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Phase 2 N=16 Randomized Quadruple-blind Treatment

Study of REGN4461, a Leptin Receptor Agonist Antibody, in Patients With Generalized Lipodystrophy

Generalized Lipodystrophy

Enrolled (actual)
16
Serious AEs
12.2%
Results posted
Feb 2025
Primary outcome: Primary: Absolute Change From Baseline in Participants With Elevated Baseline Hemoglobin A1c (HbA1c ≥7%) at Week 8 — -0.1; 0.2 millimoles per mole (mmol/mol)

Study Design & Population

Study type
Interventional
Phase
Phase 2
Interventions
Placebo (Drug); Low-Dose REGN4461 (Drug); High-dose REGN4461 (Drug)
Age
Pediatric, Adult, Older Adult · 12+ yrs
Sex
All
Sponsor
Regeneron Pharmaceuticals
Primary completion
Jan 2022

Outcome Measures

OutcomeResultp-value
PRIMARY
Absolute Change From Baseline in Participants With Elevated Baseline Hemoglobin A1c (HbA1c ≥7%) at Week 8
-0.1; 0.2
PRIMARY
Absolute Change From Baseline in Fasting Glucose at Week 8
15.5; 53.6
PRIMARY
Absolute Change From Baseline in Weighted Mean Glucose (WMG) at Week 8
-3.7; -3.7
PRIMARY
Percent Change From Baseline in Fasting Triglycerides (TG) at Week 8
-6.0; 11.8
SECONDARY
Absolute Change From Baseline in HbA1c and Fasting TG Composite Endpoint at Week 8
0.0; 0.1
SECONDARY
Absolute Change From Baseline in Fasting Glucose
-29.4; -22.0; -68.8; -21.1; -47.6; 12.5
SECONDARY
Absolute Change From Baseline in Fasting Glucose for Participants With Baseline HbA1c ≥7%
-29.4; -26.3; -68.8; -24.5; -47.6; 13.1
SECONDARY
Percent Change From Baseline in Fasting TG
-22.5; -50.2; -55.1; -45.7; -40.2; -43.9
SECONDARY
Percent Change From Baseline in Fasting TG for Participants With Baseline Fasting TG ≥250 mg/dL
-39.4; -45.4; -62.8; -42.4; -48.6; -44.0
SECONDARY
Absolute Change From Baseline in HbA1c
-0.60; -0.50; -2.34; -0.85; -2.56; -0.83
SECONDARY
Absolute Change From Baseline in HbA1c for Participants With Baseline HbA1c ≥7%
-0.60; -0.36; -2.34; -0.77; -2.56; -0.74
SECONDARY
Absolute Change From Baseline in Weighted Mean Glucose (WMG)
-10.626; -7.579; -73.634; -49.107
SECONDARY
Absolute Change From Baseline in WMG for Participants With Baseline Fasting HbA1c ≥7%
-10.626; -4.510; -73.634; -53.797
SECONDARY
Change From Baseline in Glucose Area Under the Concentration-time Curve (AUC0-4) During a Mixed Meal Tolerance Test (MMTT)
829.3; 1479.3; -5300.7; 3734.1; -18000.6; -5777.7
SECONDARY
Change From Baseline in Glucose AUC0-4 During a MMTT for Participants With Baseline HbA1c ≥7%
829.3; 3098.2; -5300.7; 5976.4; -18000.6; -5828.2
SECONDARY
Change From Baseline in Glucose Infusion Rate Per Kilogram (kg) Body Mass During Hyperinsulinemia-euglycemic Clamp
0.030; 4.789; 6.256; 4.776
SECONDARY
Change From Baseline in Glucose Infusion Rate Per kg Body Mass During Hyperinsulinemia-euglycemic Clamp for Participants With Baseline HbA1c ≥7%
0.030; 0.572; 6.256; 3.740
SECONDARY
Change From Baseline in Glucose Clearance Rate (kITT) During Insulin-tolerance Test (ITT)
0.021; 2.230; 2.311; 0.632
SECONDARY
Change From Baseline in Glucose kITT During ITT for Participants With Baseline HbA1c ≥7%
0.021; 2.230; 2.311; 0.632
SECONDARY
Number of Participants With at Least One Treatment-emergent Adverse Event (TEAE)
7; 8; 8; 7; 1; 6
SECONDARY
Concentrations of Total REGN4461 in Serum Over Time
0; 49.2; 45.8; 2.51; 2.34; 50.6
SECONDARY
Number of Participants With Anti-drug Antibodies (ADA) to REGN4461
0; 0

Summary

The primary objectives of the study are to estimate the effects of REGN4461 on glycemic parameters in the subset of patients with elevated baseline hemoglobin A1c levels (HbA1c ≥7%) and to estimate the effects of REGN4461 on fasting triglyceride levels in the subset of patients with elevated baseline fasting triglycerides (TG ≥250 mg/dL). The secondary objectives are to estimate the effects of REGN4461 on a composite endpoint of changes in either HbA1c or fasting TG for all patients, estimate the effects of 3 dose levels of REGN4461 on glycemic parameters and fasting TG, to estimate the effects of REGN4461 on insulin sensitivity, to evaluate the safety and tolerability of REGN4461 and to evaluate the pharmacokinetics (PK) and immunogenicity of REGN4461.

Eligibility Criteria

Key Inclusion Criteria

  • Diagnosis of congenital or acquired generalized lipodystrophy (GLD), as defined in the protocol
  • Presence of one or both of the following metabolic abnormalities at screening:
  • HbA1c ≥ 7% OR
  • Fasting TG ≥250 mg/dL
  • Generally stable diet (based on patient's recall) and medication regimen (that optimizes treatment for their metabolic disease) for at least 3 months prior to the screening visit

Key Exclusion Criteria

  • Treatment with metreleptin within 1 month of the screening visit
  • Treatment with over-the-counter or prescription medications for weight loss within 3 months prior to the screening visit
  • Treatment with oral glucocorticoids >7.5 mg prednisone equivalents per day within 3 months prior to screening visit or plans to begin treatment with oral glucocorticoids >7.5 mg prednisone equivalents per day during the study period
  • History of Human Immunodeficiency Virus (HIV) or HIV seropositivity at screening visit
  • Uncontrolled infection with hepatitis B or hepatitis C infection, or known active tuberculosis at screening
  • Participation in any clinical research study evaluating an Investigational product (IP) or therapy within 3 months and less than 5 half-lives of IP prior to the screening visit.
  • Pregnant or breast-feeding women

NOTE: Other protocol defined inclusion/exclusion criteria apply.

View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT04159415). 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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