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RECRUITING
NCT07611747
PHASE4

Carotid Ultrasound-Based Strategy for Primary Prevention of Cardiovascular Events in Inflammatory Rheumatic Disease (PREVENER)

Sponsor: Instituto de Investigación Marqués de Valdecilla

View on ClinicalTrials.gov

Summary

PREVENER is a randomized, open-label, multicenter, phase IV clinical trial designed to evaluate the efficacy and safety of a carotid ultrasound-based strategy for the primary prevention of cardiovascular events in patients with inflammatory rheumatic diseases (IRD). Patients with IRD, including rheumatoid arthritis (RA), psoriatic arthritis (PsA), axial spondyloarthritis (AxSpA), and systemic lupus erythematosus (SLE), have a 50% higher risk of cardiovascular (CV) events compared to the general population. However, conventional CV risk scores (SCORE2/OP) systematically underestimate this risk, leaving many high-risk patients without appropriate preventive treatment. Patients aged ≥50 years with IRD and low-to-moderate CV risk according to SCORE2/OP will be randomized 1:1 to either an experimental group (carotid ultrasound to detect subclinical atherosclerosis) or a control group (standard care according to ESC 2021 guidelines). Patients in the experimental group with carotid plaques will be reclassified as very high CV risk and treated with high-intensity statins (LDL target \<55 mg/dL). The primary endpoint is the incidence of major adverse cardiovascular events (MACE) over 48 months of follow-up.

Official title: Randomized Clinical Trial to Assess the Efficacy and Safety of a Primary Prevention Strategy for Cardiovascular Events in Patients With Inflammatory Rheumatic Diseases Based on the Use of Carotid Ultrasound

Key Details

Gender

All

Age Range

50 Years - Any

Study Type

INTERVENTIONAL

Enrollment

1944

Start Date

2026-04-22

Completion Date

2031-12

Last Updated

2026-05-28

Healthy Volunteers

No

Interventions

DIAGNOSTIC_TEST

Carotid Ultrasound

Carotid ultrasound performed to detect subclinical atherosclerosis (carotid plaques) according to Manheim consensus criteria. The presence of carotid plaques triggers reclassification to very high cardiovascular risk and initiation of high-intensity lipid-loqering therapy

DRUG

High-intensity lipid-lowering therapy

Sequential lipid-lowering therapy initiated in experimental group patinets with carotid plaques, targeting LDL \< 55 mg/dL. Treatment includes high-intensity statins (atorvastatin 40-80mg, rouvastatin 20-40mg), with possible addition of azetimibe, bempedoic acid, and/or PCSK9 inhibitors if target is not achieved.

OTHER

Standard care according to ESC 2021 guidelines

Lipid-lowerin treatment indicated and managed according to ESC 2021 cardiovascular prevention guidelines, based on SCORE/OP risk stratification, without carotid ultrasound assessment

Locations (17)

Hospital General Universitario de Alicante

Alicante, Alicante, Spain

Hospital Universitario de Elche

Elche, Alicante, Spain

Hospital Vega Baja de Orihuela

Orihuela, Alicante, Spain

Hospital Universitario Vall d'Hebrón

Barcelona, Barcelona, Spain

Hospital de Laredo

Laredo, Cantabria, Spain

Hospital Universitario Marqués de Valdecilla

Santander, Cantabria, Spain

Hospital Sierrallana

Torrelavega, Cantabria, Spain

Hospital General Universitario de Ciudad Real

Ciudad Real, Ciudad Real, Spain

Hospital Universitario Reina Sofía

Córdoba, Córdoba, Spain

Hospital Universitari Son LLàtzer

Palma, Isla Baleares, Spain

Hospital Universitario de Gran Canaria Dr. Negrín

Las Palmas de Gran Canaria, Las Palmas, Spain

Hospital Universitario La Paz

Madrid, Madrid, Spain

Hospital Universitario Ramón y Cajal

Madrid, Madrid, Spain

Hispital Universitario Virgen de la Arrixaca

Murcia, Murcia, Spain

Hospital Universitario de Canarias

San Cristóbal de La Laguna, Santa Cruz de Tenerife, Spain

Hospital Universitario de Basurto

Bilbao, Vizcaya, Spain

Hospital Universitario Araba

Vitoria-Gasteiz, Álava, Spain