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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).
Cardiovasc Drugs Ther 2018; 32(6):581-589CD

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+Show Affiliations

Department of Hypertension and Cardiovascular Disease, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.Department of Hypertension and Cardiovascular Disease, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.School of Public Health, Sun Yat-sen University, Guangzhou, China.Department of Hypertension and Cardiovascular Disease, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China. taojungz123@163.com.

Pub Type(s)

Clinical Trial Protocol
Journal Article

Language

eng

PubMed ID

30187345

Citation

Zhang, Jianning, et al. "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)." Cardiovascular Drugs and Therapy, vol. 32, no. 6, 2018, pp. 581-589.
Zhang J, Shao Y, Liu Y, et al. 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). Cardiovasc Drugs Ther. 2018;32(6):581-589.
Zhang, J., Shao, Y., Liu, Y., & Tao, J. (2018). 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). Cardiovascular Drugs and Therapy, 32(6), pp. 581-589. doi:10.1007/s10557-018-6826-6.
Zhang J, et al. 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). Cardiovasc Drugs Ther. 2018;32(6):581-589. PubMed PMID: 30187345.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - 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). AU - Zhang,Jianning, AU - Shao,Yijia, AU - Liu,Yin, AU - Tao,Jun, PY - 2018/9/7/pubmed PY - 2019/6/14/medline PY - 2018/9/7/entrez KW - Cardiovascular disease (CVD) KW - Dyslipidemias KW - Hypertension KW - Pitavastatin KW - Prediabetes KW - Randomized controlled trial (RCT) KW - Statin SP - 581 EP - 589 JF - Cardiovascular drugs and therapy JO - Cardiovasc Drugs Ther VL - 32 IS - 6 N2 - 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. SN - 1573-7241 UR - https://www.unboundmedicine.com/medline/citation/30187345/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__ L2 - https://doi.org/10.1007/s10557-018-6826-6 DB - PRIME DP - Unbound Medicine ER -