Phase 3
N=56
A Study of Inclisiran in Participants With Homozygous Familial Hypercholesterolemia (HoFH)
Homozygous Familial Hypercholesterolemia
Bottom Line
View on ClinicalTrials.gov: NCT03851705 ↗Enrolled (actual)
56
Serious AEs
10.3%
Results posted
Nov 2022
Primary outcome: Primary: Percent Change in Low-Density Lipoprotein Cholesterol (LDL-C) From Baseline to Day 150 — 2.39; 0.70 Percentage change — p=0.9047
Study Design & Population
- Study type
- Interventional
- Phase
- Phase 3
- Interventions
- Inclisiran Sodium for injection (Drug); Placebo (Drug); Placebos (Drug)
- Age
- Adult, Older Adult · 18+ yrs
- Sex
- All
- Sponsor
- Novartis Pharmaceuticals
- Primary completion
- Mar 2020
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Percent Change in Low-Density Lipoprotein Cholesterol (LDL-C) From Baseline to Day 150 |
2.39; 0.70 | 0.9047 |
| SECONDARY Absolute Change in Low-Density Lipoprotein Cholesterol (LDL-C) From Baseline to Day 150 |
-8.82; -2.35 | 0.8685 |
| SECONDARY Percent Change in Low-Density Lipoprotein Cholesterol (LDL-C) From Baseline to Subsequent Visits up to Day 180 |
3.3; -8.7; -2.9; 1.8; -1.5; -7.2 | 0.2347 |
| SECONDARY Percent Change in Low-Density Lipoprotein Cholesterol (LDL-C) From Baseline to Subsequent Visits up to Day 720 |
-10.1; -9.1; -14.4; -4.8; -6.7; -4.7 | — |
| SECONDARY Absolute Change in Low-Density Lipoprotein Cholesterol (LDL-C) From Baseline to Subsequent Visits up to Day 180 |
3.6; -16.3; -17.2; 0.5; -7.0; -14.5 | 0.4589 |
| SECONDARY Absolute Change in Low-Density Lipoprotein Cholesterol (LDL-C) From Baseline to Subsequent Visits up to Day 720 |
-27.3; -17.5; -37.2; -17.9; -12.3; -19.8 | — |
| SECONDARY Percent Change in Proprotein Convertase Subtilisin/Kexin Type 9 (PCSK9) From Baseline to Subsequent Visits up to Day 180 |
9.1; -53.5; 4.1; -56.5; 39.2; -53.1 | <.0001 sig |
| SECONDARY Percent Change in Proprotein Convertase Subtilisin/Kexin Type 9 (PCSK9) From Baseline to Subsequent Visits up to Day 720 |
-21.5; -14.4; -42.6; -57.0; -35.8; -51.1 | — |
| SECONDARY Absolute Change in Proprotein Convertase Subtilisin/Kexin Type 9 (PCSK9) From Baseline to Subsequent Visits up to Day 180 |
-25.8; -342.5; -30.7; -335.2; 88.8; -301.5 | <.0001 sig |
| SECONDARY Absolute Change in Proprotein Convertase Subtilisin/Kexin Type 9 (PCSK9) From Baseline to Subsequent Visits up to Day 720 |
-174.7; -234.4; -232.1; -392.0; -237.5; -387.6 | — |
| SECONDARY Percent Change in Total Cholesterol From Baseline to Subsequent Visits up to Day 180 |
2.0; -5.9; -1.5; 1.2; -1.4; -4.9 | 0.3299 |
| SECONDARY Absolute Change in Total Cholesterol From Baseline to Subsequent Visits up to Day 180 |
3.9; -15.1; -10.5; 0.6; -6.8; -12.6 | 0.4911 |
| SECONDARY Percent Change in Total Cholesterol From Baseline to Subsequent Visits up to Day 720 |
-7.4; -4.8; -10.9; -1.0; -4.2; -2.2 | — |
