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Acute Coronary SyndromePhase 2IR-TREATNCT03700424

Inflammation Reduction by TREhalose AdminisTration

A Phase 2 study testing Trehalose and Normal saline in people with Acute Coronary Syndrome, run by Mashhad University of Medical Sciences at 1 site in Iran.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

Arterial wall inflammation has been consistently suggested to serve a causal role in promoting atherosclerosis and predisposing to hard cardiovascular outcomes. Therefore, there is a global trend in the pharmaceutical industry to develop safe and effective anti-inflammatory agents that could lessen arterial wall… Read more about this study

Who is it for?
Ages 18 to 55 years
Conditions the study is for
Acute Coronary Syndrome
What is being tested?
Trehalose and Normal saline
Type of treatment
Injection or infusion
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
15 participants
Where
1 siteIran
Study dates
20 Aug 2020to Aug 2022
Phase
Phase 2
Are there results?
None posted in the registry

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 55 years
  • All sexes
  • No healthy volunteers
  • Adult

Who may be able to join

  • Men and women aged between 18-55 years
  • Having a history of acute coronary syndrome
  • Having a baseline high-sensitivity C-reactive protein (hs-CRP) of ≥ 2mg/L
  • Willingness to participate in the trials.

Who cannot join

  • Lactation or breastfeeding
  • Diabetes mellitus
  • Nephrotic syndrome or Estimated Glomerular Filtration Rate (eGFR) < 30/mL/min/1.73m2
  • Active or recurrent hepatic disease or/and alanine aminotransferase (ALT)/aspartate aminotransferase (AST) (ALT/AST) of > 3 times upper normal limit or total bilirubin of > 2 times upper normal limit
  • Active infectious or febrile disease
  • Any type of malignancy
  • History of transplantation
  • Consumption of immunosuppressive drugs.

Trial locations and contacts

1 site in 1 country.

Amirhossien Sahebkar, PharmD, PhD contact

+985138002299

SahebkarA@mums.ac.ir

Iran1 site, 1 recruiting
  • Ghaem Educational, Research and Treatment Center

    Mashhad, Razavi Khorasan Province, 9919991766

    Amirhossein Sahebkar, PharmD, PhD, +989151221496, sahebkara@mums.ac.ir

    Recruiting

Other trials in Iran

About this study

Official title: The Use of Intravenous Trehalose to Reduce Vascular Inflammation in Acute Coronary Syndrome

Arterial wall inflammation has been consistently suggested to serve a causal role in promoting atherosclerosis and predisposing to hard cardiovascular outcomes. Therefore, there is a global trend in the pharmaceutical industry to develop safe and effective anti-inflammatory agents that could lessen arterial wall inflammation and prevent its detrimental impact on atheroma growth and instability. To this end, autophagy has emerged as a key regulator of inflammation and dysfunctional autophagy machinery has been consistently reported as a contributing factor to atherosclerosis and inflammation. Trehalose, a natural disaccharide sugar found extensively among miscellaneous organisms, by preventing protein denaturation plays various protective roles against stress conditions. Numerous studies indicated trehalose's ability to induce macrophage autophagy-lysosomal biogenesis and reduce inflammation. Also, intravenous (IV) administration of trehalose showed beneficial effects in the reversal of atherosclerosis in atherosclerotic animals. Therefore, in this study, the investigators will explore the potential efficacy of IV trehalose administration on arterial inflammation by employing an positron emission tomography (PET) with 18F-labeled fluoro-2-deoxyglucose (18F-FDG) and computed tomography (18F-FDG PET/CT) technique which noninvasively characterizes vascular inflammation and atherosclerosis.

Being tested
Trehalose, Normal saline
Keywords
Acute Coronary Syndrome, Trehalose, Arterial inflammation, Autophagy
Medical subject headings
Acute Coronary Syndrome, Arteritis

What participants receive

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

  • TrehaloseDrug

    Also called Mycose

    Trehalose is a natural disaccharide sugar found extensively among miscellaneous organisms including bacteria, plants, insects, yeast, fungi, and invertebrates. By preventing protein denaturation, it plays various protective roles against stress conditions such as heat, freeze, oxidation, desiccation and dehydration. Owing to this capacity, trehalose is an FDA-approved pharmaceutical excipient that is used as a stabilizer in numerous medicines including parenteral products.

    In this study, all injections will be conducted by a trained nurse in the presence of a specialist physician at a duration of 45-90 minutes.

