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Phase 3 Completed N=94 Randomized Quadruple-blind Treatment

ENVISION: A Study to Evaluate the Efficacy and Safety of Givosiran (ALN-AS1) in Patients With Acute Hepatic Porphyrias (AHP)

Acute Hepatic Porphyria · Acute Intermittent Porphyria · Porphyria, Acute Intermittent · Acute Porphyria
Source: ClinicalTrials.gov NCT03338816 ↗
Enrolled (actual)
94
Serious AEs
31.2%
Results posted
Feb 2020
Primary outcomePrimary: Annualized Rate of Porphyria Attacks in Participants With Acute Intermittent Porphyria (AIP) — 12.52; 3.22 annualized attack rate — p=<0.0001
◆ Published Evidence
Highly cited
592citations · ~99 / year
Phase 3 Trial of RNAi Therapeutic Givosiran for Acute Intermittent Porphyria.
The New England journal of medicine · 2020 · Open access · Likely link

Summary

The purpose of this study is to evaluate the effect of subcutaneous givosiran (ALN-AS1), compared to placebo, on the rate of porphyria attacks in patients with Acute Hepatic Porphyrias (AHP).

Linked Publications (5)

  • Phase 3 Trial of RNAi Therapeutic Givosiran for Acute Intermittent Porphyria.
    The New England journal of medicine · 2020 · 592 citations · Open access · Likely link
  • Efficacy and safety of givosiran for acute hepatic porphyria: Final results of the randomized phase III ENVISION trial.
    Journal of hepatology · 2023 · 48 citations · Open access · Likely link
  • Disease burden in patients with acute hepatic porphyria: experience from the phase 3 ENVISION study.
    Orphanet journal of rare diseases · 2022 · 28 citations · Open access · Likely link
  • A randomized, placebo-controlled study of givosiran in patients with acute hepatic porphyrias (ENVISION): Final (36-month) analysis of the Taiwan Cohort.
    Journal of the Formosan Medical Association = Taiwan yi zhi · 2024 · 4 citations · Open access · Likely link
  • Platform Assessment of Concentration-QTc Relationship Across GalNAc-siRNA Molecules.
    Clinical pharmacokinetics · 2026 · 0 citations · Open access · Likely link

Outcome Measures

OutcomeResultp-value
PRIMARY
Annualized Rate of Porphyria Attacks in Participants With Acute Intermittent Porphyria (AIP)
12.52; 3.22 <0.0001 sig
SECONDARY
The Pharmacodynamic (PD) Effect of Givosiran on Urine Levels of Delta-aminolevulinic Acid (ALA) in Participants With AIP
19.965; 1.756; 23.150; 4.013
SECONDARY
The PD Effect of Givosiran on Urine Levels of Porphobilinogen (PBG) in Participants With AIP
49.110; 12.906
SECONDARY
Annualized Rate of Hemin Administration in Participants With AIP
29.71; 6.77
SECONDARY
Annualized Rate of Porphyria Attacks in Participants With AHP
12.26; 3.35
SECONDARY
Area Under the Curve (AUC) of the Change From Baseline in Weekly Mean Score of Daily Worst Pain as Measured by the Brief Pain Inventory-Short Form (BPI-SF) Numeric Rating Scale (NRS) in Participants With AIP
5.286; -11.514
SECONDARY
Average Change From Baseline in Weekly Mean Score of Daily Worst Pain as Measured by the Brief Pain Inventory-Short Form (BPI-SF) Numeric Rating Scale (NRS) in Participants With AIP
0.245; -0.506
SECONDARY
AUC of the Change From Baseline in Weekly Mean Score of Daily Worst Fatigue Score as Measured by the Brief Fatigue Inventory-Short Form (BFI-SF) NRS in Participants With AIP
-4.208; -11.148
SECONDARY
Average Change From Baseline in Weekly Mean Score of Daily Worst Fatigue Score as Measured by the Brief Fatigue Inventory-Short Form (BFI-SF) NRS in Participants With AIP
-0.182; -0.502
SECONDARY
AUC of the Change From Baseline in Weekly Mean Score Daily Worst Nausea Score as Measured by NRS in Participants With AIP
-4.011; 1.481
SECONDARY
Average Change From Baseline in Weekly Mean Score Daily Worst Nausea Score as Measured by NRS in Participants With AIP
-0.181; 0.067
SECONDARY
Change From Baseline in the Physical Component Summary (PCS) of the 12-Item Short Form Survey (SF-12) in Participants With AIP
1.431; 5.369

Eligibility Criteria

Inclusion Criteria

  • ≥ 12 years of age
  • Diagnosed with Acute Hepatic Porphyria (Acute Intermittent Porphyria, Hereditary Corproporhyria, Variegate Porphyria, aminolevulinic acid (ALA) dehydratase deficient porphyria)
  • Elevated urinary or plasma porphobilinogen (PBG) or ALA values within the past year,
  • Have active disease, with at least 2 documented porphyria attacks within the last 6 months
  • Willing to discontinue or not initiate the use of prophylactic hemin throughout the study.
  • Women of child bearing potential must have a negative serum pregnancy test, not be nursing, and use acceptable contraception

Exclusion Criteria

  • Clinically significant abnormal laboratory results
  • Anticipated liver transplantation
  • History of multiple drug allergies or intolerance to subcutaneous injections
  • Active HIV, hepatitis C virus, or hepatitis B virus infection(s)
  • History of recurrent pancreatitis
View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT03338816) and the linked publication. 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. Informational only — not medical advice.

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