Healia Clinical Trials Information Database

Statins for the Early Treatment of Sepsis

We propose a Phase II, randomized, placebo-controlled clinical trial to test the hypothesis that treatment with once-daily statins has a beneficial effect on inflammatory cytokines and clinical outcomes in adults hospitalized with sepsis. As our animal models suggest pretreatment with statins are required for their beneficial effects, we propose a study design intended to identify patients and initiate treatment early in their hospital stay. This Phase II study is intended to assess the feasibility of conducting a large-scale investigator-initiated translational research protocol that involves multiple clinical services within the Department of Medicine.

Status: Active, not recruiting (Phase 2). Started on February 1st, 2008.

Enrollment: 250 subjects

Study Type: Interventional

Study Design:

  • Allocation: Randomized
  • Endpoint Classification: Safety/Efficacy Study
  • Intervention Model: Parallel Assignment
  • Masking: Double Blind (Subject
  • Caregiver
  • Investigator
  • Outcomes Assessor)
  • Primary Purpose: Treatment

Conditions:

Interventions:

  • Drug: Simvastatin
  • Drug: Identical-appearing placebo

Eligibility

Inclusion Criteria:

  • Age > 18 years

  • Initial presentation to the Emergency Department or University of Chicago MD office/Dialysis Center for current hospital admission

  • Sepsis (ACCP/SCCM criteria)

    1. Clinically suspected infection as per the treating physician or confirmed infection

    2. 2 or more of the following: Temperature 38��C (100.4��F)or 36��C (96.8��F), Heart rate (HR) > 90/min, Respiratory rate (RR) > 20/min or PaCO2 < 32 mmHg, White blood cell count > 12,000/mm3 or < 4000/m3 or > 10%immature neutrophils

  • Initiation of antibiotics by treating physician for sepsis

  • Hospitalized from the Emergency Department or University of Chicago MD office/Dialysis Center to an inpatient medical service (intensive care unit (ICU)or non-ICU service) OR admission to the medical ICU (MICU) from a non-ICU inpatient medical floor.

  • Assent of the primary treating physician at the time of enrollment.

  • The meeting of SIRS criteria is due to an infection as per the treating physician.

Exclusion Criteria:

  • Pregnancy

  • ALT >3 times above the upper limit of normal

  • Elevated creatine phosphokinase (CPK) (>3 times the upper limit of normal)

  • Concurrent treatment with any of the following drugs: daptomycin, fenofibrate, ketoconazole,triaconazole, amiodarone, clarithromycin, cyclosporine, erythromycin,nefazodone, niacin, protease inhibitors, telithromycin, verapamil,danazol, gemfibrozil

  • History of allergy or intolerance to statins

  • Greater than 16 hours after meeting inclusion criteria

  • Use of 1 more doses of statins in the previous 4 weeks

  • Clinical indication for treatment with statin during hospital admission (per treating physician)

  • Sufficiently poor prognosis prior to enrollment that treating physicians have elected to employ comfort care or plan to discharge to hospice

  • Transfer from surgical service to medical service

  • Needing transfusion for either active bleeding or severe hemolysis.

Gender

Both

Mininum Age

18 Years

Maximum Age

N/A

Healthy Volunteers

No


Resources

Source: University of Chicago

Authority: United States: Institutional Review Board

Locations

  • The University of Chicago
    Chicago
    Illinois
    60637
    United States

Officials

  • Jerry Krishnan, MD (Principal Investigator, University of Chicago)

Sponsors

  • University of Chicago (Lead Sponsor)

References

  • Oba Y, Salzman GA. Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury. N Engl J Med. 2000 Sep 14;343(11):813; author reply 813-4. No abstract available.
    PMID: 10991706.
    Check for Full Text

  • Almog Y, Shefer A, Novack V, Maimon N, Barski L, Eizinger M, Friger M, Zeller L, Danon A. Prior statin therapy is associated with a decreased rate of severe sepsis. Circulation. 2004 Aug 17;110(7):880-5. Epub 2004 Aug 2.
    PMID: 15289367.
    Check for Full Text

  • [No authors listed] American College of Chest Physicians/Society of Critical Care Medicine Consensus Conference: definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. Crit Care Med. 1992 Jun;20(6):864-74. Review.
    PMID: 1597042.
    Check for Full Text

  • Dunbar LM, Wunderink RG, Habib MP, Smith LG, Tennenberg AM, Khashab MM, Wiesinger BA, Xiang JX, Zadeikis N, Kahn JB. High-dose, short-course levofloxacin for community-acquired pneumonia: a new treatment paradigm. Clin Infect Dis. 2003 Sep 15;37(6):752-60. Epub 2003 Aug 28. Erratum in: Clin Infect Dis. 2003 Oct 15;37(8):1147.
    PMID: 12955634.
    Check for Full Text

