Cardiovascular Diseases Clinical Trial
— OXIOfficial title:
Hydroxychloroquine for the Prevention of Recurrent Cardiovascular Events in Myocardial Infarction Patients - a Safety Pilot Trial
Verified date | June 2020 |
Source | Helsinki University Central Hospital |
Contact | n/a |
Is FDA regulated | No |
Health authority | |
Study type | Interventional |
This safety pilot study evaluates the effect of hydroxychloroquine on preventing recurrent cardiovascular events among myocardial infarction patients. Half of the participants will receive hydroxychloroquine, whereas the other half will receive placebo during six months.
Status | Completed |
Enrollment | 125 |
Est. completion date | December 31, 2019 |
Est. primary completion date | December 31, 2019 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 18 Years to 80 Years |
Eligibility |
Inclusion Criteria: Patients must have high-sensitivity troponin or CKMB above the upper limit of normal with at least one of the following criteria: 1. Anginal symptoms suggestive of cardiac ischemia 1. Accelerating pattern of anginal pain (episodes of angina that have at least 5 minutes duration and are more frequent, severe, longer in duration and/or precipitated by less exertion). 2. Prolonged (>20 minutes) or recurrent anginal pain at rest or with minimal effort. 3. Anginal pain at rest or with minimal exertion, and at least 20 minutes of duration, occurring >48 hours after an acute Q-wave myocardial infarction. 2. ECG criteria 1. New, persistent or transient ST-segment depression >0,1 mV (0,08 seconds after the J-point) in at least 2 extremity leads or 3 precordial leads. 2. New, persistent or transient ST-segment elevation in two contiguous leads =0.2 mV in men or =0.15 mV in women in leads V2-V3, and/or =0.1 mV in other leads. Patients will be enrolled within 96 hours of coronary angiography Exclusion Criteria: - Contraindication for hydroxychloroquine (porphyria, psoriasis, retinopathy, hypersensitivity) - Rheumatoid arthritis or other rheumatic disease - Significant neuropathy of any cause - Cardiomyopathy (diagnosed before the onset of index hospitalization) - Muscle disease (that could worsen by the use of hydroxychloroquine) - Pregnant or nursing women, and women of childbearing potential without efficient contraceptives. - Angina precipitated by obvious provoking factors - Prolonged ECG's corrected QT interval (>480 ms) - Ongoing antibiotic therapy of any duration - Uncontrolled severe cardiac arrhythmia resulting in hemodynamic instability - Severe hepatic failure (alanine transaminase or gamma-glutamyltransferase =2 times above normal limits or international normalized ratio (INR) >1,5 and patient not using warfarin, and due to other than cardiac reasons). - Renal failure, glomerular filtration rate <50 ml/min/1,73m2 - Hemoglobin <100 g/l (if not possible to correct with transfusion) - Planned percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) - Index myocardial infarction due to PCI or CABG restenosis. - Inability to interpret ST-T segment changes on ECG (e.g. complete left bundle branch block or paced rhythm) - Prior thrombolytic therapy (within 12 hours) - Inability to give informed consent - Fulminant vomiting or other disability to give oral medication - Over 80 years of age - Life expectancy less than one year - Receiving another investigational drug within 4 weeks prior to the study. (Patients who have participated in investigational trials before the 4-week time period may be randomized as long as they have reached the primary endpoint). - Patients with any other medical condition which, in the investigator's opinion, would interfere with optimal participation in the study or produce a significant risk to the patient In addition, patients are not eligible for the PET/CT subgroup if they have received statin-therapy in the last 2 months prior to the hospitalization (i.e. statin therapy started during the index hospitalization is not an exclusion criteria). |
Country | Name | City | State |
---|---|---|---|
Finland | Helsinki University Central Hospital | Helsinki | |
Finland | North Karelia Central Hospital | Joensuu | |
Finland | Kymenlaakso Central Hospital | Kotka | |
Finland | Päijät-Häme Central Hospital | Lahti | |
Finland | South Karelia Central Hospital | Lappeenranta | |
Finland | South Ostrobotnia Central Hospital | Seinäjoki |
Lead Sponsor | Collaborator |
---|---|
Helsinki University Central Hospital | Aarne Koskelo Foundation, Finnish Cultural Foundation, Finnish Foundation for Cardiovascular Research, Orion Corporation, Orion Pharma |
Finland,
Hartman O, Kovanen PT, Lehtonen J, Eklund KK, Sinisalo J. Hydroxychloroquine for the prevention of recurrent cardiovascular events in myocardial infarction patients: rationale and design of the OXI trial. Eur Heart J Cardiovasc Pharmacother. 2017 Apr 1;3(2):92-97. doi: 10.1093/ehjcvp/pvw035. — View Citation
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Rate of major cardiovascular adverse events | Myocardial infarction, mortality, hospitalization for unstable angina, and heart failure | Twelve months | |
Secondary | Rate of the primary endpoint plus stroke and urgent coronary revascularization | Twelve months | ||
Secondary | Effect on the incidence of type 2 diabetes and the level of Hba1c | Six months | ||
Secondary | Effect on cholesterol levels | The effect of hydroxychloroquine on total cholesterol, low-density lipoprotein, high-density lipoprotein, and triglyceride levels | Six months | |
Secondary | Effect on high-sensitivity C-reactive protein (hs-CRP) level | Six months | ||
Secondary | Effect on soluble biomarkers of inflammation | Frozen samples (plasma and whole blood) will be stored for future evaluation of biomarkers related to inflammation and cardiovascular disease, such as tumor necrosis factor alpha, interleukin 6 (IL-6), IL-1beta, IL-18, and messenger ribonucleic acid (mRNA) analyses. | Six months | |
Secondary | Effect on aortic inflammation assessed by PET / CT scan | Six months |
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