A Randomized, Double-blind, Placebo-Controlled, Dose-Ranging Phase 2 Study of ISIS 681257 (AKCEA-APO(a)-LRx) Administered Subcutaneously to Patients With Hyperlipoproteinemia(a) and Established Cardiovascular Disease (CVD)
试验速览
- 阶段
- 2 期
- 状态
- 已完成
- 入组人数
- 286
- 试验地点
- 1
- 主要终点
- Number of Participants With TEAEs Leading to Study Discontinuation
研究概览
简要总结
This is a multicenter, randomized, double-blind, placebo-controlled, dose-ranging study to evaluate the safety, including tolerability, of ISIS 681257 and to assess the efficacy of different doses and dosing regimens of ISIS 681257 for reduction of plasma Lipoprotein(a) [Lp(a)] levels in participants with hyperlipoproteinemia(a) and established cardiovascular disease (CVD).
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Triple (Participant, Investigator, Outcomes Assessor)
入排标准
- 年龄范围
- 18 Years 至 80 Years(Adult, Older Adult)
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Clinical diagnosis of CVD defined as documented coronary artery disease, stroke, or peripheral artery disease
- •Lp(a) plasma level ≥ 60 mg/dL
- •Must be on standard-of-care preventative therapy for other than elevated Lp(a) CVD risk factors
排除标准
- •Within 6 months of Screening: acute coronary syndrome, major cardiac surgery, or stroke/TIA
- •Within 3 months of Screening: coronary, carotid, or peripheral arterial revascularization, major non-cardiac surgery, or lipoprotein apheresis
- •Heart failure New York Heart Association (NYHA) class IV
研究组 & 干预措施
Cohort A: ISIS 681257: 20 mg Q4W
Cohort A participants received 20 milligrams (mg) ISIS 681257, subcutaneous (SC) injection, once every 4 weeks (Q4W), for up to 49 weeks and a maximum of 13 doses.
干预措施: ISIS 681257 (Drug)
Cohort B: ISIS 681257: 40 mg Q4W
Cohort B participants received 40 mg of ISIS 681257, SC injection, once Q4W, for up to 49 weeks and a maximum of 13 doses.
干预措施: ISIS 681257 (Drug)
Cohort C: ISIS 681257: 60 mg Q4W
Cohort C participants received 60 mg of ISIS 681257, SC injection, once Q4W, for up to 49 weeks and a maximum of 13 doses.
干预措施: ISIS 681257 (Drug)
Cohort D: ISIS 681257: 20 mg Q2W
Cohort D participants received 20 mg of ISIS 681257, SC injection, once every 2 weeks (Q2W), for up to 51 weeks and a maximum of 26 doses.
干预措施: ISIS 681257 (Drug)
Cohort E: ISIS 681257: 20 mg QW
Cohort E participants received 20 mg of ISIS 681257, SC injection, once weekly (QW), for up to 52 weeks and a maximum of 52 doses.
干预措施: ISIS 681257 (Drug)
Placebo
Participants in each cohort were randomized to receive placebo at a dose-matched volume of study drug (ISIS 681257).
干预措施: Placebo (Drug)
结局指标
主要结局
Number of Participants With TEAEs Leading to Study Discontinuation
时间窗: Up to 16 weeks post treatment period (up to approximately 1.3 years)
An AE was defined as any unfavorable and unintended sign (including a clinically significant abnormal laboratory finding), symptom, or disease temporally associated with the study or use of investigational drug product, whether or not the AE was considered related to the investigational drug product. TEAE was defined as any AE with onset after the first administration of study medication through the end of the study, or any event that was present at baseline but worsened in intensity or was subsequently considered drug-related by the Investigator through the end of the study.
Percent Change From Baseline in Fasting Lipoprotein A [Lp(a)] at the Primary Analysis Time Point
时间窗: Baseline and Month 6 (Week 25 for Cohorts A, B and C and Week 27 for Cohorts D and E)
An ANCOVA model was performed on the log ratio of Lp(a) value at the Primary Analysis Time Point to Lp(a) value at Baseline. The estimate of the log ratio was converted back to the original scale and percent change was calculated using formula: = (ratio of Lp(a) value at the Primary Analysis Time Point to Lp(a) value at Baseline - 1) × 100.
Number of Participants With Treatment Emergent Adverse Events (TEAEs)
时间窗: Up to 16 weeks post treatment period (up to approximately 1.3 years)
An adverse event (AE) was defined as any unfavorable and unintended sign (including a clinically significant abnormal laboratory finding), symptom, or disease temporally associated with the study or use of investigational drug product, whether or not the AE was considered related to the investigational drug product. TEAEs was defined as any AE with onset after the first administration of study medication through the end of the study, or any event that was present at baseline but worsened in intensity or was subsequently considered drug-related by the Investigator through the end of the study.
Number of Participants With TEAEs by Maximum Severity
时间窗: Up to 16 weeks post treatment period (up to approximately 1.3 years)
An AE was defined as any unfavorable and unintended sign (including a clinically significant abnormal laboratory finding), symptom, or disease temporally associated with the study or use of investigational drug product, whether or not the AE was considered related to the investigational drug product. TEAEs was defined as any AE with onset after the first administration of study medication through the end of the study, or any event that was present at baseline but worsened in intensity or was subsequently considered drug-related by the Investigator through the end of the study. The severity of TEAEs was assessed based on the National Cancer Institute's (NCI) Common Terminology Criteria for Adverse Events (CTCAE) version 4.03. TEAEs were graded on a 5-point scale where 1 = Mild, 2 = Moderate, 3 = Severe, 4 = Potentially life-threatening and 5 = Death.
次要结局
- Percent Change From Baseline in Fasting Low-Density Lipoprotein Cholesterol (LDL-C)(Baseline and Month 6 (Week 25 for Cohorts A, B and C and Week 27 for Cohorts D and E))
- Percentage of Participants Who Achieved Plasma Lp(a) ≤ 125 Nanomoles Per Liter (Nmol/L) or ≤ 50 Milligrams Per Deciliter (mg/dL)(Baseline and Month 6 (Week 25 for Cohorts A, B and C and Week 27 for Cohorts D and E))
- Percent Change From Baseline in the Plasma Levels of Oxidized Phospholipids (OxPL) on Apolipoprotein B (OxPL-apoB)(Baseline and Month 6 (Week 25 for Cohorts A, B and C and Week 27 for Cohorts D and E))
- Percentage of Participants Who Achieved Plasma Lp(a) ≤ 75 Nmol/L or ≤ 30 mg/dL(Baseline and Month 6 (Week 25 for Cohorts A, B and C and Week 27 for Cohorts D and E))
- Percent Change From Baseline in the Plasma Levels of Apolipoprotein B (apoB)(Baseline and Month 6 (Week 25 for Cohorts A, B and C and Week 27 for Cohorts D and E))
- Percent Change From Baseline in the Plasma Levels of Oxidized Phospholipids (OxPL) on Apolipoprotein(a) [OxPL-apo(a)](Baseline and Month 6 (Week 25 for Cohorts A, B and C and Week 27 for Cohorts D and E))
