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Efficacy and Safety of Alirocumab (SAR236553/REGN727) Versus Placebo on Top of Lipid-Modifying Therapy in Patients With High Cardiovascular Risk and Hypercholesterolemia (ODYSSEY COMBO I)

Phase 3
Completed
Conditions
Hypercholesterolemia
Interventions
Drug: Placebo (for alirocumab)
Drug: Lipid-Modifying Therapy (LMT)
Registration Number
NCT01644175
Lead Sponsor
Sanofi
Brief Summary

Alirocumab (SAR236553/REGN727) is a fully human monoclonal antibody that binds proprotein convertase subtilisin/kexin type 9 (PCSK9).

Primary Objective of the study:

* To demonstrate the reduction of low-density lipoprotein cholesterol (LDL-C) by alirocumab as add-on therapy to stable maximally tolerated daily statin therapy with or without other lipid-modifying therapy (LMT) in comparison with placebo after 24 weeks of treatment in high cardiovascular (CV) risk participants with hypercholesterolemia

Secondary Objectives:

* To evaluate the effect of alirocumab in comparison with placebo on LDL-C at other time points

* To evaluate the effect of alirocumab on other lipid parameters

* To evaluate the safety and tolerability of alirocumab

Detailed Description

The maximum study duration was 62 weeks per participant, including a 2-week screening period, 52-week randomized treatment period, and 8-week follow-up period.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
316
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Placebo Q2WPlacebo (for alirocumab)Placebo (for alirocumab) every 2 weeks (Q2W) added to stable Lipid-Modifying Therapy (LMT) for 52 weeks.
Placebo Q2WLipid-Modifying Therapy (LMT)Placebo (for alirocumab) every 2 weeks (Q2W) added to stable Lipid-Modifying Therapy (LMT) for 52 weeks.
AlirocumabAlirocumabAlirocumab 75 mg Q2W added to stable LMT for 52 weeks. Alirocumab dose up-titrated to 150 mg from Week 12 when LDL-C levels ≥70 mg/dL (1.81 mmol/L) at Week 8.
AlirocumabLipid-Modifying Therapy (LMT)Alirocumab 75 mg Q2W added to stable LMT for 52 weeks. Alirocumab dose up-titrated to 150 mg from Week 12 when LDL-C levels ≥70 mg/dL (1.81 mmol/L) at Week 8.
Primary Outcome Measures
NameTimeMethod
Percent Change From Baseline in Calculated LDL-C at Week 24 - Intent-to-Treat (ITT) AnalysisFrom Baseline to Week 52

Adjusted Least-squares (LS) means and standard errors at Week 24 were obtained from a mixed-effect model with repeated measures (MMRM) to account for missing data. All available post-baseline data from Week 4 to Week 52 regardless of status on- or off-treatment were used in the model (ITT analysis).

Secondary Outcome Measures
NameTimeMethod
Percent Change From Baseline in Calculated LDL-C at Week 24 - On-Treatment AnalysisFrom Baseline to Week 52

Adjusted LS means and standard errors at Week 24 were obtained from MMRM model including available post-baseline on-treatment data from Week 4 to Week 52 (i.e. up to 21 days after last injection) (on-treatment analysis).

Percent Change From Baseline in Calculated LDL-C at Week 12 - ITT AnalysisFrom Baseline to Week 52

Adjusted LS means and standard errors at Week 12 from MMRM model including all available post-baseline data from Week 4 to Week 52 regardless of status on- or off-treatment.

Percent Change From Baseline in Calculated LDL-C at Week 12 - On-Treatment AnalysisFrom Baseline to Week 52

Adjusted LS means and standard errors at Week 12 from MMRM model including available post-baseline on-treatment data from Week 4 to Week 52 (i.e. up to 21 days after last injection).

Percent Change From Baseline in Apolipoprotein (Apo) B at Week 24 - ITT AnalysisFrom baseline to Week 52

Adjusted LS means and standard errors at Week 24 from MMRM model including all available post-baseline data from Week 4 to Week 52 regardless of status on- or off-treatment.

Percent Change From Baseline in Apo B at Week 24 - On-treatment AnalysisFrom Baseline to Week 52

Adjusted LS means and standard errors at Week 24 from MMRM model including available post-baseline on-treatment data from Week 4 to Week 52 (i.e. up to 21 days after last injection).

Percent Change From Baseline in Non-High Density Lipoprotein Cholesterol (Non-HDL-C) at Week 24 - ITT AnalysisFrom Baseline to Week 52

Adjusted LS means and standard errors at Week 24 from MMRM model including all available post-baseline data from Week 4 to Week 52 regardless of status on- or off-treatment.

Percent Change From Baseline in Non-HDL-C at Week 24 - On-treatment AnalysisFrom Baseline to Week 52

Adjusted LS means and standard errors at Week 24 from MMRM model including available post-baseline on-treatment data from Week 4 to Week 52 (i.e. up to 21 days after last injection).

