Gene-by-Stress Interactions in Intervention Studies Significance

Duke University

Status and phase: Terminated; Phase 1

Conditions: Cardiovascular Diseases

Treatments: Drug: Placebo Oral Tablet; Drug: Ziprasidone; Drug: Lorcaserin

Study type: Interventional

Funder types: Other; NIH

Identifiers

NCT03011645

Pro00070047

2P01HL036587-25 (U.S. NIH Grant/Contract)

Details and patient eligibility

About

The purpose of this study is to identify gene variants that increase risk of cardiovascular disease (CVD) and type 2 diabetes, particularly genes related to stress factors.

Full description

In Aim 3, 100 subjects who participated in previous studies will be recruited to test the ability of a 5HTR2C agonist (lorcaserin) to increase and antagonist (ziprasidone) to reduce cortisol response to mental and metabolic stress in men carrying the rs6318 C allele and women in the rs6318 CC genotype of 5HTR2C. Lorcaserin is serotonin receptor agonist indicated for use as a weight loss drug. Ziprasidone is an antipsychotic indicated for treatment of bipolar disorder. Subjects will be treated with a single dose of each drug, 1 to 2 weeks apart, followed by a mental stress test and an oral glucose tolerance test with multiple blood draws. Each subject will also receive a placebo drug during one of the study visits.

Enrollment: 7 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Men and women who have been enrolled in the STRRIDE, ENHANCED, and/or REMIT studies age 18 years or greater.
• Ability and willingness to provide informed consent.
• Individuals with specific genotypes as determined from our previous work on their samples through Aim 1 of this project.

Exclusion criteria

• Women who are known to be pregnant, intend to become pregnant, or breast-feeding will be excluded. Women who are of child bearing potential (under age 55) will be informed that they will need to have their urine tested for pregnancy and that they should not participate in the research if they are not willing to have the Investigators provide them with information on positive pregnancy test results. Subjects will be informed that the pregnancy testing is not being performed for clinical purposes and that the testing is not a substitute for their regular medical care if they need to know whether or not they may be pregnant.
• History of Type II diabetes mellitus.
• History of prolonged QT interval.
• Participation in an investigational drug trial within the last 30 days.
• Already taking either ziprasidone or lorcaserin or any potential confounding medications, for example, other weight loss medications or psychotropic medications.
• Unwillingness to fast for at least 6 hours prior to the research study visit.

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Factorial Assignment

Masking: Double Blind

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7 participants in 3 patient groups, including a placebo group

Ziprasidone

Active Comparator group

Description:

Ziprasidone 60 mg tablet by mouth, once a day for one day.

Treatment:

Drug: Ziprasidone

Lorcaserin

Active Comparator group

Description:

Lorcaserin 20 mg tablet by mouth, once a day for one day.

Treatment:

Drug: Lorcaserin

Placebo Oral Tablet

Placebo Comparator group

Description:

Sugar pill (in place of ziprasidone and lorcaserin) by mouth, once a day for one day.

Treatment:

Drug: Placebo Oral Tablet