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Carotid Atherosclerotic PlaquePhase 1/2PROMISENCT07680595

Prospective Management of Plaque Instability With Statins and Extra Folic Acid

A Phase 1/2 study testing Atorvastatin plus folic acid and Atorvastatin in people with Carotid Atherosclerotic Plaque, run by Ruijin Hospital at 1 site in China.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

This is a prospective, exploratory, cohort clinical study aiming to further investigate the direct impact of folic acid on the stability of carotid atherosclerotic plaques, building upon substantial clinical evidence confirming that folic acid supplementation reduces the risk of stroke in hypertensive patients… Read more about this study

Who is it for?
Ages 18 to 75 years
Conditions the study is for
Carotid Atherosclerotic Plaque
What is being tested?
Atorvastatin plus folic acid and Atorvastatin
Type of treatment
Pill or oral medicine
Could I receive a placebo?
No, everyone receives an active treatment
How many people
180 participants
Where
1 siteChina
Study dates
1 Mar 2026to 31 Dec 2027
Phase
Phase 1/2
Are there results?
Not yet: the study is under way

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 75 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Signed and dated written informed consent form (version approved by the Ethics Committee);
  • Voluntary participation and commitment to comply with the study protocol;
  • Aged 18 to 75 years, regardless of sex;
  • Confirmed carotid plaque by ultrasound or computed tomography angiography (CTA), defined-according to the Expert Consensus on Standardized Ultrasound Operation and Reporting of Carotid Atherosclerotic Plaques (2025, Shanghai)-as the presence of at least one lesion with a carotid intima-media thickness (cIMT) ≥ 1.5 mm or plaque formation;
  • Able to cooperate and complete the 6-month study follow-up, including regular imaging examinations and blood sample collections.

Who cannot join

  • History of plaque excision or interventional procedures, such as carotid endarterectomy (CEA) or carotid artery stenting (CAS);
  • History of severe hepatic or renal impairment, malignancies, autoimmune diseases, or psychiatric disorders;
  • Pregnant or lactating women;
  • Hypersensitivity (or allergy) to any components of the study medications;
  • Current or long-term regular use of any dietary supplements or medications that may significantly affect the folate metabolic cycle (e.g., vitamin B6, vitamin B12, multivitamins, etc.).

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

China1 site, 1 recruiting
  • Shanghai Jiao Tong University Medical School Affiliated Ruijing Hospital

    Shanghai, Shanghai Municipality, 200433

    Yudong Sun, 18818263589, drsunyudong@hotmail.com

    Recruiting

Other trials in China

About this study

Official title: A Prospective, Exploratory, Cohort Clinical Study Comparing the Effects of Oral Statins With or Without Folic Acid on Carotid Plaque Stability.

This is a prospective, exploratory, cohort clinical study aiming to further investigate the direct impact of folic acid on the stability of carotid atherosclerotic plaques, building upon substantial clinical evidence confirming that folic acid supplementation reduces the risk of stroke in hypertensive patients, thereby providing a basis for subsequent confirmatory randomized controlled trials. The study will enroll patients with carotid plaques who have not undergone carotid endarterectomy or stent implantation, with lesions defined-according to the Expert Consensus on Standardized Ultrasound Operation and Reporting of Carotid Atherosclerotic Plaques (2025, Shanghai)-as the presence of at least one site with a carotid intima-media thickness (cIMT) ≥ 1.5 mm or visible plaque formation. Participants will be allocated into Cohort 1 (statin therapy) and Cohort 2 (statin therapy plus folic acid); Cohort 1 will receive oral atorvastatin 20 mg daily, while Cohort 2 will receive an additional oral folic acid 5 mg daily on top of the 20 mg oral atorvastatin regimen, both for a continuous duration of 6 months. Statin therapy in both groups will be standardized and managed in accordance with current clinical guidelines, and all subjects will undergo comprehensive evaluations at baseline and after the 6-month intervention. The primary endpoint is the change in carotid plaque thickness at 6 months post-treatment, while secondary endpoints encompass changes in maximum plaque diameter, analysis of plaque composition ratio, and the regulatory effects on serum metabolic markers and the peripheral immune microenvironment, alongside continuous monitoring of treatment-related adverse events throughout the study to comprehensively evaluate overall safety and tolerability.