  • Greenwood J, Walters CE, Pryce G, Kanuga N, Beraud E, Baker D, Adamson P. Lovastatin inhibits brain endothelial cell Rho-mediated lymphocyte migration and attenuates experimental autoimmune encephalomyelitis. FASEB J. 2003 May;17(8):905-7. Epub 2003 Mar 5.
    PMID: 12626426.
    Check for Full Text

  • Gupta R, Plantinga LC, Fink NE, Melamed ML, Coresh J, Fox CS, Levin NW, Powe NR. Statin use and hospitalization for sepsis in patients with chronic kidney disease. JAMA. 2007 Apr 4;297(13):1455-64.
    PMID: 17405971.
    Check for Full Text

  • Hackam DG, Mamdani M, Li P, Redelmeier DA. Statins and sepsis in patients with cardiovascular disease: a population-based cohort analysis. Lancet. 2006 Feb 4;367(9508):413-8.
    PMID: 16458766.
    Check for Full Text

  • Jacobson JR, Barnard JW, Grigoryev DN, Ma SF, Tuder RM, Garcia JG. Simvastatin attenuates vascular leak and inflammation in murine inflammatory lung injury. Am J Physiol Lung Cell Mol Physiol. 2005 Jun;288(6):L1026-32. Epub 2005 Jan 21.
    PMID: 15665042.
    Check for Full Text

  • Leung BP, Sattar N, Crilly A, Prach M, McCarey DW, Payne H, Madhok R, Campbell C, Gracie JA, Liew FY, McInnes IB. A novel anti-inflammatory role for simvastatin in inflammatory arthritis. J Immunol. 2003 Feb 1;170(3):1524-30.
    PMID: 12538717.
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  • Liappis AP, Kan VL, Rochester CG, Simon GL. The effect of statins on mortality in patients with bacteremia. Clin Infect Dis. 2001 Oct 15;33(8):1352-7. Epub 2001 Sep 20.
    PMID: 11565076.
    Check for Full Text

  • Majumdar SR, McAlister FA, Eurich DT, Padwal RS, Marrie TJ. Statins and outcomes in patients admitted to hospital with community acquired pneumonia: population based prospective cohort study. BMJ. 2006 Nov 11;333(7576):999. Epub 2006 Oct 23.
    PMID: 17060337.
    Check for Full Text

  • Merx MW, Liehn EA, Graf J, van de Sandt A, Schaltenbrand M, Schrader J, Hanrath P, Weber C. Statin treatment after onset of sepsis in a murine model improves survival. Circulation. 2005 Jul 5;112(1):117-24.
    PMID: 15998696.
    Check for Full Text

  • Naidu BV, Woolley SM, Farivar AS, Thomas R, Fraga C, Mulligan MS. Simvastatin ameliorates injury in an experimental model of lung ischemia-reperfusion. J Thorac Cardiovasc Surg. 2003 Aug;126(2):482-9.
    PMID: 12928648.
    Check for Full Text

  • Schmidt H, Hennen R, Keller A, Russ M, Muller-Werdan U, Werdan K, Buerke M. Association of statin therapy and increased survival in patients with multiple organ dysfunction syndrome. Intensive Care Med. 2006 Aug;32(8):1248-51. Epub 2006 Jun 21.
    PMID: 16788803.
    Check for Full Text

  • Thomsen RW, Hundborg HH, Johnsen SP, Pedersen L, Sorensen HT, Schonheyder HC, Lervang HH. Statin use and mortality within 180 days after bacteremia: a population-based cohort study. Crit Care Med. 2006 Apr;34(4):1080-6.
    PMID: 16484926.
    Check for Full Text

  • Yasuda H, Yuen PS, Hu X, Zhou H, Star RA. Simvastatin improves sepsis-induced mortality and acute kidney injury via renal vascular effects. Kidney Int. 2006 May;69(9):1535-42.
    PMID: 16557230.
    Check for Full Text

Links

None.


Date Verified
January 1st, 2011
First Received
January 27th, 2011
Last Changed
January 27th, 2011

Information obtained from ClinicalTrials.gov on June 09, 2011. Link to the current ClinicalTrials.gov record.


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The Healia Clinical Trials Search Engine searches the data set at clinicaltrials.gov, providing up-to-date information about current clinical trials. In the Healia Clinical Trials Database you can find information on new experimental drugs, medical devices, and other types of treatments for all types of diseases. Each clinical trial description includes information about the phase of the trial (phase I, phase II, or phase III), the trial’s methods, such as whether it is a randomized, placebo controlled, double blind study, and the status of the trial including whether or not the trial is currently enrolling new participants.


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