| SECONDARY Absolute Change in Total Cholesterol From Baseline to Subsequent Visits up to Day 720 |
-24.9; -13.3; -35.6; -13.0; -7.9; -14.4 | — |
| SECONDARY Percent Change in Apolipoprotein B (apoB) From Baseline to Subsequent Visits up to Day 180 |
6.3; -6.4; 2.8; -0.7; 4.5; -5.8 | 0.1371 |
| SECONDARY Percent Change in Apolipoprotein B (apoB) From Baseline to Subsequent Visits up to Day 720 |
-0.6; -3.3; -7.9; -3.6; -1.3; -3.5 | — |
| SECONDARY Absolute Change in Apolipoprotein B (apoB) From Baseline to Subsequent Visits up to Day 180 |
10.0; -9.4; 3.3; -1.4; 8.4; -7.4 | 0.2044 |
| SECONDARY Absolute Change in Apolipoprotein B (Apo B) From Baseline to Subsequent Visits up to Day 720 |
-1.3; -1.9; -11.5; -7.3; 3.0; -6.9 | — |
| SECONDARY Percent Change in Non-HDL Cholesterol (Non-HDL-C) From Baseline to Subsequent Visits up to Day 180 |
2.9; -7.2; -1.7; 1.3; -1.1; -6.2 | 0.2877 |
| SECONDARY Percent Change in Non-HDL Cholesterol (Non-HDL-C) From Baseline to Subsequent Visits up to Day 720 |
-8.4; -7.6; -13.1; -2.3; -5.5; -3.1 | — |
| SECONDARY Absolute Change in Non-HDL Cholesterol (Non-HDL-C) From Baseline to Subsequent Visits up to Day 180 |
3.8; -15.3; -11.6; 0.6; -5.7; -12.7 | 0.4848 |
| SECONDARY Absolute Change in Non-HDL Cholesterol (Non-HDL-C) From Baseline to Subsequent Visits up to Day 720 |
-24.7; -17.1; -37.2; -13.9; -8.8; -15.8 | — |
| SECONDARY Individual Responsiveness of Subjects: Part 1 |
0; 0; 1; 0; 1; 2 | — |
| SECONDARY Individual Responsiveness of Subjects: Part 2 |
0; 0; 1; 0; 2; 1 | — |
| SECONDARY Proportional Responsiveness: Part 1 |
1; 3; 0; 3 | — |
| SECONDARY Proportional Responsiveness of Subjects: Part 2 |
2; 2; 0; 4; 0; 1 | — |
| SECONDARY LDL-C Reduction ≥20% or ≥30% From Baseline: Part 1 |
4; 14; 3; 9; 3; 12 | — |
| SECONDARY LDL-C Reduction ≥20% or ≥30% From Baseline: Part 2 |
5; 13; 6; 11; 8; 11 | — |
| SECONDARY Percent Change in High-Density Lipoprotein Cholesterol Levels (HDL-C) From Baseline to Subsequent Visits up to Day 180 |
-1.1; 1.4; 2.3; 3.6; -1.9; 1.5 | 0.6028 |
| SECONDARY Percent Change in High-Density Lipoprotein Cholesterol Levels (HDL-C) From Baseline to Subsequent Visits up to Day 720 |
3.2; 4.3; 1.6; 4.8; 2.9; 7.9 | — |
| SECONDARY Absolute Change in High-Density Lipoprotein Cholesterol Levels (HDL-C) From Baseline to Subsequent Visits up to Day 180 |
-0.0; 0.2; 1.0; -0.0; -1.2; 0.0 | 0.9237 |
| SECONDARY Absolute Change in High-Density Lipoprotein Cholesterol Levels (HDL-C) From Baseline to Subsequent Visits up to Day 720 |
1.6; 0.9; 0.9; 1.4; 1.5; 2.5 | — |
| SECONDARY Absolute Change in Very-Low-Density Lipoprotein Cholesterol (VLDL-C) From Baseline to Subsequent Visits up to Day 180 |
0.6; 1.6; 3.0; 0.4; 1.8; 1.5 | 0.6497 |
| SECONDARY Absolute Change in Very-Low-Density-Lipoprotein Cholesterol Levels (VLDL-C) From Baseline to Subsequent Visits up to Day 720 |
