Phase 3
N=69
Study in Participants With Homozygous Familial Hypercholesterolemia (HoFH)
Homozygous Familial Hypercholesterolemia
Bottom Line
View on ClinicalTrials.gov: NCT03156621 ↗Enrolled (actual)
69
Serious AEs
0.7%
Results posted
Jun 2021
Primary outcome: Primary: Percent Change in Low-density Lipoprotein Cholesterol (LDL-C) From Baseline to Week 12 (Intent-to-Treat [ITT] Estimand) — 8.6; -26.9 Percentage of change — p=<0.0001
Study Design & Population
- Study type
- Interventional
- Phase
- Phase 3
- Interventions
- Alirocumab (Drug); Placebo (Drug)
- Age
- Adult, Older Adult · 18+ yrs
- Sex
- All
- Sponsor
- Regeneron Pharmaceuticals
- Primary completion
- Sep 2019
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Percent Change in Low-density Lipoprotein Cholesterol (LDL-C) From Baseline to Week 12 (Intent-to-Treat [ITT] Estimand) |
8.6; -26.9 | <0.0001 sig |
| SECONDARY Percent Change in Apolipoprotein (Apo) B From Baseline to Week 12 (ITT Estimand) |
7.2; -22.5 | < 0.0001 sig |
| SECONDARY Percent Change in Non-high-density Lipoprotein Cholesterol (Non-HDL-C) From Baseline to Week 12 |
8.0; -24.8 | < 0.0001 sig |
| SECONDARY Percent Change in Total Cholesterol (TC) From Baseline to Week 12 |
6.6; -19.8 | < 0.0001 sig |
| SECONDARY Percentage of Participants With ≥15% Reduction in LDL-C at Week 12 |
12.5; 61.9 | = 0.0004 sig |
| SECONDARY Percentage of Participants With ≥30% Reduction in LDL-C at Week 12 |
4.2; 57.1 | = 0.0010 sig |
| SECONDARY Percent Change in Lipoprotein(a) [Lp(a)] From Baseline to Week 12 |
8.8; -19.6 | < 0.0001 sig |
| SECONDARY Percentage of Participants With ≥50% Reduction in LDL-C at Week 12 |
0; 26.7 | = 0.0017 sig |
| SECONDARY Percent Change in HDL-C From Baseline to Week 12 - ITT Analysis |
2.7; 6.3 | = 0.3541 |
| SECONDARY Percent Change in Fasting Triglycerides (TG) From Baseline to Week 12 |
3.9; -7.4 | — |
| SECONDARY Percent Change in Apo A-1 From Baseline to Week 12 -- ITT Analysis |
1.4; 5.0 | — |
| SECONDARY Percent Change in LDL-C From Baseline to Week 12 (On-treatment Estimand) |
8.6; -26.9 | — |
| SECONDARY Percent Change in Apo B From Baseline to Week 12 (On-treatment Estimand) |
7.2; -22.5 | — |
| SECONDARY Percent Change in Non-HDL-C From Baseline to Week 12 (On-treatment Estimand) |
8.0; -24.8 | — |
| SECONDARY Percent Change in TC From Baseline to Week 12 (On-treatment Estimand) |
6.6; -19.8 | — |
| SECONDARY Percent Change in Lp(a) From Baseline to Week 12 (On-treatment Estimand) |
8.8; -19.6 | — |
| SECONDARY Percent Change in HDL-C From Baseline to Week 12 (On-treatment Estimand) |
2.7; 6.3 | — |
| SECONDARY Percent Change in Fasting TG From Baseline to Week 12 (On-treatment Estimand) |
3.9; -7.4 | — |
| SECONDARY Percent Change in Apo A-1 From Baseline to Week 12 (On-treatment Estimand) |
1.4; 5.0 | — |
| SECONDARY Percentage of Participants With ≥15% Reduction, ≥30% Reduction, and ≥50% Reduction in LDL-C at Week 12 (On-treatment Estimand) |
12.5; 61.9; 4.2; 57.1; 0; 26.7 | — |
| SECONDARY Absolute Change in the Ratio of Apo B/Apo A-1 From Baseline to Week 12 (ITT Estimand) |
0.0; -0.3 | — |
| SECONDARY Number of Participants With Anti-Drug Antibodies (ADA) to REGN727 Over Time |
1; 1 | — |
| SECONDARY Number of Participants With Adverse Events (AEs) |
12; 20; 24; 0; 0; 1 | — |
Summary
The primary objective of the study is to demonstrate the reduction of low-density lipoprotein cholesterol (LDL-C) with alirocumab subcutaneous (SC) every 2 weeks (Q2W) in comparison to placebo after 12 weeks of treatment.
