Phase 2
N=266
Study of Evinacumab (REGN1500) in Participants With Persistent Hypercholesterolemia
Hypercholesterolemia
Bottom Line
View on ClinicalTrials.gov: NCT03175367 ↗Enrolled (actual)
266
Serious AEs
8.6%
Results posted
Feb 2023
Primary outcome: Primary: Percent Change From Baseline in Calculated Low Density Lipoprotein Cholesterol (LDL-C) at Week 16 (Intent-to-Treat [ITT] Estimand) — 8.8; -29.7; -44.0; -47.2 Percent Change — p=< .0001
Study Design & Population
- Study type
- Interventional
- Phase
- Phase 2
- Interventions
- Evinacumab (Drug); Matching placebo (Drug); Background Lipid Modifying Therapy (LMT) (Other)
- Age
- Adult, Older Adult · 18+ yrs
- Sex
- All
- Sponsor
- Regeneron Pharmaceuticals
- Primary completion
- May 2020
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Percent Change From Baseline in Calculated Low Density Lipoprotein Cholesterol (LDL-C) at Week 16 (Intent-to-Treat [ITT] Estimand) |
8.8; -29.7; -44.0; -47.2; 0.6; -23.5 | < .0001 sig |
| SECONDARY Percent Change From Baseline in Apolipoprotein B (Apo B) at Week 16 (ITT Estimand) |
6.7; -19.9; -35.2; -38.8; -3.8; -20.4 | = 0.0003 sig |
| SECONDARY Percent Change From Baseline in Apo B at Week 24 (ITT Estimand) |
5.9; -15.9; -34.5 | = 0.0111 sig |
| SECONDARY Percent Change From Baseline in Non High Density Lipoprotein Cholesterol (Non-HDL-C) at Week 16 (ITT Estimand) |
8.0; -31.3; -45.8; -50.6; -1.1; -24.8 | < 0.0001 sig |
| SECONDARY Percent Change From Baseline in Non-HDL-C at Week 24 (ITT Estimand) |
10.4; -20.2; -44.3 | = 0.0021 sig |
| SECONDARY Percentage of Participants With >= 30% Reduction in Calculated LDL-C at Week 16 (ITT Estimand) |
11.3; 68.1; 73.9; 71.4; 15.5; 57.9 | < 0.0001 sig |
| SECONDARY Percentage of Participants With >= 50% Reduction in Calculated LDL-C at Week 16 (ITT Estimand) |
5.2; 28.6; 53.7; 60.6; 12.3; 24.6 | = 0.0100 sig |
| SECONDARY Percentage of Participants With Calculated LDL-C < 50 mg/dL (1.30 mmol/L) at Week 16 (ITT Estimand) |
5.1; 22.8; 29.7; 40.8; 9.3; 13.2 | = 0.0718 |
| SECONDARY Percent Change From Baseline in Calculated LDL-C at Week 24 (ITT Estimand) |
14.8; -17.7; -39.7 | = 0.0059 sig |
| SECONDARY Percent Change From Baseline in Total Cholesterol (TC) at Week 16 (ITT Estimand) |
6.1; -31.0; -40.3; -45.4; -0.4; -22.6 | < .0001 sig |
| SECONDARY Percent Change From Baseline in Total Cholesterol at Week 24 (ITT Estimand) |
8.5; -19.9; -40.8 | = 0.0001 sig |
| SECONDARY Percent Change From Baseline in Fasting Triglycerides at Week 16 (ITT Estimand) |
8.1; -38.0; -47.7; -53.4; -6.9; -32.1 | < .0001 sig |
| SECONDARY Percent Change From Baseline in Fasting Triglycerides at Week 24 (ITT Estimand) |
-6.1; -23.2; -51.3 | = 0.0228 sig |
| SECONDARY Percent Change From Baseline in Lipoprotein a [Lp(a)] at Week 16 (ITT Estimand) |
0.3; -10.3; -11.6; -8.9; 0.8; -15.7 | = 0.0635 |
| SECONDARY Percent Change From Baseline in Lipoprotein (a) [Lp(a)] at Week 24 (ITT Estimand) |
-1.4; -17.5; -16.0 | = 0.0054 sig |
Summary
The primary objective of the study is to evaluate the reduction of LDL-C by evinacumab in comparison to placebo after 16 weeks in patients with primary hypercholesterolemia (HeFH, or non-HeFH with a history of clinical ASCVD) with persistent hypercholesterolemia despite receiving maximally-tolerated LMT. Persistent hypercholesterolemia is defined as LDL-C ≥70 mg/dL (1.81 mmol/L) for those patients with clinical ASCVD and LDL-C ≥100 mg/dL (2.59 mmol/L) for those patients without clinical ASCVD.
