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A Study of Olezarsen (Formerly Known as AKCEA-APOCIII-LRx) Administered to Patients With Familial Chylomicronemia Syndrome (FCS)

Phase 3
Completed
Conditions
Familial Chylomicronemia Syndrome
Interventions
Drug: Placebo
Registration Number
NCT04568434
Lead Sponsor
Ionis Pharmaceuticals, Inc.
Brief Summary

The purpose of the study was to evaluate the efficacy of olezarsen as compared to placebo on the percent change in fasting triglycerides (TG) from baseline.

Detailed Description

This was a multi-center, double-blind, Phase 3 study in up to 60 patients with FCS. Participants were randomized in a 2:1 ratio to receive Olezarsen or matching placebo in a 53-week treatment period. The length of participation in the study was approximately 74 weeks, which included an up to 8-week screening period, a 53-week treatment period, and a 13-week post-treatment evaluation period. Following the treatment period, eligible patients had the option to enroll in the Open-label Extension (OLE) Study ISIS 678354-CS13 (NCT05130450).

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
66
Inclusion Criteria
  • A diagnosis of genetically confirmed Familial Chylomicronemia Syndrome (type 1 Hyperlipoproteinemia)
  • Fasting TG ≥ 880 mg/dL (10 millimoles per liter (mmol/L) at Screening
  • History of pancreatitis. Patients without a documented history of pancreatitis are also eligible but their enrollment will be capped at 35%
  • Stable doses of statins, omega-3 fatty acids, fibrates, or other lipid-lowering medications are allowed

Key

Exclusion Criteria
  • Acute coronary syndrome within 6 months of Screening
  • Major surgery within 3 months of Screening
  • Have any other conditions, which, in the opinion of the Investigator would make the participant unsuitable for inclusion, or could interfere with participating in or completing the study

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
PlaceboPlaceboParticipants received olezarsen-matching placebo, once every 4 weeks by subcutaneous (SC) injection, during Weeks 1 to 49 of the 53-week treatment period.
Olezarsen 50 mgOlezarsenParticipants received olezarsen, 50 milligrams (mg), once every 4 weeks by SC injection, during Weeks 1 to 49 of the 53-week treatment period.
Olezarsen 80 mgOlezarsenParticipants received olezarsen 80 mg, once every 4 weeks by SC injection, during Weeks 1 to 49 of the 53-week treatment period.
Primary Outcome Measures
NameTimeMethod
Percent Change From Baseline in Fasting TG at Month 6Baseline, Month 6
Secondary Outcome Measures
NameTimeMethod
Percent Change From Baseline in Fasting TG at Month 12Baseline, Month 12
Percent Change From Baseline in Fasting Apolipoprotein C-III (apoC-III) at Months 6 and 12Baseline, Months 6 and 12
Percentage of Participants With ≥ 40% Reduction in Fasting TG at Month 6Month 6

Percentages are rounded off to the nearest single decimal place.

Percent Change From Baseline in Fasting Apolipoprotein B-48 (apoB-48) at Months 6 and 12Baseline, Months 6 and 12
Percent Change From Baseline in Fasting Non-High-Density Lipoprotein Cholesterol (Non-HDL-C) at Months 6 and 12Baseline, Months 6 and 12
Adjudicated Acute Pancreatitis Mean Event Rate Per 100 Participant-Years During the Treatment Period (Week 1 Through Week 53) in Participants With Prior History of PancreatitisDuring the treatment period Week 1 through Week 53

All AEs and SAEs that consistently occurred during the study with an event of acute pancreatitis were adjudicated by a blinded, independent committee according to the Atlanta classification of acute pancreatitis as outlined in the Acute Pancreatitis Adjudication Committee (PAC) Charter. These events were categorized as 1) documented pancreatitis, 2) probable pancreatitis, 3) possible pancreatitis, 4) unable to adjudicate and 5) no diagnosis of acute pancreatitis. The adjudicated event rate represents the average number of events per 100 participant-years during the treatment period.

