years. Gender(s): Both.

Criteria:

Inclusion Criteria: 1. Type-Two Diabetes (treated with diet alone, with oral hypoglycemic agents, or with a single injection of basal insulin daily) 2. Normal blood pressure, or Mild (Stage 1) Hypertension that is either untreated, or adequately treated with a single anti-hypertensive drug. 3. Age >18 years and <70 years 4. Estimated GFR > 60ml/min 5. Normal laboratory values for: Complete blood count, sodium, potassium, glucose, liver enzymes, urinalysis 6. Electrocardiogram without any signs of prior infarction, ventricular conduction abnormality, or supraventricular arrhythmia. Exclusion Criteria: 1. Chronic Kidney Disease or eGFR<60 2. History of nephrolithiasis (kidney stones) 3. Multiple (more than one) insulin injections daily (since insulin can alter the RAS) 4. Poorly controlled type 2 diabetes (That may require more aggressive therapy) as defined by an HbA1c>8. 5% 5. Type 1 diabetes 6. Stage 2 or Stage 3 hypertension or the use of more than 1 antihypertensive drug 7. Chronic inflammatory conditions (such as inflammatory bowel disease or arthritis) that are treated with prescribed doses of NSAIDs by a physician. 8. The use of prescribed doses of potassium supplements. 9. History of liver failure 10. History of parathyroid or granulomatous disorders 11. History of heart failure, cerebrovascular disease or coronary heart disease 12. History of known microvascular complications of diabetes (including retinopathy, neuropathy, nephropathy) 13. Illness requiring overnight hospitalization in the past 6 months 14. Active tobacco or recreational drug use 15. Pregnancy or current breast feeding

Locations and Contacts

Molly Connors, Phone: 617-732-5186

Brigham and Women's Hospital, Boston, Massachusetts 02115, United States; Recruiting
Additional Information

Starting date: September 2012
Last updated: July 31, 2015

Page last updated: August 23, 2015

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