Percent Change From Baseline in Total Cholesterol (Total-C) at Week 24 - ITT AnalysisFrom Baseline to Week 52

Adjusted LS means and standard errors at Week 24 from MMRM model including all available post-baseline data from Week 4 to Week 52 regardless of status on- or off-treatment.

Percent Change From Baseline in Apo B at Week 12 - ITT AnalysisFrom Baseline to Week 52

Adjusted LS means and standard errors at Week 12 from MMRM model including all available post-baseline data from Week 4 to Week 52 regardless of status on- or off-treatment.

Percent Change From Baseline in Non-HDL-C at Week 12 - ITT AnalysisFrom Baseline to Week 52

Adjusted LS means and standard errors at Week 12 from MMRM model including all available post-baseline data from Week 4 to Week 52 regardless of status on- or off-treatment.

Percent Change From Baseline in Total-C at Week 12 - ITT AnalysisFrom Baseline to Week 52

Adjusted LS means and standard errors at Week 12 from MMRM model including all available post-baseline data from Week 4 to Week 52 regardless of status on- or off-treatment.

Percent Change From Baseline in Calculated LDL-C at Week 52 - ITT AnalysisFrom Baseline to Week 52

Adjusted LS means and standard errors at Week 52 from MMRM model including all available post-baseline data from Week 4 to Week 52 regardless of status on- or off-treatment.

Percentage of Participants Reaching Calculated LDL-C <70 mg/dL (1.81 mmol/L) at Week 24 - ITT AnalysisUp to Week 52

Adjusted percentages at Week 24 were obtained from multiple imputation approach model for handling of missing data. All available post-baseline data from Week 4 to Week 52 regardless of status on- or off-treatment were included in the imputation model.

Percentage of Participants Reaching Calculated LDL-C <70 mg/dL (1.81 mmol/L) at Week 24 - On-treatment AnalysisUp to Week 52

Adjusted percentages at Week 24 from multiple imputation approach model including available post-baseline on-treatment data from Week 4 to Week 52 i.e. up to 21 days after last injection.

Percent Change From Baseline in Lipoprotein(a) at Week 24 - ITT AnalysisFrom baseline to Week 52

Adjusted means and standard errors at Week 24 were obtained from multiple imputation approach followed by robust regression model for handling of missing data. All available post-baseline data from Week 4 to Week 52 regardless of status on- or off-treatment were included in the imputation model.

Percent Change From Baseline in HDL-C at Week 24 - ITT AnalysisFrom Baseline to Week 52

Adjusted LS means and standard errors at Week 24 from MMRM model including all available post-baseline data from Week 4 to Week 52 regardless of status on- or off-treatment.

Percent Change From Baseline in Fasting Triglycerides at Week 24 - ITT AnalysisFrom Baseline to Week 52

Adjusted means and standard errors at Week 24 from multiple imputation approach followed be robust regression model including all available post-baseline data from Week 4 to Week 52 regardless of status on- or off-treatment.

Percent Change From Baseline in Apolipoprotein A-1 at Week 24 - ITT AnalysisFrom Baseline to Week 52

Adjusted LS means and standard errors at Week 24 from MMRM model including all available post-baseline data from Week 4 to Week 52 regardless of status on- or off-treatment.

Percent Change From Baseline in Lipoprotein(a) at Week 12- ITT AnalysisFrom Baseline to Week 52

Adjusted means and standard errors at Week 12 from multiple imputation approach followed by robust regression model including all available post-baseline data from Week 4 to Week 52 regardless of status on- or off-treatment.

Percent Change From Baseline in HDL-C at Week 12 - ITT AnalysisFrom Baseline to Week 52

Adjusted LS means and standard errors at Week 12 from MMRM model including all available post-baseline data from Week 4 to Week 52 regardless of status on- or off-treatment.

Percent Change From Baseline in Fasting Triglycerides at Week 12 - ITT AnalysisFrom Baseline to Week 52

Adjusted means and standard errors at Week 12 from multiple imputation approach followed by a robust regression model including all available post-baseline data from Week 4 to Week 52 regardless of status on- or off-treatment.

Percent Change From Baseline in Apo A-1 at Week 12 - ITT AnalysisFrom Baseline to Week 52

Adjusted LS means and standard errors at Week 12 from MMRM model including all available post-baseline data from Week 4 to Week 52 regardless of status on- or off-treatment.

