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The Study of an Investigational Drug, MGL-3196, for the treatment of Hypercholesterolemia

Phase 1
Conditions
Heterozygous Familial Hypercholesterolemia (HeFH)
MedDRA version: 20.0Level: LLTClassification code 10057079Term: Heterozygous familial hypercholesterolemiaSystem Organ Class: 100000004850
Therapeutic area: Diseases [C] - Cardiovascular Diseases [C14]
Registration Number
EUCTR2016-002315-17-NL
Lead Sponsor
Madrigal Pharmaceuticals, Inc.
Brief Summary

Not available

Detailed Description

Not available

Recruitment & Eligibility

Status
ot Recruiting
Sex
All
Target Recruitment
105
Inclusion Criteria

The population for this study is male and female patients 18 years of age who have met the diagnostic criteria for HeFH outlined by the Simon Broome Register Group (Scientific Steering Committee 1991).
Patients who meet all of the following criteria will be eligible to participate in the study:
1. Must be willing to participate in the study and provide written informed consent;
2. Male and female adults 18 years of age;
3. Female patients of child bearing potential with negative serum pregnancy test who are not breastfeeding, do not plan to become pregnant during the study, and agree to use effective birth control (ie, condoms, hormonal contraception, diaphragm, intrauterine device, or sexual abstinence if this is in line with the patient’s current lifestyle) throughout the study and for at least 1 month after study completion; if using hormonal contraception, female patients should also use 1 additional form of effective birth control throughout the study. Female patients of non-child bearing potential (ie, surgically [bilateral oophorectomy, hysterectomy, or tubal ligation] or naturally sterile [>12 consecutive months without menses]);
4. Must have a diagnosis of HeFH by genetic testing or by having met the diagnostic criteria for definite familial hypercholesterolemia outlined by the Simon Broome Register Group (Scientific Steering Committee 1991) or World Health Organization (WHO)/Dutch Lipid Network (score >8);
5. Must have a fasting LDL-C >= 2.6 mmol/L (100 mg/dL)
Any one of the following subgroups of patients with documented history of cardiovascular disease as outlined below can be included with a fasting LDL-C of 1.8 mmol/L (70 mg/dL):
A)Coronary Artery Disease (CAD) including one or more of the following:
•Acute myocardial infarction (MI)
•Silent myocardial infarction
•Unstable angina
•Coronary revascularization procedure (e.g. percutaneous coronary intervention [PCI] or coronary artery bypass graft surgery [CABG])
•Clinically significant CAD diagnosed by invasive or non-invasive testing (such as coronary angiography, stress test using treadmill, stress echocardiography or nuclear imaging).
B)Previous ischemic stroke with a focal ischemic neurological deficit that persisted more than 24 hours, considered as being of atherothrombotic origin.
C)Peripheral arterial disease (one of the following criteria must be satisfied):
•Current intermittent claudication (muscle discomfort in the lower limb produced by exercise that is both reproducible and relieved by rest within 10 minutes) of presumed atherosclerotic origin together with ankle-brachial index equal to or less than 0.90 in either leg at rest, or
•History of intermittent claudication (muscle discomfort in the lower limb produced by exercise that is both reproducible and relieved by rest within 10 minutes) together with endovascular procedure or surgical intervention in one or both legs because of atherosclerotic disease, or
•History of critical limb ischemia together with thrombolysis, endovascular procedure or surgical intervention in one or both legs because of atherosclerotic disease.

6.Must be on a stable or maximally tolerated dose (4 weeks prior to screening) of an approved statin (rosuvastatin 40 mg daily, atorvastatin 80 mg daily), with or without ezetimibe. Patients intolerant to statins are allowed. See section 1.2.1 drug interaction studies with statins for details
Are the trial subjects under 18? no
Number of subjects for this age range:

Exclusion Criteria

1. Homozygous familial hypercholesterolemia;
2. Low-density lipoprotein (LDL) or plasma apheresis within 2 months prior to randomization;
3. New York Heart Association class III or IV heart failure, or known left ventricular ejection fraction <30%;
4. Uncontrolled cardiac arrhythmia, including confirmed QT interval corrected using Fridericia’s formula (QTcF) >450 msec for males and >470 msec for females at the screening electrocardiogram (ECG) assessment;
5. Myocardial infarction, unstable angina, percutaneous coronary intervention, coronary artery bypass graft, or stroke within 3 months prior to randomization;
6. Type 1 diabetes, or newly diagnosed or uncontrolled type 2 diabetes (hemoglobin A1c [HbA1c] >8%);
7.History of significant alcohol consumption for a period of more than 3 consecutive months within 1 year prior to screening;
Note: Significant alcohol consumption is defined as average of >20 g/day in female patients and >30 g/day in male patients;
8. Hyperthyroidism;
9. Thyroid replacement therapy
10. Hypothyroidism note: If TSH is up to 1.5 x ULN on screening with normal free T4, one repeat test is allowed to confirm the elevation in TSH. If TSH and free T4 are normal upon repeat testing, patient may be included. Patients with a history of thyroid hormone replacement therapy or patients who have discontinued thyroid hormone replacement therapy (including thyroxine) 2 months prior to randomization may be included in the study if this criterion is met
11. Evidence of chronic liver disease
12. Hepatitis B, as defined by the presence of hepatitis B surface antigen (HBsAg);
13. Hepatitis C, as defined by the presence of hepatitis C virus (HCV), ribonucleic acid, or hepatitis C antibody (anti-HCV). Patients with positive anti-HCV who test negative for HCV RNA at screening will be allowed to participate in the study.
14. Serum alanine aminotransferase (ALT) >1.5 × ULN (one repeat allowed)
15. Estimated glomerular filtration rate <60 mL/min
16. Creatine kinase >3 × ULN (one repeat allowed)
17. History of biliary diversion
18. Positive for human immunodeficiency virus infection
19. History of malignant hypertension
20. Systolic blood pressure >160 mmHg or diastolic blood pressure >100 mmHg at screening or randomization and confirmed at an unscheduled visit
21. Triglycerides >5.7 mmol/L (500 mg/dL) at screening and confirmed by repeat assessment
22. Active, serious medical disease with likely life expectancy <2 years
23. Active substance abuse, including inhaled or injection drugs within the year prior to screening
24. Use of any excluded medications or procedures listed in the protocol
25. Participation in an investigational new drug trial within the 30 days prior to randomization; or
26. Any other condition which, in the opinion of the Investigator, would impede compliance, hinder completion of the study, or compromise the well-being of the patient

Study & Design

Study Type
Interventional clinical trial of medicinal product
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Secondary Outcome Measures
NameTimeMethod
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