The secondary objectives of the study are:
* To evaluate the effect of alirocumab Q2W on other lipid parameters (ie, apolipoprotein [Apo] A-1 and B, non-high-density lipoprotein cholesterol [non-HDL-C], total-cholesterol [TC], proportion of participants with 15%, 30%, and 50% LDL-C reductions, Lp(a), HDL-C, triglycerides [TG]) in participants with HoFH
* To evaluate the safety and tolerability of alirocumab SC Q2W in participants with HoFH
* To assess the pharmacokinetics of alirocumab SC Q2W in participants with HoFH
* To assess the potential development of anti-drug (alirocumab) antibodies
Eligibility Criteria
Note: The information listed below is not intended to contain all considerations relevant to a patient's potential participation in this clinical trial, therefore not all inclusion/exclusion criteria are listed.
Key Inclusion Criteria
- Diagnosis of HoFH by at least 1 of the following genotype or clinical criteria (all patients on LDL apheresis must be diagnosed based on genotype):
- Documented homozygous or compound heterozygous mutations in both low-density lipoprotein receptor (LDLR) alleles
- Presence of homozygous or compound heterozygous mutations in Apo B, PCSK9 or LDL receptor adaptor protein 1 (LDLRAP1)
- Presence of double heterozygous mutations, i.e, mutations on different genes in the LDLR, Apo B or PCSK9 alleles
- Untreated TC >500 mg/dL (12.93 mmol/L) and TG 250 mg/dL (6.46 mmol/L) OR cutaneous or tendinous xanthoma before age 10
- Receiving a stable dose of a statin at the screening visit (documentation if statin ineffective or patient unable to tolerate statin)
- If undergoing LDL apheresis, must have initiated LDL apheresis at least 3 months prior to screening and must have been on a stable weekly (every 7 days) or every other week (every 14 days) schedule or stable settings for at least 8 weeks
Key Exclusion Criteria
- Documented evidence of a null mutation in both LDLR alleles
- Use of a PCSK9 inhibitor within 10 weeks from screening visit
- Background medical lipid modifying therapy (LMT) that has not been stable for at least 4 weeks (6 weeks for fibrates, 24 weeks for mipomersen, 12 weeks for maximum tolerated dose of lomitapide) before the screening visit.
- LDL apheresis schedule/apheresis settings that have not been stable for at least 8 weeks before the screening visit or an apheresis schedule/settings that is not anticipated to be stable over the next 24 weeks.
- Use of nutraceuticals or over-the-counter (OTC) therapies known to affect lipids, at a dose/amount that has not been stable for at least 4 weeks prior to the screening visit or between the screening and randomization visits.
- Chronic use of systemic corticosteroids, unless on a stable regimen of 10 mg daily prednisone equivalent or less for at least 6 weeks prior to randomization. Note: topical, intra-articular, nasal, inhaled and ophthalmic steroid therapies are not considered as 'systemic' and are allowed
- Systolic blood pressure >160 mmHg or diastolic blood pressure >100 mmHg at the screening visit (1 repeat measurement is allowed).
- LDL-C level <70 mg/dL (1.81 mmol/L) at the screening visit
- History of a myocardial infarction (MI), unstable angina leading to hospitalization, coronary artery bypass graft surgery, percutaneous coronary intervention , uncontrolled cardiac arrhythmia, carotid surgery or stenting, stroke, transient ischemic attack, valve replacement surgery, carotid revascularization, endovascular procedure or surgical intervention for peripheral vascular disease within 3 months prior to the screening visit.
Data sourced from ClinicalTrials.gov (NCT03156621). 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.