A Multi-Center, Open-Label, Two-Arm Parallel Group Non-inferiority Randomized Controlled Trial Evaluating the Effect of Pitavastatin, Compared to Atorvastatin, on Glucose Metabolism in Prediabetics with Hypertension and Dyslipidemia: Rationale and Design for the China Hemoglobin A1c Metabolism Protection Union Study (CAMPUS).

Abstract

BACKGROUND:

Hypertension and dyslipidemia are major risk factors for cardiovascular disease (CVD). In 2012, over 270 million patients (25.2%) in China were hypertensive and 40.4% was dyslipidemic. The majority of these patients rely on statins for the prevention of cardiovascular disease. However, certain types of statins (e.g., atorvastatin), compared to others (e.g., pitavastatin), may be associated with unfavorable effects on glucose metabolism. This leads to concerns when prescribing statins to patients who also have a predisposition to glucose metabolic disorders (i.e., prediabetes). Thus, this study aims to investigate the effect of pitavastatin, compared to atorvastatin, on glucose metabolism, as measured by hemoglobin A1c (HbA1c), in Chinese prediabetics with hypertension and dyslipidemias.

METHODS:

The China hemoglobin A1c Metabolism Protection Union Study (CAMPUS) is a multi-center, prospective, open-label, 12-month, two-arm parallel group, and non-inferiority randomized controlled trial (RCT). A total of 396 prediabetics with hypertension and dyslipidemias will be randomly assigned 1:1 to either pitavastatin 2 mg/day or atorvastatin 20 mg/day, and followed for 12 months (follow-up visits at 1, 3, 6, and 12 months) for HbA1c levels, as well as other measures of glucose metabolism, serum lipid levels, blood pressure control, measures of inflammation, vascular endothelial function, carotid atherosclerosis, and hypertension-related left ventricular hypertrophy. If the results of low-density lipoprotein cholesterol (LDL-C) levels in month 3 after treatment initiation do not meet individual target, drug dose for the participant would be doubled.

DISCUSSION:

CAMPUS will be the first RCT to investigate the effect of pitavastatin, compared to atorvastatin, on glucose metabolism in Chinese prediabetics with hypertension and dyslipidemias. Further, this study might eventually provide information to design a clinical strategy, and facilitate the improvement of primary prevention in patients at risk for diabetes and CVD.

TRIAL REGISTRATION:

ClinicalTrials.gov number: NCT03532620. Registered 22 May 2018.

• Authors: Jianning Zhang, Yijia Shao, Yin Liu, Jun Tao
• Journal: Cardiovascular drugs and therapy (Cardiovasc Drugs Ther) Vol. 32 Issue 6 Pg. 581-589 (12 2018) ISSN: 1573-7241 [Electronic] United States
• PMID: 30187345 (Publication Type: Clinical Trial Protocol, Journal Article)

Chemical References

• Biomarkers
• Blood Glucose
• Glycated Hemoglobin A
• Hydroxymethylglutaryl-CoA Reductase Inhibitors
• Quinolines
• hemoglobin A1c protein, human
• Atorvastatin
• pitavastatin

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Atorvastatin (adverse effects, therapeutic use)
• Biomarkers (blood)
• Blood Glucose (drug effects, metabolism)
• Blood Pressure (drug effects)
• China
• Dyslipidemias (blood, complications, diagnosis, drug therapy)
• Equivalence Trials as Topic
• Female
• Glycated Hemoglobin (metabolism)
• Humans
• Hydroxymethylglutaryl-CoA Reductase Inhibitors (adverse effects, therapeutic use)
• Hypertension (complications, diagnosis, physiopathology)
• Male
• Middle Aged
• Multicenter Studies as Topic
• Prediabetic State (blood, complications, diagnosis)
• Prospective Studies
• Quinolines (adverse effects, therapeutic use)
• Time Factors
• Treatment Outcome
• Young Adult