Trial Locations

Locations (76)

Investigational Site Number 840827

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Mt. Pleasant, South Carolina, United States

Investigational Site Number 840832

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Southfield, Michigan, United States

Investigational Site Number 840891

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Mobile, Alabama, United States

Investigational Site Number 840862

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Torrance, California, United States

Investigational Site Number 840870

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Burbank, California, United States

Investigational Site Number 840851

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Los Angeles, California, United States

Investigational Site Number 840816

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West Palm Beach, Florida, United States

Investigational Site Number 840898

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Evanston, Illinois, United States

Investigational Site Number 840896

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Indianapolis, Indiana, United States

Investigational Site Number 840824

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Cary, North Carolina, United States

Investigational Site Number 840831

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Columbus, Ohio, United States

Investigational Site Number 840860

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Kettering, Ohio, United States

Investigational Site Number 840818

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Norman, Oklahoma, United States

Investigational Site Number 840872

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Anderson, South Carolina, United States

Investigational Site Number 840869

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Philadelphia, Pennsylvania, United States

Investigational Site Number 840825

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Pittsburgh, Pennsylvania, United States

Investigational Site Number 840868

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Corpus Christi, Texas, United States

Investigational Site Number 840841

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Houston, Texas, United States

Investigational Site Number 840877

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Houston, Texas, United States

Investigational Site Number 840899

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Cincinnati, Ohio, United States

Investigational Site Number 840805

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Miami, Florida, United States

Investigational Site Number 840857

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Birmingham, Alabama, United States

Investigational Site Number 840888

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Minneapolis, Minnesota, United States

Investigational Site Number 840854

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San Antonio, Texas, United States

Investigational Site Number 840830

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San Antonio, Texas, United States

Investigational Site Number 840863

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Salt Lake City, Utah, United States

Investigational Site Number 840876

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Montgomery, Alabama, United States

Investigational Site Number 840865

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Glendale, Arizona, United States

Investigational Site Number 840826

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Jonesboro, Arkansas, United States

Investigational Site Number 840801

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San Jose, California, United States

Investigational Site Number 840886

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Tarzana, California, United States

Investigational Site Number 840893

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Vista, California, United States

Investigational Site Number 840867

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Boca Raton, Florida, United States

Investigational Site Number 840836

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Clearwater, Florida, United States

Investigational Site Number 840884

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Boynton Beach, Florida, United States

Investigational Site Number 840866

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Coral Gables, Florida, United States

Investigational Site Number 840811

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Oviedo, Florida, United States

Investigational Site Number 840850

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Columbus, Georgia, United States

Investigational Site Number 840881

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Port Orange, Florida, United States

Investigational Site Number 840894

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Michigan City, Indiana, United States

Investigational Site Number 840842

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Chicago, Illinois, United States

Investigational Site Number 840858

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Eunice, Louisiana, United States

Investigational Site Number 840823

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Paducah, Kentucky, United States

Investigational Site Number 840847

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Morton, Illinois, United States

Investigational Site Number 840839

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Edina, Minnesota, United States

Investigational Site Number 840814

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Jefferson City, Missouri, United States

Investigational Site Number 840837

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Port Gibson, Mississippi, United States

Investigational Site Number 840853

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New Windsor, New York, United States

Investigational Site Number 840809

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Willoughby Hills, Ohio, United States

Investigational Site Number 840803

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Downington, Pennsylvania, United States

Investigational Site Number 840813

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Greer, South Carolina, United States

Investigational Site Number 840819

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Orem, Utah, United States

Investigational Site Number 840804

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Manassas, Virginia, United States

Investigational Site Number 840882

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Norfolk, Virginia, United States

Investigational Site Number 840810

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Weber City, Virginia, United States

Investigational Site Number 840845

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Los Gatos, California, United States

Investigational Site Number 840840

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Eagle, Idaho, United States

Investigational Site Number 840880

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Smithfield, North Carolina, United States

Investigational Site Number 840817

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Newington, New Hampshire, United States

Investigational Site Number 840820

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Hialeah, Florida, United States

Investigational Site Number 840838

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Mishawaka, Indiana, United States

Investigational Site Number 840895

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Ft. Lauderdale, Florida, United States

Investigational Site Number 840890

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Battle Creek, Michigan, United States

Investigational Site Number 840855

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Salisbury, Massachusetts, United States

Investigational Site Number 840833

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Sparks, Nevada, United States

Investigational Site Number 840846

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Cincinnati, Ohio, United States

Investigational Site Number 840878

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Bountiful, Utah, United States

Investigational Site Number 840812

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Eugene, Oregon, United States

Investigational Site Number 840883

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San Antonio, Texas, United States

Investigational Site Number 840889

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Tomball, Texas, United States

Investigational Site Number 840844

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Sacramento, California, United States

Investigational Site Number 840802

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New Orleans, Louisiana, United States

Investigational Site Number 840502

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Winston-Salem, North Carolina, United States

Investigational Site Number 840852

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Winston-Salem, North Carolina, United States

Investigational Site Number 840885

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Charleston, South Carolina, United States

Investigational Site Number 840822

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Rochester, New York, United States

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