NCT00032435

Brief Summary

The primary objective of this study is to test the hypothesis that administration of folate, pyridoxine (vitamin B6) and cyanocobalamin (vitamin B12) in high doses to patients with advanced chronic renal failure or end stage renal disease and abnormally high plasma homocysteine levels will lower the homocysteine levels and the death rate compared to patients who receive placebo. The secondary objective is to test the hypothesis that intake of the vitamins compared to placebo decreases the incidence of myocardial infarction, disabling stroke, and amputation of a lower extremity and, in hemodialysis patients, thrombosis of the vascular access.

Trial Health

90
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
2,003

participants targeted

Target at P75+ for phase_3

Timeline
Completed

Started May 2001

Longer than P75 for phase_3

Geographic Reach
2 countries

37 active sites

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Start

First participant enrolled

May 1, 2001

Completed
11 months until next milestone

First Submitted

Initial submission to the registry

March 20, 2002

Completed
2 days until next milestone

First Posted

Study publicly available on registry

March 22, 2002

Completed
4.4 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

August 1, 2006

Completed
1 month until next milestone

Study Completion

Last participant's last visit for all outcomes

September 1, 2006

Completed
Last Updated

October 15, 2010

Status Verified

October 1, 2010

Enrollment Period

5.3 years

First QC Date

March 20, 2002

Last Update Submit

October 14, 2010

Conditions

Keywords

folatepyridoxinevitamin B6cyanocobalaminhomoc

Study Arms (2)

1

EXPERIMENTAL

PAL-40 Active

Drug: PAL-40 Active

2

PLACEBO COMPARATOR

PAL-40 Placebo

Drug: PAL-40 Placebo

Interventions

Eligibility Criteria

Age21 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Patients will be screened by their plasma homocysteine concentration. They must have a level of at least 15 mM/L to be enrolled in the study.
  • Patients will be excluded by any of the following criteria: age less than 21 years, expected life span less than 6 months, pregnancy, metastatic cancer, end-stage liver disease, treatment with methotrexate, other anti-folate medication or anticonvulsants, unreliable or likely noncompliant, participation in another long-term trial, or unwilling or unable to give informed consent.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (37)

VA Medical Center, Birmingham

Birmingham, Alabama, 35233, United States

Location

Health Economics Resource Center (HERC), Menlo Park

Menlo Park, California, 94025, United States

Location

VA Palo Alto Health Care System

Palo Alto, California, 94304-1290, United States

Location

VA San Diego Healthcare System, San Diego

San Diego, California, 92161, United States

Location

VA Eastern Colorado Health Care System, Denver

Denver, Colorado, 80220, United States

Location

VA Connecticut Health Care System (West Haven)