Being tested
Atorvastatin plus folic acid, Atorvastatin

What participants receive

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

  • Atorvastatin plus folic acidDrug

    Patients will receive oral folic acid 5 mg daily plus 20 mg atorvastatin regimen, with both treatments continuing for a duration of 6 months

  • AtorvastatinDrug

    Patients will receive 20 mg atorvastatin regimen for a duration of 6 months

Study groups in NCT07680595
Study groupRoleWhat they receive
Statin + Folic acidExperimentalNot described
Receives: Drug: Atorvastatin plus folic acid
StatinActive comparatorNot described
Receives: Drug: Atorvastatin

What is being measured

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

  1. Effects of oral folic acid combined with statins on carotid plaque thickness

    Change from baseline in carotid plaque thickness at 6 months post-treatment

    Measured: 6 months

Secondary outcomes (4)
  1. To investigate the effect of oral folic acid combined with statins on the maximum diameter of carotid plaques;

    Changes in maximum plaque diameter

    Measured: 6 months

  2. To investigate the changes in plaque composition ratios following the administration of oral folic acid combined with statins-including changes in intraplaque calcification area, fibrous cap thickness, intraplaque neovascularization, echo intensity.

    Plaque composition ratio: To observe post-treatment changes in intraplaque calcification area and fibrous cap thickness; to quantify intraplaque neovascularization density via contrast-enhanced ultrasound (CEUS); and to analyze changes in plaque echogenicity (grayscale values) in order to evaluate the stability of plaque components

    Measured: 6 months

  3. To evaluate the impact on the proportions of peripheral blood B-cell subsets (via flow cytometry) and serum IgM/IgG titers (via ELISA)

    Determination of peripheral blood B-cell subset proportions (via flow cytometry) and serum IgM/IgG titers (via ELISA)

    Measured: 6 months

  4. Safety and Tolerability: To monitor the incidence of adverse events (AEs) during the treatment period. This includes, but is not limited to, drug-specific safety profiles (e.g., gastrointestinal reactions, hepatic and renal dysfunction, and allergic reac

    Safety and tolerability: To record the incidence rate of adverse events (AEs) during the treatment period

    Measured: 6 months

Timeline

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

  1. First posted2 Jul 2026
  2. Study start1 Mar 2026
  3. Primary completion1 Sep 2027 (estimated)
  4. Study completion31 Dec 2027 (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 1/2
Primary purpose
Treatment
Allocation
Non-randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
180 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07680595
Sponsor's protocol ID
RX-2006-001
Acronym
PROMISE
Status last verified
Mar 2026
First submitted
22 Jun 2026
Last updated
2 Jul 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes

Publications

  • Zeng Y, Chen YB, Pan BZ, Zhang DW. Complete mitochondrial genome of Schizopygopsis malacanthus (Teleostei: Cypriniformes: Cyprinidae). Mitochondrial DNA A DNA Mapp Seq Anal. 2016;27(2):1405-6. doi: 10.3109/19401736.2014.947602. Epub 2014 Aug 8.

    PubMed 25103444
  • Hartert M, Mann WJ, Senbaklavaci O. Relocation of an infected tracheostoma: anterior mediastinal tracheostomy as Mission:Impossible. Interact Cardiovasc Thorac Surg. 2021 Jul 26;33(2):319-321. doi: 10.1093/icvts/ivab071.

    PubMed 33792686
  • Yang YY, Gao ZX, Mao ZH, Liu DW, Liu ZS, Wu P. Identification of ULK1 as a novel mitophagy-related gene in diabetic nephropathy. Front Endocrinol (Lausanne). 2023 Jan 18;13:1079465. doi: 10.3389/fendo.2022.1079465. eCollection 2022.

    PubMed 36743936
  • Fernandez DM, Rahman AH, Fernandez NF, Chudnovskiy A, Amir ED, Amadori L, Khan NS, Wong CK, Shamailova R, Hill CA, Wang Z, Remark R, Li JR, Pina C, Faries C, Awad AJ, Moss N, Bjorkegren JLM, Kim-Schulze S, Gnjatic S, Ma'ayan A, Mocco J, Faries P, Merad M, Giannarelli C. Single-cell immune landscape of human atherosclerotic plaques. Nat Med. 2019 Oct;25(10):1576-1588. doi: 10.1038/s41591-019-0590-4. Epub 2019 Oct 7.

    PubMed 31591603
  • Shibata H, Yasumi T, Shimodera S, Hiejima E, Izawa K, Kawai T, Shirakawa R, Wada T, Nishikomori R, Horiuchi H, Ohara O, Ishii E, Heike T. Human CTL-based functional analysis shows the reliability of a munc13-4 protein expression assay for FHL3 diagnosis. Blood. 2018 May 3;131(18):2016-2025. doi: 10.1182/blood-2017-10-812503. Epub 2018 Mar 16.

    PubMed 29549174
  • Clasca F, Rubio-Garrido P, Jabaudon D. Unveiling the diversity of thalamocortical neuron subtypes. Eur J Neurosci. 2012 May;35(10):1524-32. doi: 10.1111/j.1460-9568.2012.08033.x.

