NCT06568601

Brief Summary

Statins are the most cost-effective medications to lower cholesterol and cardiovascular disease (CVD) risk. However, many patients at high-risk for CVD do not accept or adhere to statins. This gap in patient's use of statins limits the full impact of these effective medications resulting in higher cholesterol levels and CVD risk. The main barriers to using statins are patients' perceived lack of benefit, excess risk of statin toxicity as well as their misperceptions of their CVD risk. Statin pharmacogenomic testing - an application of precision medicine - is a readily available, feasible, and inexpensive intervention that addresses this barrier by using genetic testing to identify the nearly 1 out of 2 patients with enhanced benefit and/or reduced risk of statin toxicity or increased risk for CVD. By communicating statin pharmacogenomic test results to Veterans at high-risk for CVD not taking statin therapy, the investigators aim to improve patients' perceptions of their risk of CVD and statins and, in turn, their acceptance of and adherence to statins to reduce their cholesterol levels and CVD risk.

Trial Health

77
On Track

Trial Health Score

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

Enrollment
410

participants targeted

Target at P75+ for not_applicable

Timeline
25mo left

Started Apr 2025

Longer than P75 for not_applicable

Geographic Reach
1 country

2 active sites

Status
recruiting

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 Progress36%
Apr 2025Jul 2028

First Submitted

Initial submission to the registry

August 21, 2024

Completed
2 days until next milestone

First Posted

Study publicly available on registry

August 23, 2024

Completed
7 months until next milestone

Study Start

First participant enrolled

April 1, 2025

Completed
2.2 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

May 31, 2027

Expected
1.2 years until next milestone

Study Completion

Last participant's last visit for all outcomes

July 28, 2028

Last Updated

April 13, 2026

Status Verified

April 1, 2026

Enrollment Period

2.2 years

First QC Date

August 21, 2024

Last Update Submit

April 6, 2026

Conditions

Keywords

AtherosclerosisHydroxymethylglutaryl-CoA Reductase InhibitorsPharmacogenomic TestingGenetic Risk Score

Outcome Measures

Primary Outcomes (1)

  • Change in low density lipoprotein cholesterol

    The primary effectiveness outcome will be the change in LDL-cholesterol level from baseline to 15-months.

    15-months

Study Arms (2)

Genetic testing arm

EXPERIMENTAL

The intervention involves: genetic testing; interpretation; and prior to and shortly following an upcoming appointment, communication to patients and providers about the patients' predicted statin efficacy and toxicity, genetic risk for CVD, and individualized recommended statin type/dose.

Genetic: Pharmacogenetic and polygenic risk testing

Control

ACTIVE COMPARATOR

The control condition involves receipt of a report highlighting the risk of cardiovascular disease and benefits of statins (without genetic test results).

Other: Active control

Interventions

The intervention involves: genetic testing; interpretation; and prior to and shortly following an upcoming appointment, communication to patients and providers about the patients' predicted statin efficacy and toxicity, genetic risk for CVD, and individualized recommended statin type/dose.

Genetic testing arm

The control condition involves receipt of a report highlighting the risk of cardiovascular disease and benefits of statins (without genetic test

Also known as: Control
Control

Eligibility Criteria

Age40 Years - 75 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Patients will be included in the analysis if they:
  • Are a Veteran
  • Aged 40-75 years
  • Diabetes mellitus or cardiovascular disease (coronary, cerebral, or peripheral artery disease)
  • An upcoming primary care appointment in the next 4 months
  • No active statin prescription (any time/dose, VA, or non-VA) in the prior 6 months
  • English speaking
  • At least 1 current active VA prescription
  • At least 1 primary care appointment within the prior 2 years

You may not qualify if:

  • Non-Veterans
  • End-stage renal disease
  • History of rhabdomyolysis
  • Active treatment for non-dermatologic cancer
  • Known, prior SLCO1B1 genetic test results
  • Liver cirrhosis
  • Palliative care or hospice in 1-year prior to admission, during hospital stay, or at discharge
  • Active prescription for PCSK9 inhibitor
  • Inability to provide informed consent due to language impairment, cognitive disease, or other similar factors at the discretion of the research assistant or project coordinator.
  • Active enrollment in a different, interventional clinical trial, at the discretion of PI.
  • History of allogeneic stem cell transplant or liver transplant.
  • Documentation of specific adverse drug reactions thought to be attributed to statins:
  • Myopathy with associated elevation in creatinine kinase \> 10x upper limit of normal
  • Angioedema
  • Elevated AST/ALT
  • +1 more criteria

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (2)

Richard L. Roudebush VA Medical Center, Indianapolis, IN

Indianapolis, Indiana, 46202-2884, United States

RECRUITING

Durham VA Medical Center, Durham, NC

Durham, North Carolina, 27705-3875, United States

NOT YET RECRUITING

MeSH Terms

Conditions

HypercholesterolemiaAtherosclerosisGenetic Risk Score

Interventions

Pharmacogenomic Testing

Condition Hierarchy (Ancestors)

HyperlipidemiasDyslipidemiasLipid Metabolism DisordersMetabolic DiseasesNutritional and Metabolic DiseasesArteriosclerosisArterial Occlusive DiseasesVascular DiseasesCardiovascular DiseasesGenetic Predisposition to DiseaseDisease SusceptibilityDisease AttributesPathologic ProcessesPathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

Genetic TestingClinical Laboratory TechniquesDiagnostic Techniques and ProceduresDiagnosisInvestigative TechniquesGenetic TechniquesGenetic ServicesHealth ServicesHealth Care Facilities Workforce and ServicesDiagnostic ServicesPreventive Health Services

Study Officials

  • Deepak Voora, MD

    Durham VA Medical Center, Durham, NC

    PRINCIPAL INVESTIGATOR
  • Dawn M. Bravata, MD

    Richard L. Roudebush VA Medical Center, Indianapolis, IN

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Deepak Voora, MD

CONTACT

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
NONE
Purpose
HEALTH SERVICES RESEARCH
Intervention Model
PARALLEL
Model Details: Patient randomized, open-label, parallel group
Sponsor Type
FED
Responsible Party
SPONSOR

Study Record Dates

First Submitted

August 21, 2024

First Posted

August 23, 2024

Study Start

April 1, 2025

Primary Completion (Estimated)

May 31, 2027

Study Completion (Estimated)

July 28, 2028

Last Updated

April 13, 2026

Record last verified: 2026-04

Data Sharing

IPD Sharing
Will not share

Locations