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Phase 2 N=52 Randomized Quadruple-blind Treatment

Safety and Efficacy Following Repeat-Dose of Evinacumab (Anti-ANGPTL3) in Patients With Severe Hypertriglyceridemia (sHTG) at Risk for Acute Pancreatitis

Severe Hypertriglyceridemia (sHTG)

Enrolled (actual)
52
Serious AEs
22.5%
Results posted
Feb 2023
Primary outcome: Primary: Percent Change From Baseline in Fasting Triglycerides (TG) Level Following 12 Weeks of Repeated IV Doses of Evinacumab in Actual Cohort 3 Participants — 19.2; -37.2 Percent Change

Study Design & Population

Study type
Interventional
Phase
Phase 2
Interventions
evinacumab (Drug); Placebo (Drug)
Age
Adult, Older Adult · 18+ yrs
Sex
All
Sponsor
Regeneron Pharmaceuticals
Primary completion
Dec 2019

Outcome Measures

OutcomeResultp-value
PRIMARY
Percent Change From Baseline in Fasting Triglycerides (TG) Level Following 12 Weeks of Repeated IV Doses of Evinacumab in Actual Cohort 3 Participants
19.2; -37.2
SECONDARY
Percent Change From Baseline in Fasting TG Level Following 2 to 24 Weeks of Repeated IV Doses of Evinacumab Overall Group
1.99; -51.38; -3.52; -43.70; 92.56; -52.69
SECONDARY
Percent Change From Baseline in Fasting TG Level Following 2 to 24 Weeks of Repeated IV Doses of Evinacumab in Actual Cohorts 1, 2, and 3
-28.3; -77.5; -74.4; -19.0; -48.0; -70.3
SECONDARY
Change From Baseline in Total Score of Participants Reported Abdominal and Gastrointestinal (GI) Symptoms Using Hypertriglyceridemia and Acute Pancreatitis Symptom Scale (HAP-SS)
-0.69; -0.74; -0.12
SECONDARY
Change From Baseline in Total Score of Participants Reported Dietary Behavior Questionnaire (HAP-DB)
-2.267; 2.021; -1.255
SECONDARY
DBTP: Change From Baseline in Degree of Pancreatic Injury/Inflammation Through 18F-2-Fluoro-2-Deoxy-D Glucose Positron Emission Tomography (18F-FDG-PET) Imaging Following 12 Weeks of Treatment With Evinacumab Assessed by 18F-FDG SUVmax and SUVmean
2.318; 2.738; 0.576; 0.185; 1.212; 1.478
SECONDARY
DBTP: Change From Baseline in Degree of Pancreatic Injury/Inflammation Through Diffusion Weighted-Magnetic Resonance Imaging (DW-MRI) Following 12 Weeks of Treatment With Evinacumab Assessed by Apparent Diffusion Coefficient (ADC)
0.00144; 0.00154; -0.00007; 0.00001
SECONDARY
SBTP: Change From Baseline to Degree of Pancreatic Injury/Inflammation Through DW-MRI Following 24 Weeks of Treatment With Evinacumab as Assessed by ADC
-0.00001
SECONDARY
Total Evinacumab Concentration in Serum
NA; NA; 24.3; 561; NA; 73.6
SECONDARY
Total Angiopoietin-like (ANGPTL3) Concentration in Serum
0.0929; 0.105; 0.0950; 0.258; 0.111; 0.265
SECONDARY
Number of Participants With Antidrug Antibodies (ADA)
14; 29; 1; 4; 0; 0
SECONDARY
DBTP: Number of Participants With Treatment-emergent Adverse Events (TEAEs) and Serious TEAEs
11; 25; 3; 4
SECONDARY
SBTP: Number of Participants With TEAEs and Serious TEAEs
38; 15
SECONDARY
Number of Participants With Liver Function Laboratory Abnormalities in Alanine Aminotransferase (ALT), Aspartate Aminotransferase (AST), Alkaline Phosphatase (ALP), and Total Bilirubin
0; 1; 0; 0; 2; 0

Summary

The primary objective is to determine the change in Triglyceride (TG) levels following 12 weeks of repeated Intravenous (IV) doses of evinacumab.

Eligibility Criteria

Key Inclusion Criteria

  • Previous documentation in the patient's medical records of a fasting serum TG measurement ≥ 1000 mg/dL (11.3 mmol/L) on more than 1 occasion, and all fasting TG values ≥500 mg/dL (5.6 mmol/L) at screening
  • History of a hospitalization and diagnosis of acute pancreatitis in the past 10 years
  • On stable lipid-modifying diet with or without medications (eg, statins, niacin, omega-3 fatty acids). Lipid-modifying diet and doses of medications should be stable for at least 4 weeks (6 weeks for fibrates, 8 weeks for PCSK9 inhibitors) prior to screening
  • Body mass index (BMI) of 18-40 kg/m2

Key Exclusion Criteria

  • A hospital or clinic discharge diagnosis of acute pancreatitis within 12 weeks of screening
  • Lipid apheresis or plasma exchange treatment within the last 4 weeks or plans to undergo apheresis or plasma exchange during the time frame of the study
  • History of class 3/4 heart failure at any time in the past, or hospitalization for heart failure, diagnosis of a myocardial infarction, stroke, Transient ischemic attack (TIA), unstable angina, Coronary artery bypass surgery (CABG), Percutaneous coronary intervention (PCI), carotid surgery/stenting within 3 months before the screening visit
  • History of bleeding disorders, esophageal varices, heparin induced thrombocytopenia, or contraindications to receiving heparin (eg, allergic reaction to heparin)
  • Previous treatment with Glybera® in the past 5 years or treatment with lomitapide or mipomersen in the past 6 months
  • Pregnant or breast feeding women

Note: Other protocol defined Inclusion/Exclusion criteria may apply

View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT03452228). 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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