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Metabolic Syndrome XPhase 2ARCH-MSNCT00455325

Chloroquine to Treat People With Metabolic Syndrome Aim2 (ARCH-MS)

A Phase 2 study testing Active Comparator: Second Intervention (3 weeks), Active Comparator: Third Intervention (3 weeks) and Active Comparator: Fourth Intervention (3 weeks) in people with Metabolic Syndrome X and Overweight, run by Washington University School of Medicine at 1 site in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Metabolic syndrome consists of a group of co-occuring conditions that increase an individual's risk of developing heart disease, stroke, and diabetes. The purpose of this study is to evaluate the short-term effectiveness of chloroquine, a protein-activation medication, at improving metabolic syndrome. Read more about this study

Who is it for?
Ages 18 to 60 years
Conditions the study is for
Metabolic Syndrome X, Overweight, Hypertension
What is being tested?
Active Comparator: Second Intervention (3 weeks), Active Comparator: Third Intervention (3 weeks) and Active Comparator: Fourth Intervention (3 weeks)
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
35 participants
Where
1 siteUnited States
Study dates
Sep 2004to Mar 2012
Phase
Phase 2
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 60 years
  • All sexes
  • No healthy volunteers
  • Adult

Who may be able to join

  • Diagnosis of metabolic syndrome, as determined by at least three of the following five criteria:
  • Elevated fasting triglyceride levels greater than or equal to 150 mg/dL
  • Low HDL cholesterol levels: less than 50 mg/dL for women and less than 40 mg/dL for men
  • Hypertension (=>130/85 mm Hg =<160/100 mm Hg) untreated; or hypertension controlled (=<150/90 mm Hg) on a stable medication regimen for 4 weeks prior to baseline visit.
  • Increased waist circumference: greater than 35 inches in women and greater than 40 inches in men
  • Elevated fasting glucose levels =<100 mg/dL but =>126 mg/dL
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  • Subjects may be on a stable doses of a statin drug for at least 3 months
  • Subjects may be on a stable doses of L-thyroxine for at least 3 months
  • Willing to use acceptable form of birth control (e.g., hormonal birth control, double barrier methods)

Who cannot join

  • Prior travel treatment with chloroquine or hydroxychloroquine as follows:
  • any exposure in the past 2 years,
  • >30 days of therapy if exposure was between 2 and 5 years ago,
  • >90 days of therapy if exposure was between 5 and 10 years ago,
  • >6 months of therapy if exposure was 10 to 20 years ago,
  • >1 year of therapy if exposure was 20 to 30 years ago,
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  • No limit if last exposure was >30 years ago, ex. during the Vietnam conflict.
  • Morbid obesity (body mass index [BMI] greater than 45)
  • Coronary artery disease or other vascular disease
  • History of stroke
  • Chronic kidney insufficiency (i.e.,estimated glomerular filtration rate (eGFR) less than 60 ml/min/1.73m2)
  • Diabetes
  • Seizure disorder
  • History of psoriasis
  • Blood disorders, including anemia (i.e., hemoglobin levels less than 13 g/dL in men and less than 12 g/dL in women)
  • Current malignancy or active treatment for recurrence prevention, example tamoxifen. Cancer considered to be cured, either as a result of surgery or other treatment is not exclusionary.
  • Asthma requiring daily beta agonist therapy or intermittent oral steroids is exclusionary. Inhaled steroids are acceptable. Obstructive sleep apnea will be allowed if Continuous Positive Airway Pressure (CPAP) or other therapy has been stable for 6 months. Other active respiratory diseases are excluded.
  • Liver disease, or liver function test results greater than twice the normal value
  • Active infection, including HIV
  • Serious illness requiring ongoing medical care or medication
  • Treatment with atypical anti-psychotic medication. Treatment with any other medication for psychiatric illness, unless on a stable dose for 6 weeks prior to enrollment. Patients with unstable psychiatric disorders are excluded per the decision of the study MD regardless of medication history.
  • Taking any of the following lipid lowering medications: niacin, fibrates, and greater than 1 gm fish oils
  • Uncontrolled hypertension (BP >150/90) at enrollment.
  • Need for daily over the counter medications, or currently taking cimetidine or >1000 IU vitamin E daily and unwilling to reduce or discontinue the use of vitamin E or discontinue cimetidine for the duration of the study. Persons taking >1000 IU of vitamin E should reduce the dose 30 days prior to randomization.
  • Pregnant, breastfeeding, or intending to become pregnant
  • Glucose-6-phosphate dehydrogenase (G6PD) deficiency
  • Retinal disease (in particular, drusen or pigmentary changes at the macula); any ocular disease that interferes with the eye examination (e.g., cataracts)
  • Auditory disease or hearing loss; persons with total, irreversible hearing loss can be enrolled.
  • Participation in another clinical trial within past 30 days prior to screening and 60 days prior to randomization. Questionnaire or observational studies are not exclusionary.

