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Safety and Efficacy of Mipomersen (ISIS 301012) As Add-on Therapy in High Risk Hypercholesterolemic Patients

Phase 3
Completed
Conditions
Coronary Heart Disease
Hypercholesterolemia
Interventions
Registration Number
NCT00770146
Lead Sponsor
Kastle Therapeutics, LLC
Brief Summary

The purpose of this study is to evaluate the safety and efficacy of dosing with mipomersen for 26 weeks in patients with high cholesterol who are on a maximally tolerated dose of statin and who have a diagnosis that puts them at least at high risk of coronary heart disease (CHD).

Detailed Description

Hypercholesterolemia is characterized by markedly elevated low density lipoproteins (LDL). Elevated LDL is a major risk factor for CHD.

Mipomersen is an antisense drug that reduces a protein in the liver cells called apolipoprotein B (apo-B). Apo-B plays a role in producing low density lipoprotein cholesterol (LDL-C) (the "bad" cholesterol) and moving it from the liver to one's bloodstream. High LDL-C is an independent risk factor for the development of CHD or other diseases of blood vessels. It has been shown that lowering LDL-C reduces the risk of heart attacks and other major adverse cardiovascular events. The purpose of this study is to determine whether mipomersen safely and effectively lowers LDL-C in patients with high cholesterol who are at high risk for CHD and who are already on the maximally tolerated dose of statin.

This study consisted of a 26-week treatment period and a 24-week post-treatment follow-up period. Participants who finished treatment or who discontinued prematurely from the study for any reason were assessed for safety for 24 weeks after the last study drug dose.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
158
Inclusion Criteria
  • Diagnosis of hypercholesterolemia (LDL-C ≥ 100 mg/dL)
  • At high risk of CHD
  • On stable, maximally tolerated statin therapy for 8 weeks
  • On stable, low fat diet for 12 weeks
  • Stable weight for 6 weeks
Exclusion Criteria
  • Significant health problems in the recent past including heart attack, stroke, coronary syndrome, unstable angina, heart failure, significant arrhythmia, hypertension, liver disease, cancer, type I diabetes.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
PlaceboPlaceboParticipants received placebo subcutaneous injection once a week for 26 weeks.
MipomersenMipomersen sodiumParticipants received mipomersen 200 mg as a subcutaneous injection once a week for 26 weeks.
Primary Outcome Measures
NameTimeMethod
Percent Change From Baseline in Low-density Lipoprotein Cholesterol (LDL-C) at the Primary Efficacy Time PointBaseline (the average of the screening and Day 1 pre-treatment assessments) and the Primary Efficacy Time point (PET; Week 28 or the post-baseline visit closest to 14 days after the last dose).

LDL cholesterol was measured in mg/dL. Samples were taken following an overnight fast. LDL-C was obtained using Friedewald's calculation for patients with triglycerides ≤400 mg/dL and was directly measured by the central laboratory using ultracentrifugation for patients with triglycerides \>400 mg/dL. The primary efficacy time point was the post-baseline visit closest to 14 days after the last dose of study treatment.

Low-density Lipoprotein Cholesterol (LDL-C) at Baseline and at the Primary Efficacy Time PointBaseline (the average of the screening and Day 1 pre-treatment assessments) and the Primary Efficacy Time point (PET; Week 28 or the post-baseline visit closest to 14 days after the last dose).

The primary efficacy time point (PET) was the post-baseline visit closest to 14 days after the last dose of study treatment.

Secondary Outcome Measures
NameTimeMethod
Non-High-Density Lipoprotein Cholesterol at Baseline and at the Primary Efficacy Time PointBaseline (the average of the screening and Day 1 pre-treatment assessments) and the Primary Efficacy Time point (PET; Week 28 or the post-baseline visit closest to 14 days after the last dose).

The primary efficacy time point (PET) was the post-baseline visit closest to 14 days after the last dose of study treatment.

Apolipoprotein B at Baseline and at the Primary Efficacy Time PointBaseline (the average of the screening and Day 1 pre-treatment assessments) and the Primary Efficacy Time point (PET; Week 28 or the post-baseline visit closest to 14 days after the last dose).

The primary efficacy time point (PET) was the post-baseline visit closest to 14 days after the last dose of study treatment.

Percent Change From Baseline in Total Cholesterol at the Primary Efficacy Time PointBaseline (the average of the screening and Day 1 pre-treatment assessments) and the Primary Efficacy Time point (PET; Week 28 or the post-baseline visit closest to 14 days after the last dose).

Total cholesterol was measured in mg/dL. Samples were taken following an overnight fast. The primary efficacy time point was the post-baseline visit closest to 14 days after the last dose of study treatment.

Percent Change From Baseline in Apolipoprotein B at the Primary Efficacy Time PointBaseline (the average of the screening and Day 1 pre-treatment assessments) and the Primary Efficacy Time point (PET; Week 28 or the post-baseline visit closest to 14 days after the last dose).

Apolipoprotein B was measured in mg/dL. Samples were taken following an overnight fast. The primary efficacy time point was the post-baseline visit closest to 14 days after the last dose of study treatment.

Total Cholesterol at Baseline and at the Primary Efficacy Time PointBaseline (the average of the screening and Day 1 pre-treatment assessments) and the Primary Efficacy Time point (PET; Week 28 or the post-baseline visit closest to 14 days after the last dose).

The primary efficacy time point (PET) was the post-baseline visit closest to 14 days after the last dose of study treatment.

Percent Change From Baseline in Non-High-Density Lipoprotein Cholesterol at the Primary Efficacy Time PointBaseline (the average of the screening and Day 1 pre-treatment assessments) and the Primary Efficacy Time point (PET; Week 28 or the post-baseline visit closest to 14 days after the last dose).

Non-high-density lipoprotein cholesterol was measured in mg/dL. Samples were taken following an overnight fast. The primary efficacy time point was the post-baseline visit closest to 14 days after the last dose of study treatment.

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