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Phase 3 N=69 Randomized Triple-blind Treatment

Study in Participants With Homozygous Familial Hypercholesterolemia (HoFH)

Homozygous Familial Hypercholesterolemia

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

OutcomeResultp-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.
View full record on ClinicalTrials.gov →

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.

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