    PubMed 22606998
  • Huo Y, Li J, Qin X, Huang Y, Wang X, Gottesman RF, Tang G, Wang B, Chen D, He M, Fu J, Cai Y, Shi X, Zhang Y, Cui Y, Sun N, Li X, Cheng X, Wang J, Yang X, Yang T, Xiao C, Zhao G, Dong Q, Zhu D, Wang X, Ge J, Zhao L, Hu D, Liu L, Hou FF; CSPPT Investigators. Efficacy of folic acid therapy in primary prevention of stroke among adults with hypertension in China: the CSPPT randomized clinical trial. JAMA. 2015 Apr 7;313(13):1325-35. doi: 10.1001/jama.2015.2274.

    PubMed 25771069
  • Qin X, Xu M, Zhang Y, Li J, Xu X, Wang X, Xu X, Huo Y. Effect of folic acid supplementation on the progression of carotid intima-media thickness: a meta-analysis of randomized controlled trials. Atherosclerosis. 2012 Jun;222(2):307-13. doi: 10.1016/j.atherosclerosis.2011.12.007. Epub 2011 Dec 9.

    PubMed 22209480
  • Ntaios G, Savopoulos C, Karamitsos D, Economou I, Destanis E, Chryssogonidis I, Pidonia I, Zebekakis P, Polatides C, Sion M, Grekas D, Hatzitolios A. The effect of folic acid supplementation on carotid intima-media thickness in patients with cardiovascular risk: a randomized, placebo-controlled trial. Int J Cardiol. 2010 Aug 6;143(1):16-9. doi: 10.1016/j.ijcard.2009.01.023. Epub 2009 Feb 8.

    PubMed 19201496
  • Laugaland K, Aase K, Waring J. Hospital discharge of the elderly--an observational case study of functions, variability and performance-shaping factors. BMC Health Serv Res. 2014 Aug 30;14:365. doi: 10.1186/1472-6963-14-365.

    PubMed 25175924
  • Zamani M, Rezaiian F, Saadati S, Naseri K, Ashtary-Larky D, Yousefi M, Golalipour E, Clark CCT, Rastgoo S, Asbaghi O. The effects of folic acid supplementation on endothelial function in adults: a systematic review and dose-response meta-analysis of randomized controlled trials. Nutr J. 2023 Feb 24;22(1):12. doi: 10.1186/s12937-023-00843-y.

    PubMed 36829207
  • Carnicer R, Navarro MA, Arbones-Mainar JM, Acin S, Guzman MA, Surra JC, Arnal C, de Las Heras M, Blanco-Vaca F, Osada J. Folic acid supplementation delays atherosclerotic lesion development in apoE-deficient mice. Life Sci. 2007 Jan 23;80(7):638-43. doi: 10.1016/j.lfs.2006.10.014. Epub 2006 Nov 10.

    PubMed 17118406
  • Barwick BG, Scharer CD, Martinez RJ, Price MJ, Wein AN, Haines RR, Bally APR, Kohlmeier JE, Boss JM. B cell activation and plasma cell differentiation are inhibited by de novo DNA methylation. Nat Commun. 2018 May 15;9(1):1900. doi: 10.1038/s41467-018-04234-4.

    PubMed 29765016
  • Blanco M, Vazquez JA, Perez-Martin RI, Sotelo CG. Hydrolysates of Fish Skin Collagen: An Opportunity for Valorizing Fish Industry Byproducts. Mar Drugs. 2017 May 5;15(5):131. doi: 10.3390/md15050131.

    PubMed 28475143
  • Ciginskiene A, Dambrauskiene A, Rello J, Adukauskiene D. Ventilator-Associated Pneumonia due to Drug-Resistant Acinetobacter baumannii: Risk Factors and Mortality Relation with Resistance Profiles, and Independent Predictors of In-Hospital Mortality. Medicina (Kaunas). 2019 Feb 13;55(2):49. doi: 10.3390/medicina55020049.

    PubMed 30781896

Questions about this trial

What is this clinical trial studying?

A Phase 1/2 study testing Atorvastatin plus folic acid and Atorvastatin in people with Carotid Atherosclerotic Plaque, run by Ruijin Hospital at 1 site in China.

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 5 inclusion and 5 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: looking for participants now, as of the sponsor's last update on 2 Jul 2026. 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 China. 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. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this combined phase mean?

Phase 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.

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?

This study is still under way. Results are not available in the source record yet.

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

Contact Junyi Yan, M.D. (+8613480161737, drsunyudong@hotmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Effects of oral folic acid combined with statins on carotid plaque thickness (time frame: 6 months). 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 NCT07680595, which also lists 20 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 2 Jul 2026.

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