A Randomized, Double-Blind, Placebo-Controlled, Parallel-Group Study to Evaluate the Efficacy and Safety of REGN727/SAR236553 in Patients With Heterozygous Familial Hypercholesterolemia Not Adequately Controlled With Their Lipid-Modifying Therapy

Regeneron Pharmaceuticals0 sites249 target enrollmentDecember 2012

ConditionsHeterozygous Familial Hypercholesterolemia

InterventionsLMT (atorvastatin, simvastatin, or rosuvastatin)alirocumab Placebo

DrugsLMT (atorvastatin, simvastatin, or rosuvastatin)alirocumab Placebo

Overview

Phase: Phase 3
Intervention: LMT (atorvastatin, simvastatin, or rosuvastatin)
Conditions: Heterozygous Familial Hypercholesterolemia
Sponsor: Regeneron Pharmaceuticals
Enrollment: 249
Primary Endpoint: Percent Change From Baseline in Calculated LDL-C at Week 24 - Intent--to--Treat (ITT) Analysis
Status: Completed
Last Updated: 10 years ago

Overview Investigators Eligibility Criteria Arms & Interventions Outcomes Similar Trials

Overview

Brief Summary

This is a randomized, double-blind, placebo-controlled, parallel-group, multi-national study alirocumab (REGN727/SAR236553) in patients with Heterozygous Familial Hypercholesterolemia (heFH) who are not adequately controlled with their Lipid-Modifying Therapy (LMT).

Registry

clinicaltrials.gov

Start Date

December 2012

End Date

January 2015

Last Updated

10 years ago

Study Type

Interventional

Study Design

Parallel

Sex

All

Investigators

Sponsor

Regeneron Pharmaceuticals

Responsible Party

Sponsor

Eligibility Criteria

Inclusion Criteria

•Patients with heFH\* who are not adequately controlled\*\* with a maximally-tolerated daily dose\*\*\* of statin with or without other LMT, at a stable dose prior to the screening visit (week -2).
•\*Diagnosis of heFH must be made either by genotyping or by clinical criteria. For those patients not genotyped, the clinical diagnosis may be based on either the Simon Broome criteria for definite FH (Appendix 1) or the WHO/Dutch Lipid Network criteria with a score of \>8 points (Appendix 2).
•\*\* "Not adequately controlled" is defined as LDL-C ≥70 mg/dL (1.81 mmol/L) at the screening visit (week -2) in patients with a history of documented CVD (Appendix 3), or LDL-C ≥100 mg/dL (2.59 mmol/L) at the screening visit (week -2) in patients without a history of documented CVD.
•\*\*\* "Maximally-tolerated dose" is defined as (any of the following are acceptable):
•Rosuvastatin 20 mg or 40 mg daily
•Atorvastatin 40 mg or 80 mg daily
•Simvastatin 80 mg daily (if already on this dose for \>1 year - see exclusion criterion #7)
•Note: Patients who are not able to be on any of the above statin doses should be treated with the dose of daily atorvastatin, rosuvastatin, or simvastatin which is considered appropriate for the patient, according to the investigator's judgment. Some examples of acceptable reasons for a patient taking a lower statin dose include, but are not limited to: adverse effects on higher doses, advanced age, low body mass index, regional practices, local prescribing information, concomitant medications, co-morbid conditions such as impaired glucose tolerance/impaired fasting glucose. The reason(s) will be documented in the case report form (CRF).
•Provide signed informed consent

Exclusion Criteria

•Patient without diagnosis of heFH made either by genotyping or by clinical criteria
•LDL-C \<70 mg/dL (\<1.81 mmol/L) at the screening visit (week-2) in patients with history of documented cardiovascular disease
•LDL-C \<100 mg/dL (\<2.59 mmol/L) at the screening visit (week -2) in patients without history of documented cardiovascular disease
•Not on a stable dose of LMT (including statin) for at least 4 weeks and/or fenofibrate for at least 6 weeks, as applicable, prior to the screening visit (week -2) and from screening to randomization
•Currently taking another statin than simvastatin, atorvastatin, or rosuvastatin
•Simvastatin, atorvastatin, or rosuvastatin is not taken daily or not taken at a registered dose
•Daily doses above atorvastatin 80 mg, rosuvastatin 40 mg, or simvastatin 40 mg (except for patients on simvastatin 80 mg for more than 1 year, who are eligible)
•Use of fibrates, other than fenofibrate within 6 weeks of the screening visit (week-2) or between screening and randomization visits
•Use of nutraceutical products or over-the-counter therapies that may affect lipids which have not been at a stable dose/amount for at least 4 weeks prior to the screening visit (week -2) or between screening and randomization visits
•Use of red yeast rice products within 4 weeks of the screening visit (week-2), or between screening and randomization visits

Arms & Interventions

Alirocumab 75 mg/up to 150 mg

Alirocumab 75 mg every two weeks (Q2W) added to stable dose of statin with or without LMT for 78 weeks. Alirocumab dose up-titrated to 150 mg Q2W from Week 12 when LDL-C levels ≥70 mg/dL at Week 8.