  • Normal salineDrug

    Also called Physiological saline, Isotonic saline

    A solution of 0.90% w/v of sodium chloride (NaCl) in water

Study groups in NCT03700424
Study groupRoleWhat they receive
TrehaloseExperimentalParticipants will be received intravenous trehalose infusion weekly (15 g/week) for a period of 12 weeks
Receives: Drug: Trehalose
PlaceboPlacebo comparatorParticipants will be received equal volume of normal saline weekly for a period of 12 weeks
Receives: Drug: Normal saline

What is being measured

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

  1. Arterial wall inflammation in the aorta and carotid arteries

    This will be assessed using the 18F-FDG PET/CT imaging technique

    Measured: At the beginning and end of the intervention trial (Day 0 and week 12)

Secondary outcomes (11)
  1. Carotid intima-media thickness (cIMT)

    This will be assessed using doppler sonography

    Measured: At the beginning and end of the intervention trial (Day 0 and week 12)

  2. Measuring beclin-1 to assess autophagy activation

    Measured: At the beginning and end of the intervention trial (Day 0 and week 12)

  3. Measuring high-sensitivity C-reactive protein (hs-CRP) to assess systemic inflammation

    Measured: At the beginning and end of the intervention trial (Day 0 and week 12)

  4. Measuring complete blood count (CBC) (Safety)

    Measured: At the beginning and end of the intervention trial (Day 0 and week 12)

  5. Assessing lipid profile (Safety)

    Including triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C)

    Measured: At the beginning and end of the intervention trial (Day 0 and week 12)

  6. Assessing glucose (Safety)

    Fasting blood glucose (FBS)

    Measured: At the beginning and end of the intervention trial (Day 0 and week 12)

  7. Measuring thyroid-stimulating hormone (TSH) to assess thyroid function (Safety)

    Measured: At the beginning and end of the intervention trial (Day 0 and week 12)

  8. Measuring alanine aminotransferase (ALT), aspartate aminotransferase (AST) and bilirubin (Bil) to assess liver function (Safety)

    Measured: At the beginning and end of the intervention trial (Day 0 and week 12)

  9. Measuring creatinine (Cr), urine (Ur) and blood urea nitrogen (BUN) to assess renal function (Safety)

    Measured: At the beginning and end of the intervention trial (Day 0 and week 12)

  10. Evaluating electrocardiogram (ECG) and heart rhythm to assess heart function (Safety)

    Measured: At the beginning and end of the intervention trial (Day 0 and week 12)

  11. Measuring creatinine phosphokinase (CPK) to detect muscle damage (Safety)

    Measured: At the beginning and end of the intervention trial (Day 0 and week 12)

Timeline

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

  1. First posted9 Oct 2018
  2. Study start20 Aug 2020
  3. Primary completion20 May 2022 (estimated)
  4. Study completionAug 2022 (estimated)

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
Randomised
Intervention model
Parallel groups
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
15 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03700424
Sponsor's protocol ID
964334
Acronym
IR-TREAT
Status last verified
Sep 2020
First submitted
3 Oct 2018
Last updated
21 Sep 2020
Results posted
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Libby P. Inflammation in atherosclerosis. Arterioscler Thromb Vasc Biol. 2012 Sep;32(9):2045-51. doi: 10.1161/ATVBAHA.108.179705.

    PubMed 22895665
  • Libby P, Hansson GK. Taming Immune and Inflammatory Responses to Treat Atherosclerosis. J Am Coll Cardiol. 2018 Jan 16;71(2):173-176. doi: 10.1016/j.jacc.2017.10.081. No abstract available.

    PubMed 29325641
  • Liao X, Sluimer JC, Wang Y, Subramanian M, Brown K, Pattison JS, Robbins J, Martinez J, Tabas I. Macrophage autophagy plays a protective role in advanced atherosclerosis. Cell Metab. 2012 Apr 4;15(4):545-53. doi: 10.1016/j.cmet.2012.01.022. Epub 2012 Mar 22.

    PubMed 22445600
  • Maiuri MC, Grassia G, Platt AM, Carnuccio R, Ialenti A, Maffia P. Macrophage autophagy in atherosclerosis. Mediators Inflamm. 2013;2013:584715. doi: 10.1155/2013/584715. Epub 2013 Jan 21.

    PubMed 23401644
  • Shao BZ, Han BZ, Zeng YX, Su DF, Liu C. The roles of macrophage autophagy in atherosclerosis. Acta Pharmacol Sin. 2016 Feb;37(2):150-6. doi: 10.1038/aps.2015.87. Epub 2016 Jan 11.