West Haven, Connecticut, 06516, United States

Location

VA Medical Center, DC

Washington D.C., District of Columbia, 20422, United States

Location

VA Medical Center, Bay Pines

Bay Pines, Florida, 33708, United States

Location

North Florida/South Georgia Veterans Health System

Gainesville, Florida, 32608, United States

Location

VA Medical Center, Miami

Miami, Florida, 33125, United States

Location

West Palm Beach VA Medical Center

West Palm Beach, Florida, 33410, United States

Location

Edward Hines, Jr. VA Hospital

Hines, Illinois, 60141-5000, United States

Location

Richard Roudebush VA Medical Center, Indianapolis

Indianapolis, Indiana, 46202-2884, United States

Location

Southeast Veterans Healthcare System, New Orleans

New Orleans, Louisiana, 70112, United States

Location

VA Medical Center, Jamaica Plain Campus

Boston, Massachusetts, 02130, United States

Location

VA Ann Arbor Healthcare System

Ann Arbor, Michigan, 48113, United States

Location

John D. Dingell VA Medical Center, Detroit

Detroit, Michigan, 48201, United States

Location

VA Medical Center, Minneapolis

Minneapolis, Minnesota, 55417, United States

Location

G.V. (Sonny) Montgomery VA Medical Center, Jackson

Jackson, Mississippi, 39216, United States

Location

VA Medical Center, Kansas City MO

Kansas City, Missouri, 64128, United States

Location

VA Western New York Healthcare System at Buffalo

Buffalo, New York, 14215, United States

Location

New York Harbor HCS

New York, New York, 10010, United States

Location

VA Medical Center, Northport

Northport, New York, 11768, United States

Location

VA Medical Center, Syracuse

Syracuse, New York, 13210, United States

Location

VA Medical Center, Bronx

The Bronx, New York, 10468, United States

Location

VA Medical Center, Cleveland

Cleveland, Ohio, 44106, United States

Location

VA Medical Center, Dayton

Dayton, Ohio, 45428, United States

Location

VA Medical Center, Portland

Portland, Oregon, 97201, United States

Location

VA Pittsburgh Health Care System

Pittsburgh, Pennsylvania, 15240, United States

Location

Ralph H Johnson VA Medical Center, Charleston

Charleston, South Carolina, 29401-5799, United States

Location

VA Medical Center, Memphis

Memphis, Tennessee, 38104, United States

Location

VA North Texas Health Care System, Dallas

Dallas, Texas, 75216, United States

Location

Michael E. DeBakey VA Medical Center (152)

Houston, Texas, 77030, United States

Location

Hunter Holmes McGuire VA Medical Center

Richmond, Virginia, 23249, United States

Location

VA Puget Sound Health Care System, Seattle

Seattle, Washington, 98108, United States

Location

Zablocki VA Medical Center, Milwaukee

Milwaukee, Wisconsin, 53295-1000, United States

Location

VA Medical Center, San Juan

San Juan, 00921, Puerto Rico

Location

Related Publications (3)

  • Brady CB, Gaziano JM, Cxypoliski RA, Guarino PD, Kaufman JS, Warren SR, Hartigan P, Goldfarb DS, Jamison RL. Homocysteine lowering and cognition in CKD: the Veterans Affairs homocysteine study. Am J Kidney Dis. 2009 Sep;54(3):440-9. doi: 10.1053/j.ajkd.2009.05.013. Epub 2009 Jul 23.

  • Jamison RL, Shih MC, Humphries DE, Guarino PD, Kaufman JS, Goldfarb DS, Warren SR, Gaziano JM, Lavori P; Veterans Affairs Site Investigators. Effect of the MTHFR C677T and A1298C polymorphisms on survival in patients with advanced CKD and ESRD: a prospective study. Am J Kidney Dis. 2009 May;53(5):779-89. doi: 10.1053/j.ajkd.2008.12.023. Epub 2009 Mar 9.

  • Jamison RL, Hartigan P, Kaufman JS, Goldfarb DS, Warren SR, Guarino PD, Gaziano JM; Veterans Affairs Site Investigators. Effect of homocysteine lowering on mortality and vascular disease in advanced chronic kidney disease and end-stage renal disease: a randomized controlled trial. JAMA. 2007 Sep 12;298(10):1163-70. doi: 10.1001/jama.298.10.1163.

MeSH Terms

Conditions

Kidney Failure, ChronicRenal Insufficiency

Condition Hierarchy (Ancestors)

Renal Insufficiency, ChronicKidney DiseasesUrologic DiseasesFemale Urogenital DiseasesFemale Urogenital Diseases and Pregnancy ComplicationsUrogenital DiseasesMale Urogenital DiseasesChronic DiseaseDisease AttributesPathologic ProcessesPathological Conditions, Signs and Symptoms

Study Officials

  • Rex L. Jamison

    VA Palo Alto Health Care System

    STUDY CHAIR

Study Design

Study Type
interventional
Phase
phase 3
Masking
DOUBLE
Sponsor Type
FED

Study Record Dates

First Submitted

March 20, 2002

First Posted

March 22, 2002

Study Start

May 1, 2001

Primary Completion

August 1, 2006

Study Completion

September 1, 2006

Last Updated

October 15, 2010

Record last verified: 2010-10

Locations