Intervention: LMT (atorvastatin, simvastatin, or rosuvastatin)

Alirocumab 75 mg/up to 150 mg

Alirocumab 75 mg every two weeks (Q2W) added to stable dose of statin with or without LMT for 78 weeks. Alirocumab dose up-titrated to 150 mg Q2W from Week 12 when LDL-C levels ≥70 mg/dL at Week 8.

Intervention: alirocumab

Placebo

Placebo matched to alirocumab SC injection for 78-week treatment duration.

Intervention: Placebo

Outcomes

Primary Outcomes

Percent Change From Baseline in Calculated LDL-C at Week 24 - Intent--to--Treat (ITT) Analysis

Time Frame: From Baseline to Week 52

Calculated LDL-C values were obtained using the Friedewald formula. 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.

Secondary Outcomes

Percent Change From Baseline in Calculated LDL-C at Week 24 - On-Treatment Analysis(From Baseline to Week 52)
Percent Change From Baseline in Calculated LDL-C at Week 12 - ITT Analysis(From Baseline to Week 52)
Percent Change From Baseline in Calculated LDL-C at Week 12 - On- Treatment Analysis(From Baseline to Week 52)
Percent Change From Baseline in Apolipoprotein (Apo) B at Week 24 - ITT Analysis(From Baseline to Week 52)
Percent Change From Baseline in Apo B at Week 24 - On-Treatment Analysis(From Baseline to Week 52)
Percent Change From Baseline in Non-High -Density Lipoprotein Cholesterol (Non-HDL-C) at Week 24 - ITT Analysis(From Baseline to Week 52)
Percent Change From Baseline in Non-HDL-C at Week 24 - On-Treatment Analysis(From Baseline to Week 52)
Percent Change From Baseline in Total Cholesterol (Total-C) at Week 24 - ITT Analysis(From Baseline to Week 52)
Percent Change From Baseline in Apo B at Week 12 - ITT Analysis(From Baseline to Week 52)
Percent Change From Baseline in Non-HDL-C at Week 12 - ITT Analysis(From Baseline to Week 52)
Percent Change From Baseline in Total-C at Week 12 - ITT Analysis(From Baseline to Week 52)
Percent Change From Baseline in Calculated LDL-C at Week 52 - ITT Analysis(From Baseline to Week 52)
Percentage of Very High CV Risk Participants Reaching Calculated LDL-C <70 mg/dL (1.81 mmol/L) or High CV Risk Participants Reaching Calculated LDL-C <100 mg/dL (2.59 mmol/L) at Week 24 - ITT Analysis(Up to Week 52)
Percentage of Very High CV Risk Participants Reaching Calculated LDL--C <70 mg/dL (1.81 mmol/L) or High CV Risk Participants Reaching Calculated LDL--C <100 mg/dL (2.59 mmol/L) at Week 24 - On-Treatment Analysis(Up to week 52)
Percentage of Participants Reaching Calculated LDL-C <70 mg/dL (1.81 mmol/L) at Week 24 - ITT Analysis(Up to Week 52)
Percentage of Participants Reaching Calculated LDL--C <70 mg/dL (1.81 mmol/L) at Week 52 - On-Treatment Analysis(Up to Week 52)
Percent Change From Baseline in Lipoprotein (a) at Week 24 - ITT Analysis(From Baseline to Week 52)
Percent Change From Baseline in HDL-C at Week 24 - ITT Analysis(From Baseline to Week 52)
Percent Change From Baseline in Fasting Triglycerides at Week 24 - ITT Analysis(From Baseline to Week 52)
Percent Change From Baseline in Apo A-1 at Week 24 - ITT Analysis(From Baseline to Week 52)
Percent Change From Baseline in Lipoprotein (a) at Week 12 - ITT Analysis(From Baseline to Week 52)
Percent Change From Baseline in HDL-C at Week 12 - ITT Analysis(From Baseline to Week 52)
Percent Change From Baseline in Fasting Triglycerides at Week 12 - ITT Analysis(From Baseline to Week 52)
Percent Change From Baseline in Apo A-1 at Week 12 - ITT Analysis(From Baseline to Week 52)