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Randomized Controlled Trial of Lipid Apheresis in Patients With Elevated Lipoprotein(a) (ELAILa)

Charité University Medicine Berlin logo

Charité University Medicine Berlin

Status

Withdrawn

Conditions

Hyperlipoproteinemia(a)
Progressive Cardiovascular Disease

Treatments

Procedure: Lipid apheresis
Other: Standard care

Study type

Interventional

Funder types

Other

Identifiers

NCT01064934
ELAILa-01

Details and patient eligibility

About

Lipoprotein(a) [Lp(a)] is an independent risk factor for cardiovascular disease. Non-medical treatment measures (e.g. dietary therapy or weight loss) can hardly influence Lp(a) plasma concentrations. Drug therapy has only limited influence, e.g. treatment with niacin. Statins are usually without effect. Lipid apheresis is the only treatment known to lower elevated Lp(a) levels in a relevant way. In patients with pronounced elevation of Lp(a) and normal LDL cholesterol levels, who suffer from progressive cardiovascular disease, the treatment with lipid apheresis seems to be a last-resort treatment option. The current trial will evaluate the effectiveness of lipid apheresis on cardioavascular endpoints.

Full description

Lipoprotein(a) [Lp(a)] is an independent risk factor for cardiovascular disease. Non-medical treatment measures (e.g. dietary therapy or weight loss) can hardly influence Lp(a) plasma concentrations. Drug therapy has only limited influence, e.g. treatment with niacin. Statins are usually without effect. Lipid apheresis is the only treatment known to lower elevated Lp(a) levels in a relevant way. In patients with pronounced elevation of Lp(a) and normal LDL cholesterol levels, who suffer from progressive cardiovascular disease, the treatment with lipid apheresis seems to be a last-resort treatment option. The current trial will evaluate the effectiveness of lipid apheresis on cardioavascular endpoints. The trial is a randomized multicenter trial in Germany. Patients will be randomized to the apheresis group or to the control group. All patients will receive maximal risk minimizing therapies. The apheresis group will receive in addition weekly lipid apheresis. The principal outcome parameter is a composite endpoint of non-fatal myocardial infarction, interventional therapeutic procedure (PCI, stenting), coronary bypass surgery (CABG), non-fatal ischemic cerebrovascular accident, hospitalization due to acute coronary syndrome (ACS), critical limb ischemia, peripheral arterial revascularization procedure; amputation, death from cardiovascular cause.

Sex

All

Ages

18+ years old

Volunteers

No Healthy Volunteers

Inclusion criteria

  • Above 18 years of age
  • Male or female
  • Written informed consent
  • Lipoprotein(a) >=60 mg/dL
  • Low-density lipoprotein cholesterol <130 mg/dL
  • Progressive cardiovascular disease
  • Positive recommendation by the Inclusion Committee

Exclusion criteria

  • Current participation in a lipid apheresis program
  • Previous participation in a lipid apheresis program
  • Low-density lipoprotein cholesterol >=130 mg/dL under maximally tolerated (or necessary) drug treatment
  • Triglyceride concentrations >=450 mg/dL
  • Known homozygous familial hypercholesterolemia
  • Known type III hyperlipoproteinemia
  • Pregnancy, breast feeding
  • History of malignant disease (with the exception of non-melanoma carcinomas of the skin and carcinoma in situ of the cervix)
  • Planned major surgical procedures in the next 3 months
  • Current participation in another interventional trial
  • Previous randomization in the current trial (applies only for the RCT)

Trial design

Primary purpose

Treatment

Allocation

Randomized

Interventional model

Parallel Assignment

Masking

None (Open label)

0 participants in 2 patient groups

Lipid apheresis
Experimental group
Description:
Lipid apheresis
Treatment:
Procedure: Lipid apheresis
Standard care
Active Comparator group
Description:
Standard care
Treatment:
Other: Standard care

Trial contacts and locations

1

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Data sourced from clinicaltrials.gov

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