Trial locations and contacts

1 site in 1 country.

United States1 site
  • Washington University in St. Louis

    St Louis, Missouri, 63110

Other trials in United States

About this study

Official title: Genotoxic Stress, Atherosclerosis, and Metabolic Syndrome-AIM 2

Metabolic syndrome consists of a group of co-occuring conditions that increase an individual's risk of developing heart disease, stroke, and diabetes. The purpose of this study is to evaluate the short-term effectiveness of chloroquine, a protein-activation medication, at improving metabolic syndrome.

Read the detailed description

Metabolic syndrome is one of the most common disorders in industrialized countries. It consists of abnormal serum lipids, glucose intolerance, elevated blood pressure, and central obesity in the setting of insulin resistance. The syndrome substantially increases the risk of developing diabetes and vascular disease, but there is no clear unifying approach to treat this disorder. In animals, activation of the protein ataxia telangiectasia mutated (ATM) using the antimalarial drug chloroquine improves features of metabolic syndrome and decreases atherosclerosis, a build-up of fatty plaque within arteries. The purpose of this study is to evaluate the effectiveness of short-term treatment with low doses of chloroquine as a way of managing metabolic syndrome.

Participants in this study will initially receive placebo for 3 weeks, followed by increasing doses of chloroquine in three, 3-week intervals. Following each 3-week treatment, participants will be admitted to the research center for one day. There will be a period of no active treatment for 5 to 7 weeks following each admission to the research center to allow recovery from the blood drawing of the clamp procedure before the start of the next treatment interval.

Being tested
Placebo Comparator: First Intervention (3 weeks), Active Comparator: Second Intervention (3 weeks), Active Comparator: Third Intervention (3 weeks), Active Comparator: Fourth Intervention (3 weeks)
Keywords
Insulin Resistance, Atherosclerosis, Metabolic Syndrome
Medical subject headings
Metabolic Syndrome, Overweight, Hypertension, Dyslipidemias, Prediabetic State, Insulin Resistance, Atherosclerosis

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Placebo Comparator: First Intervention (3 weeks)Drug

    Also called Placebo once daily

    once daily placebo tablet for 3 weeks followed by: euglycemic clamp procedure; 24 hour Ambulatory Blood Pressure; Oral Glucose tolerance Test; serum collection; 24 hour urine collection; collection of peripheral blood mononuclear cells

  • Active Comparator: Second Intervention (3 weeks)Drug

    Also called 80 mg chloroquine or placebo tablet once daily

    Once daily 80mg chloroquine or placebo tablet 3 Weeks followed by euglycemic clamp procedure; 24 hour Ambulatory Blood Pressure; Oral Glucose tolerance Test; serum collection; 24 hour urine collection; collection of peripheral blood mononuclear cells

  • Active Comparator: Third Intervention (3 weeks)Drug

    Also called 80 mg chloroquine tablet once daily

    Once daily 80mg tablet for 3 weeks followed by: euglycemic clamp procedure; 24 hour Ambulatory Blood Pressure; Oral Glucose tolerance Test; serum collection; 24 hour urine collection; collection of peripheral blood mononuclear cells

  • Active Comparator: Fourth Intervention (3 weeks)Drug

    Also called 250 mg chloroquine tablet once daily

    Once daily 250mg tablet for 3 weeks followed by: euglycemic clamp procedure; 24 hour Ambulatory Blood Pressure; Oral Glucose tolerance Test; serum collection; 24 hour urine collection; collection of peripheral blood mononuclear cells

Study groups in NCT00455325
Study groupRoleWhat they receive
First Intervention (3 weeks)Placebo comparatorCohort 1: Chloroquine placebo one tablet daily for 3 weeks, followed by 5-7 week rest period.
Receives: Drug: Placebo Comparator: First Intervention (3 weeks)
Second Intervention (3 weeks)Active comparatorCohort 2: 80mg chloroquine or placebo tablet once daily for Weeks 3, followed by 5-7 week rest period.
Receives: Drug: Active Comparator: Second Intervention (3 weeks)
Third Intervention (3 weeks)Active comparatorCohort 3: 80mg chloroquine tablet daily: for 3 weeks, followed by 5-7 week rest period.
Receives: Drug: Active Comparator: Third Intervention (3 weeks)
Fourth Intervention (3 weeks)Active comparatorCohort 4: 250mg chloroquine tablet daily: for 3 weeks, followed by 5-7 week rest period.
Receives: Drug: Active Comparator: Fourth Intervention (3 weeks)