Eligibility Criteria
The inclusion/ exclusion criteria below, include, but are not limited to, the following:
Key Inclusion Criteria
- Men and women, ages 18 through 80 at the screening visit
- Diagnosis of primary hypercholesterolemia, either HeFH or non-HeFH with clinical ASCVD
- A history of clinical ASCVD, for those patients who are non-HeFH.
- Receiving a stable maximally tolerated statin (± ezetimibe) for at least 4 weeks at screening
- For those patients with HeFH who are not receiving a statin at screening, documentation of inability to tolerate at least 2 statins.
- Receiving alirocumab 150 mg SC Q2W, OR evolocumab 140 mg SC Q2W or 420 mg SC Q4W for at least 8 weeks prior to the screening visit
- For those patients with a history of clinical ASCVD, serum LDL-C ≥ 70 mg/dL at screening (1 repeat lab is allowed)
- For those patients without a history of clinical ASCVD, serum LDL-C ≥ 100 mg/dL at screening (1 repeat lab is allowed)
- Provide signed informed consent
Key Exclusion Criteria
- Known history of homozygous FH (clinically, or by previous genotyping)
- Presence of any clinically significant uncontrolled endocrine disease known to influence serum lipids or lipoproteins
- Newly diagnosed diabetes (within 3 months prior to screening)
- Use of thyroid medications (except for replacement therapy which has been stable for at least 12 weeks before screening)
- Laboratory findings during screening period (not including randomization labs):
- Triglycerides > 400 mg/dL (> 4.52 mmol/L) for patients without a known history of diabetes mellitus; OR Triglycerides > 300 mg/dL (> 3.39 mmol/L) for patients with a known history of diabetes mellitus
- Positive test for Hepatitis B surface antigen and/or Hepatitis C antibody (associated with a positive HCV ribonucleic acid [RNA] polymerase chain reaction)
- Positive serum beta-human chorionic gonadotropin or urine pregnancy test in women of childbearing potential
- Estimated glomerular filtration rate 1.5 x ULN
- Alanine aminotransferase (ALT) or aspartate aminotransferase (AST) > 2 x ULN
- Systolic blood pressure > 160 mmHg or diastolic blood pressure > 100 mmHg at screening visit or time of randomization
- History of heart failure (New York Heart Association [NYHA] Class III-IV) within 12 months before screening
- History of MI, unstable angina leading to hospitalization, CABG surgery, PCI, uncontrolled cardiac arrhythmia, carotid surgery or stenting, stroke, TIA, carotid revascularization, endovascular procedure or surgical intervention for peripheral vascular disease within 3 months prior screening
- History of cancer within the past 5 years (except for adequately treated basal cell skin cancer, squamous cell skin cancer, or in situ cervical cancer)
- Having received LDL apheresis within 2 months before screening
- Pregnant or breast-feeding women
- Women of childbearing potential who are unwilling to practice a highly effective birth control method
- Men who are sexually active with women of childbearing potential (WOCBP) and are unwilling to consistently use condoms during the study drug treatment period regardless of vasectomy status.
Data sourced from ClinicalTrials.gov (NCT03175367). 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.