0.0; 2.7; 1.1; 4.4; -0.9; -0.2 | — |
| SECONDARY Percent Change in Very-Low-Density Lipoprotein Cholesterol (VLDL-C) From Baseline to Subsequent Visits up to Day 180 |
0.6; 11.9; 16.3; 4.9; 10.0; 12.3 | 0.3105 |
| SECONDARY Percent Change in Very-Low-Density-Lipoprotein Cholesterol Levels (VLDL-C) From Baseline to Subsequent Visits up to Day 720 |
6.8; 20.8; 7.1; 23.9; 2.1; 7.1 | — |
| SECONDARY Absolute Change in Apolipoprotein A-1 (Apo-A1) mg/dL From Baseline to Subsequent Visits up to Day 180 |
2.6; 0.6; 4.0; -1.4; 1.4; -1.3 | 0.6848 |
| SECONDARY Absolute Change Apolipoprotein A-1 (Apo-A1) From Baseline to Subsequent Visits up to Day 720 |
0.9; 1.2; 4.9; 4.7; 6.7; 7.8 | — |
| SECONDARY Percent Change in Apolipoprotein A-1 (Apo-A1) From Baseline to Subsequent Visits up to Day 180 |
1.6; 0.6; 3.0; 0.4; 1.6; -1.0 | 0.7958 |
| SECONDARY Percent Change Apolipoprotein A-1 (Apo-A1) From Baseline to Subsequent Visits up to Day 720 |
0.4; 1.3; 4.4; 3.9; 6.2; 6.8 | — |
| SECONDARY Percent Change in Lipoprotein(a) [Lp(a)] From Baseline to Subsequent Visits up to Day 180 |
4.3; -4.6; 15.2; -3.8; 4.9; -4.8 | 0.1716 |
| SECONDARY Percent Change in Lipoprotein(a) [Lp(a)] From Baseline to Subsequent Visits up to Day 720 |
2.5; -1.4; 3.4; 0.2; 8.3; 13.4 | — |
| SECONDARY Absolute Change in Lipoprotein(a) [Lp(a)] From Baseline to Subsequent Visits up to Day 180 |
5.8; -3.8; 3.9; -5.6; 1.2; -5.1 | 0.3077 |
| SECONDARY Absolute Change in Lipoprotein(a) [Lp(a)] From Baseline to Subsequent Visits up to Day 720 |
-3.1; -5.2; -3.8; 3.1; 14.5; 18.4 | — |
| SECONDARY Percent Change in High-Sensitivity C-Reactive Protein (hsCRP) From Baseline to Subsequent Visits up to Day 180: Part 1 |
41.2; 42.0; 230.8; 126.9; 115.1; 45.2 | — |
| SECONDARY Percent Change in High-Sensitivity C-Reactive Protein (hsCRP) From Baseline to Subsequent Visits up to Day 720: Part 2 |
178.9; 17.3; 266.7; 64.7; 29.0; 37.5 | — |
| SECONDARY Absolute Change in High-Sensitivity C-Reactive Protein (hsCRP) From Baseline to Subsequent Visits up to Day 180: Part 1 |
-3.2; 0.7; 0.5; 1.1; -3.8; 0.2 | — |
| SECONDARY Absolute Change in High-Sensitivity C-Reactive Protein (hsCRP) From Baseline to Subsequent Visits up to Day 720: Part 2 |
-4.0; -0.4; -3.4; 0.9; -4.7; 0.7 | — |
| SECONDARY Percent Change in Apo-B From Baseline to Day 150 |
3.55; -0.75 | 0.6814 |
| SECONDARY Percent Change in Non-HDL-C From Baseline to Day 150 |
2.46; 0.37 | 0.8725 |
| SECONDARY Percent Change in Total Cholesterol From Baseline to Day 150 |
1.51; 0.71 | 0.9425 |
| SECONDARY Proportion of Subjects With ≥30% LDL-C Reduction of From Baseline at Day 150 |
3; 6 | — |
Summary
This study was a Phase III,A two-part (double-blind placebo-controlled/open-label) multicenter study to evaluate safety, tolerability, and efficacy of inclisiran in subjects with homozygous familial hypercholesterolemia (HoFH).