Adjudicated Acute Pancreatitis Mean Event Rate Per 100 Participant-Years During the Treatment Period (Week 1 Through Week 53)During the treatment period Week 1 through Week 53

All AEs and SAEs that consistently occurred during the study with an event of acute pancreatitis were adjudicated by a blinded, independent committee according to the Atlanta classification of acute pancreatitis as outlined in the PAC Charter. These events were categorized as 1) documented pancreatitis, 2) probable pancreatitis, 3) possible pancreatitis, 4) unable to adjudicate and 5) no diagnosis of acute pancreatitis. The adjudicated event rate represents the average number of events per 100 participant-years during the treatment period.

Adjudicated Acute Pancreatitis Mean Event Per 100 Participant-Years Rate During Week 13 Through Week 53 in Participants With Prior History of PancreatitisWeek 13 through Week 53

All AEs and SAEs that consistently occurred during the study with an event of acute pancreatitis were adjudicated by a blinded, independent committee according to the Atlanta classification of acute pancreatitis as outlined in the PAC Charter. These events were categorized as 1) documented pancreatitis, 2) probable pancreatitis, 3) possible pancreatitis, 4) unable to adjudicate and 5) no diagnosis of acute pancreatitis. The adjudicated event rate represents the average number of events per 100 participant-years during the specified duration.

Adjudicated Acute Pancreatitis Mean Event Rate Per 100 Participant-Years During Week 13 to Week 53Week 13 through Week 53

All AEs and SAEs that consistently occurred during the study with an event of acute pancreatitis were adjudicated by a blinded, independent committee according to the Atlanta classification of acute pancreatitis as outlined in the PAC Charter. These events were categorized as 1) documented pancreatitis, 2) probable pancreatitis, 3) possible pancreatitis, 4) unable to adjudicate and 5) no diagnosis of acute pancreatitis. The adjudicated event rate represents the average number of events per 100 participant-years during the specified duration.

Percentage of Participants With ≥ 70% Reduction in Fasting TG at Month 6Month 6

Percentages are rounded off to the nearest single decimal place.

Percentage of Participants With Fasting TG ≤ 880 mg/dL at Month 6Month 6

Percentages are rounded off to the nearest single decimal place.

Adjudicated Acute Pancreatitis Mean Event Rate Per 100 Participant-Years During Treatment Period in Participants With ≥ 2 Events in 5 Years Prior to EnrollmentDuring the treatment period Week 1 through Week 53

All AEs and SAEs that consistently occurred during the study with an event of acute pancreatitis were adjudicated by a blinded, independent committee according to the Atlanta classification of acute pancreatitis as outlined in the PAC Charter. These events were categorized as 1) documented pancreatitis, 2) probable pancreatitis, 3) possible pancreatitis, 4) unable to adjudicate and 5) no diagnosis of acute pancreatitis. The adjudicated event rate represents the average number of events per 100 participant-years during the treatment period.

Adjudicated Acute Pancreatitis Mean Event Rate Per 100 Participant-Years From Week 13 to Week 53 in Participants With ≥ 2 Events in 5 Years Prior to EnrollmentWeek 13 to Week 53

All AEs and SAEs that consistently occurred during the study with an event of acute pancreatitis were adjudicated by a blinded, independent committee according to the Atlanta classification of acute pancreatitis as outlined in the PAC Charter. These events were categorized as 1) documented pancreatitis, 2) probable pancreatitis, 3) possible pancreatitis, 4) unable to adjudicate and 5) no diagnosis of acute pancreatitis. The adjudicated event rate represents the average number of events per 100 participant-years during the specified duration.

Percentage of Participants With Fasting TG ≤ 500 mg/dL at Month 6Month 6

Percentages are rounded off to the nearest single decimal place.

