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Phase 3 N=249 Randomized Quadruple-blind Treatment

Study of Alirocumab (REGN727/SAR236553) in Patients With heFH (Heterozygous Familial Hypercholesterolemia) Who Are Not Adequately Controlled With Their LMT (Lipid-Modifying Therapy)

Heterozygous Familial Hypercholesterolemia

Enrolled (actual)
249
Serious AEs
6.9%
Results posted
Oct 2015
Primary outcome: Primary: Percent Change From Baseline in Calculated LDL-C at Week 24 - Intent--to--Treat (ITT) Analysis — -48.7; 2.8 percent change — p=<0.0001

Study Design & Population

Study type
Interventional
Phase
Phase 3
Interventions
LMT (atorvastatin, simvastatin, or rosuvastatin) (Drug); alirocumab (Drug); Placebo (Drug)
Age
Adult, Older Adult · 18+ yrs
Sex
All
Sponsor
Regeneron Pharmaceuticals
Primary completion
May 2014

Outcome Measures

OutcomeResultp-value
PRIMARY
Percent Change From Baseline in Calculated LDL-C at Week 24 - Intent--to--Treat (ITT) Analysis
-48.7; 2.8 <0.0001 sig
SECONDARY
Percent Change From Baseline in Calculated LDL-C at Week 24 - On-Treatment Analysis
-49.4; 2.7 <0.0001 sig
SECONDARY
Percent Change From Baseline in Calculated LDL-C at Week 12 - ITT Analysis
-43.8; 4.6 <0.0001 sig
SECONDARY
Percent Change From Baseline in Calculated LDL-C at Week 12 - On- Treatment Analysis
-44.2; 4.6 <0.0001 sig
SECONDARY
Percent Change From Baseline in Apolipoprotein (Apo) B at Week 24 - ITT Analysis
-42.8; -3.5 <0.0001 sig
SECONDARY
Percent Change From Baseline in Apo B at Week 24 - On-Treatment Analysis
-43.2; -3.5 <0.0001 sig
SECONDARY
Percent Change From Baseline in Non-High -Density Lipoprotein Cholesterol (Non-HDL-C) at Week 24 - ITT Analysis
-42.6; 3.1 <0.0001 sig
SECONDARY
Percent Change From Baseline in Non-HDL-C at Week 24 - On-Treatment Analysis
-43.2; 3.1 <0.0001 sig
SECONDARY
Percent Change From Baseline in Total Cholesterol (Total-C) at Week 24 - ITT Analysis
-30.6; 2.1 <0.0001 sig
SECONDARY
Percent Change From Baseline in Apo B at Week 12 - ITT Analysis
-35.4; -0.9 <0.0001 sig
SECONDARY
Percent Change From Baseline in Non-HDL-C at Week 12 - ITT Analysis
-37.9; 4.1 <0.0001 sig
SECONDARY
Percent Change From Baseline in Total-C at Week 12 - ITT Analysis
-26.6; 3.4 <0.0001 sig
SECONDARY
Percent Change From Baseline in Calculated LDL-C at Week 52 - ITT Analysis
-50.3; 8.4 <0.0001 sig
SECONDARY
Percentage of Very High CV Risk Participants Reaching Calculated LDL-C <70 mg/dL (1.81 mmol/L) or High CV Risk Participants Reaching Calculated LDL-C <100 mg/dL (2.59 mmol/L) at Week 24 - ITT Analysis
81.4; 11.3 <0.0001 sig
SECONDARY
Percentage of Very High CV Risk Participants Reaching Calculated LDL--C <70 mg/dL (1.81 mmol/L) or High CV Risk Participants Reaching Calculated LDL--C <100 mg/dL (2.59 mmol/L) at Week 24 - On-Treatment Analysis
82.1; 11.6 <0.0001 sig
SECONDARY
Percentage of Participants Reaching Calculated LDL-C <70 mg/dL (1.81 mmol/L) at Week 24 - ITT Analysis
68.2; 1.2 <0.0001 sig
SECONDARY
Percentage of Participants Reaching Calculated LDL--C <70 mg/dL (1.81 mmol/L) at Week 52 - On-Treatment Analysis
68.8; 1.3 <0.0001 sig
SECONDARY
Percent Change From Baseline in Lipoprotein (a) at Week 24 - ITT Analysis
-30.3; -10 <0.0001 sig
SECONDARY
Percent Change From Baseline in HDL-C at Week 24 - ITT Analysis
6.0; -0.8 = 0.0009 sig
SECONDARY
Percent Change From Baseline in Fasting Triglycerides at Week 24 - ITT Analysis
-10.4; 0.5 = 0.0012 sig
SECONDARY
Percent Change From Baseline in Apo A-1 at Week 24 - ITT Analysis
2.8; -1.6 = 0.0062 sig
SECONDARY
Percent Change From Baseline in Lipoprotein (a) at Week 12 - ITT Analysis
-24.7; -5.6 <0.0001 sig
SECONDARY
Percent Change From Baseline in HDL-C at Week 12 - ITT Analysis
6.0; -0.8 = 0.0147 sig
SECONDARY
Percent Change From Baseline in Fasting Triglycerides at Week 12 - ITT Analysis
-8.1; 0.6 = 0.024 sig
SECONDARY
Percent Change From Baseline in Apo A-1 at Week 12 - ITT Analysis
0.4; -1.9 = 0.1475