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Insulin Sensitivity

    Hepatic insulin sensitivity was measured by comparing glucose production at baseline of zero insulin infusion rate with glucose production at 56 pmol/m2/min. Hepatic insulin sensitivity was expressed as the percent suppression, such that greater percent suppression indicated greater hepatic insulin sensitivity. There are no reference values, since the patients served as their own controls.

    Measured: assessed every 8 - 10 weeks at the end of each treatment period

Secondary outcomes (6)
  1. Systolic Blood Pressure

    Two techniques were employed: auscultation of seated subjects at rest was performed by a trained observer who recorded the first and fifth phases of the Korotkoff sounds; and, a portable oscillometric device (SpaceLabs Medical) recorded results every 20 min during the day and every hour during the night. Data were analyzed as mean values over 24 hours.

    Measured: Assessed every 8-10 weeks at the end of each treatment period

  2. Diastolic Blood Pressure

    Two techniques were employed: auscultation of seated subjects at rest was performed by a trained observer who recorded the first and fifth phases of the Korotkoff sounds; and, a portable oscillometric device (SpaceLabs Medical) recorded results every 20 min during the day and every hour during the night. Data were analyzed as mean values over 24 hours.

    Measured: Assessed every 8-10 weeks at the end of each treatment period.

  3. Total Cholesterol

    Fasting Serum Blood Sample

    Measured: Assessed every 8-10 weeks at the end of each treatment period.

  4. Non-HDL Cholesterol

    Fasting Serum Blood Sample

    Measured: Assessed every 8-10 weeks at the end of each treatment period.

  5. Low-density Lipoprotein

    Fasting Serum Blood Sample

    Measured: Assessed every 8-10 weeks at the end of each treatment period.

  6. Triglycerides

    Fasting Serum Blood Sample

    Measured: Assessed every 8-10 weeks at the end of each treatment period.

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted3 Apr 2007 (estimated)
  2. Study startSep 2004
  3. Primary completionJun 2010
  4. Study completionMar 2012

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Treatment
Allocation
Non-randomised
Intervention model
Sequential
Masking
Single blind
Who is masked
Participant
Enrolment
35 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT00455325
Sponsor's protocol ID
395
Other IDs
P50HL083762
Acronym
ARCH-MS
Status last verified
Apr 2022
First submitted
30 Mar 2007
Last updated
10 May 2022
Data monitoring committee
Yes

Publications

  • Schneider JG, Finck BN, Ren J, Standley KN, Takagi M, Maclean KH, Bernal-Mizrachi C, Muslin AJ, Kastan MB, Semenkovich CF. ATM-dependent suppression of stress signaling reduces vascular disease in metabolic syndrome. Cell Metab. 2006 Nov;4(5):377-89. doi: 10.1016/j.cmet.2006.10.002.

    PubMed 17084711
  • McGill JB, Johnson M, Hurst S, Cade WT, Yarasheski KE, Ostlund RE, Schechtman KB, Razani B, Kastan MB, McClain DA, de las Fuentes L, Davila-Roman VG, Ory DS, Wickline SA, Semenkovich CF. Low dose chloroquine decreases insulin resistance in human metabolic syndrome but does not reduce carotid intima-media thickness. Diabetol Metab Syndr. 2019 Jul 29;11:61. doi: 10.1186/s13098-019-0456-4. eCollection 2019.

    PubMed 31384309
  • Razani B, Feng C, Semenkovich CF. p53 is required for chloroquine-induced atheroprotection but not insulin sensitization. J Lipid Res. 2010 Jul;51(7):1738-46. doi: 10.1194/jlr.M003681. Epub 2010 Mar 5.

    PubMed 20208057

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Active Comparator: Second Intervention (3 weeks), Active Comparator: Third Intervention (3 weeks) and Active Comparator: Fourth Intervention (3 weeks) in people with Metabolic Syndrome X and Overweight, run by Washington University School of Medicine at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 9 inclusion and 29 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 10 May 2022. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 10 May 2022). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Insulin Sensitivity (time frame: assessed every 8 - 10 weeks at the end of each treatment period). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT00455325, which also lists 3 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 10 May 2022.

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