Trial Locations

Locations (47)

Hospital da Senhora da Oliveira - Guimaraes

🇵🇹

Creixomil, Portugal

Universitair Medisch Centrum Utrecht

🇳🇱

Utrecht, Netherlands

The Lipid Clinic (Oslo University Hospital)

🇳🇴

Oslo, Norway

Centro Hospitalar de Lisboa Ocidental. E.P.E, - Hospital Santa Cruz

🇵🇹

Carnaxide, Portugal

Diabetes/Lipid Management & Research Center

🇺🇸

Huntington Beach, California, United States

University of California, San Francisco (UCSF) - Medical Center

🇺🇸

San Francisco, California, United States

Excel Medical Clinical Trials, LLC

🇺🇸

Boca Raton, Florida, United States

NorthShore University Health System

🇺🇸

Evanston, Illinois, United States

Advocate Health and Hospitals Corporation - Lutheran General Hospital

🇺🇸

Park Ridge, Illinois, United States

Ascension St. Vincent Cardiovascular Research Institute

🇺🇸

Indianapolis, Indiana, United States

University of Kansas Medical Center (KUMC)

🇺🇸

Kansas City, Kansas, United States

University of Michigan- Endocrinology & Metabolism

🇺🇸

Ann Arbor, Michigan, United States

New York University (NYU) Langone Medical Center

🇺🇸

New York, New York, United States

Columbia University Medical Center

🇺🇸

New York, New York, United States

Moses H. Cone Memorial Hospital

🇺🇸

Greensboro, North Carolina, United States

University of Pennsylvania

🇺🇸

Philadelphia, Pennsylvania, United States

Vanderbilt University

🇺🇸

Nashville, Tennessee, United States

University of Texas Southwestern

🇺🇸

Dallas, Texas, United States

Baylor College of Medicine

🇺🇸

Houston, Texas, United States

York Clinical Research LLC

🇺🇸

Norfolk, Virginia, United States

West Virginia University Heart and Vascular Institute

🇺🇸

Morgantown, West Virginia, United States

Ecogene-21

🇨🇦

Chicoutimi, Quebec, Canada

Nathalie Saint-Pierre

🇨🇦

Montréal, Quebec, Canada

Clinique des Maladies Lipidiques de Quebec Inc.

🇨🇦

Québec, Quebec, Canada

Institute de Recherches Cliniques de Montreal

🇨🇦

Montréal, Canada

Hôpital Louis Pradel - HCL

🇫🇷

Bron, France

CHU Dijon - Bocage

🇫🇷

Dijon, France

Assistance Publique - Hopitaux de Marseille

🇫🇷

Marseille, France

ASST Grande Ospedale Metropolitano Niguarda

🇮🇹

Milano, Italy

Azienda Ospedaliera Universitaria Federico II

🇮🇹

Napoli, Italy

Azienda Ospedaliera Universitaria Policlinico Paolo Giaccone

🇮🇹

Palermo, Italy

Azienda Ospedaliero Universitaria Policlinico Umberto I

🇮🇹

Roma, Italy

Academic Medical Center - Department of Vascular Medicine

🇳🇱

Amsterdam, Netherlands

Erasmus MC

🇳🇱

Rotterdam, Netherlands

Centro Hospitalar de Lisboa Ocidental, EPE - Hospital Egas Moniz

🇵🇹

Lisboa, Portugal

Metabolicke centrum MUDr Katariny Raslovej s. r. o.

🇸🇰

Bratislava, Slovakia

Hospital Abente y Lago

🇪🇸

A Coruña, Spain

Hospital Clinic Barcelona

🇪🇸

Barcelona, Spain

Hospital Universitario 12 de Octubre

🇪🇸

Madrid, Spain

Hospital Universitario Virgen del Rocio

🇪🇸

Sevilla, Spain

Fundacio Pere Virgili

🇪🇸

Tarragona, Spain

Sahlgrenska University Hospital

🇸🇪

Göteborg, Sweden

Karolinska University Hospital

🇸🇪

Solna, Sweden

The Royal Free Hospital

🇬🇧

London, United Kingdom

St. Thomas' Hospital

🇬🇧

London, United Kingdom

Manchester University NHS Foundation Trust (MFT)

🇬🇧

Manchester, United Kingdom

Sandwell General Hospital

🇬🇧

West Bromwich, United Kingdom

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