Summary

This is a randomized, double-blind, placebo-controlled, parallel-group, multi-national study alirocumab (REGN727/SAR236553) in patients with Heterozygous Familial Hypercholesterolemia (heFH) who are not adequately controlled with their Lipid-Modifying Therapy (LMT).

Eligibility Criteria

Inclusion Criteria

  • Patients with heFH* who are not adequately controlled** with a maximally-tolerated daily dose*** of statin with or without other LMT, at a stable dose prior to the screening visit (week -2).

*Diagnosis of heFH must be made either by genotyping or by clinical criteria. For those patients not genotyped, the clinical diagnosis may be based on either the Simon Broome criteria for definite FH (Appendix 1) or the WHO/Dutch Lipid Network criteria with a score of >8 points (Appendix 2).

** "Not adequately controlled" is defined as LDL-C ≥70 mg/dL (1.81 mmol/L) at the screening visit (week -2) in patients with a history of documented CVD (Appendix 3), or LDL-C ≥100 mg/dL (2.59 mmol/L) at the screening visit (week -2) in patients without a history of documented CVD.

*** "Maximally-tolerated dose" is defined as (any of the following are acceptable):

  • Rosuvastatin 20 mg or 40 mg daily
  • Atorvastatin 40 mg or 80 mg daily
  • Simvastatin 80 mg daily (if already on this dose for >1 year - see exclusion criterion #7)

Note: Patients who are not able to be on any of the above statin doses should be treated with the dose of daily atorvastatin, rosuvastatin, or simvastatin which is considered appropriate for the patient, according to the investigator's judgment. Some examples of acceptable reasons for a patient taking a lower statin dose include, but are not limited to: adverse effects on higher doses, advanced age, low body mass index, regional practices, local prescribing information, concomitant medications, co-morbid conditions such as impaired glucose tolerance/impaired fasting glucose. The reason(s) will be documented in the case report form (CRF).

  • Provide signed informed consent

Exclusion Criteria

  • Patient without diagnosis of heFH made either by genotyping or by clinical criteria
  • LDL-C <70 mg/dL (<1.81 mmol/L) at the screening visit (week-2) in patients with history of documented cardiovascular disease
  • LDL-C <100 mg/dL (<2.59 mmol/L) at the screening visit (week -2) in patients without history of documented cardiovascular disease
  • Not on a stable dose of LMT (including statin) for at least 4 weeks and/or fenofibrate for at least 6 weeks, as applicable, prior to the screening visit (week -2) and from screening to randomization
  • Currently taking another statin than simvastatin, atorvastatin, or rosuvastatin
  • Simvastatin, atorvastatin, or rosuvastatin is not taken daily or not taken at a registered dose
  • Daily doses above atorvastatin 80 mg, rosuvastatin 40 mg, or simvastatin 40 mg (except for patients on simvastatin 80 mg for more than 1 year, who are eligible)
  • Use of fibrates, other than fenofibrate within 6 weeks of the screening visit (week-2) or between screening and randomization visits
  • Use of nutraceutical products or over-the-counter therapies that may affect lipids which have not been at a stable dose/amount for at least 4 weeks prior to the screening visit (week -2) or between screening and randomization visits
  • Use of red yeast rice products within 4 weeks of the screening visit (week-2), or between screening and randomization visits
  • Patient who has received plasmapheresis treatment within 2 months prior to the screening visit (week -2), or has plans to receive it during the study
  • Recent (within 3 months prior to the screening visit [week -2] or between screening and randomization visits) MI, unstable angina leading to hospitalization, percutaneous coronary intervention (PCI), coronary artery bypass graft surgery (CABG), uncontrolled cardiac arrhythmia, stroke, transient ischemic attack (TIA), carotid revascularization, endovascular procedure or surgical intervention for peripheral vascular disease

(The inclusion/exclusion criteria provided above is not intended to contain all considerations relevant to a participant's potential participation in this clinical trial).

View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT01709500). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.

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