    PubMed 26750103
  • Iwatsuka R, Matsue Y, Yonetsu T, O'uchi T, Matsumura A, Hashimoto Y, Hirao K. Arterial inflammation measured by 18F-FDG-PET-CT to predict coronary events in older subjects. Atherosclerosis. 2018 Jan;268:49-54. doi: 10.1016/j.atherosclerosis.2017.11.016. Epub 2017 Nov 21.

    PubMed 29175654
  • Chrapko BE, Chrapko M, Nocun A, Stefaniak B, Zubilewicz T, Drop A. Role of 18F-FDG PET/CT in the diagnosis of inflammatory and infectious vascular disease. Nucl Med Rev Cent East Eur. 2016;19(1):28-36. doi: 10.5603/NMR.2016.0006.

    PubMed 26841377
  • Menezes LJ, Kotze CW, Hutton BF, Endozo R, Dickson JC, Cullum I, Yusuf SW, Ell PJ, Groves AM. Vascular inflammation imaging with 18F-FDG PET/CT: when to image? J Nucl Med. 2009 Jun;50(6):854-7. doi: 10.2967/jnumed.108.061432. Epub 2009 May 14.

    PubMed 19443587
  • Chen Q, Haddad GG. Role of trehalose phosphate synthase and trehalose during hypoxia: from flies to mammals. J Exp Biol. 2004 Aug;207(Pt 18):3125-9. doi: 10.1242/jeb.01133.

    PubMed 15299033
  • Castillo K, Nassif M, Valenzuela V, Rojas F, Matus S, Mercado G, Court FA, van Zundert B, Hetz C. Trehalose delays the progression of amyotrophic lateral sclerosis by enhancing autophagy in motoneurons. Autophagy. 2013 Sep;9(9):1308-20. doi: 10.4161/auto.25188. Epub 2013 Jun 6.

    PubMed 23851366
  • Mardones P, Rubinsztein DC, Hetz C. Mystery solved: Trehalose kickstarts autophagy by blocking glucose transport. Sci Signal. 2016 Feb 23;9(416):fs2. doi: 10.1126/scisignal.aaf1937.

    PubMed 26905424
  • Sergin I, Evans TD, Zhang X, Bhattacharya S, Stokes CJ, Song E, Ali S, Dehestani B, Holloway KB, Micevych PS, Javaheri A, Crowley JR, Ballabio A, Schilling JD, Epelman S, Weihl CC, Diwan A, Fan D, Zayed MA, Razani B. Exploiting macrophage autophagy-lysosomal biogenesis as a therapy for atherosclerosis. Nat Commun. 2017 Jun 7;8:15750. doi: 10.1038/ncomms15750.

    PubMed 28589926
  • van der Valk FM, Bekkering S, Kroon J, Yeang C, Van den Bossche J, van Buul JD, Ravandi A, Nederveen AJ, Verberne HJ, Scipione C, Nieuwdorp M, Joosten LA, Netea MG, Koschinsky ML, Witztum JL, Tsimikas S, Riksen NP, Stroes ES. Oxidized Phospholipids on Lipoprotein(a) Elicit Arterial Wall Inflammation and an Inflammatory Monocyte Response in Humans. Circulation. 2016 Aug 23;134(8):611-24. doi: 10.1161/CIRCULATIONAHA.116.020838. Epub 2016 Aug 5.

    PubMed 27496857
  • van der Valk FM, Verweij SL, Zwinderman KA, Strang AC, Kaiser Y, Marquering HA, Nederveen AJ, Stroes ES, Verberne HJ, Rudd JH. Thresholds for Arterial Wall Inflammation Quantified by 18F-FDG PET Imaging: Implications for Vascular Interventional Studies. JACC Cardiovasc Imaging. 2016 Oct;9(10):1198-1207. doi: 10.1016/j.jcmg.2016.04.007. Epub 2016 Sep 14.

    PubMed 27639759

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Trehalose and Normal saline in people with Acute Coronary Syndrome, run by Mashhad University of Medical Sciences at 1 site in Iran.

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 4 inclusion and 8 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: status not confirmed, as of the sponsor's last update on 21 Sep 2020. 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 Iran. 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?

Results are not available in the source record.

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

Contact Amirhossien Sahebkar, PharmD, PhD (+985138002299, SahebkarA@mums.ac.ir), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Arterial wall inflammation in the aorta and carotid arteries (time frame: At the beginning and end of the intervention trial (Day 0 and week 12)). 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 NCT03700424, which also lists 14 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 21 Sep 2020.

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