Eligibility Criteria
Inclusion Criteria
- Diagnosis of HoFH by genetic confirmation or a clinical diagnosis based on a history of an untreated LDL-C concentration >500 mg/dL (13 mmol/L) together with either xanthoma before 10 years of age or evidence of heterozygous familial hypercholesterolemia in both parents
- Stable on a low-fat diet.
- Subjects on statins should be receiving a maximally tolerated dose. Maximum tolerated dose is defined as the maximum dose of statin that can be taken on a regular basis without intolerable adverse events.
- Subjects not receiving statins must have documented evidence of intolerance to at least two different statins.
- Subjects on lipid-lower therapies (such as statin and/or ezetimibe) should be on a stable dose for ≥30 days before screening with no planned medication or dose change during study participation.
- Fasting central laboratory LDL-C concentration ≥130 mg/dL (3.4 mmol/L).
- Triglyceride concentration 180 mmHg or diastolic blood pressure >110 mmHg prior to randomization despite anti-hypertensive therapy
- Active liver disease defined as any known current infectious, neoplastic, or metabolic pathology of the liver or unexplained alanine aminotransferase (ALT), aspartate aminotransferase (AST), elevation >3x ULN, or total bilirubin >2x upper limit of normal (ULN) at screening confirmed by a repeat measurement at least 1 week apart
- Severe concomitant noncardiovascular disease that carries the risk of reducing life expectancy to less than the duration of the trial
- History of malignancy that required surgery (excluding local and wide-local excision), radiation therapy and/or commencement of systemic therapy as treatment during the 3 years prior to randomization
- Females who are pregnant or nursing, or who are of childbearing potential and unwilling to use at least one acceptable effective method of contraception (eg, oral contraceptives, barrier methods, approved contraceptive implant, long- term injectable contraception, intrauterine device) for the entire duration of the study. Exemptions from this criterion:
- Women >2 years postmenopausal (defined as 1 year or longer since their last menstrual period) AND more than 55 years of age
- Postmenopausal women (as defined above) and less than 55 years of age with a negative pregnancy test within 24 hours of enrolment
- Women who are surgically sterilized at least 3 months prior to enrolment
- Known history of alcohol and/or drug abuse within 5 years
- Any condition that according to the investigator could interfere with the conduct of the study, such as but not limited to:
- Subjects who are unable to communicate or to cooperate with the investigator.
- Unable to understand the protocol requirements, instructions and study-related restrictions, the nature, scope, and possible consequences of the study (including subjects whose cooperation is doubtful due to drug abuse or alcohol dependency)
- Unlikely to comply with the protocol requirements, instructions, and study-related restrictions (eg, uncooperative attitude, inability to return for follow-up visits, and improbability of completing the study)
- Have any medical or surgical condition, which in the opinion of the investigator would put the subject at increased risk from participating in the study
- Persons directly involved in the conduct of the study
- Any uncontrolled or serious disease, or any medical or surgical condition, that may either interfere with participation in the clinical study, and/or put the subject at significant risk (according to investigator's [or delegate] judgment) if he/she participates in the clinical study
- Any underlying known disease, or surgical, physical, or medical condition that, in the opinion of the Investigator, might interfere with the interpretation of clinical study results
- Treatment with other investigational medicinal products or devices within 30 days or 5 half-lives of the screening visit, whichever is longer
- Previous p
Data sourced from ClinicalTrials.gov (NCT03851705). 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.