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The APPROACH Study: A Study of Volanesorsen (Formerly IONIS-APOCIIIRx) in Patients With Familial Chylomicronemia Syndrome

Phase 3
Completed
Conditions
Familial Chylomicronemia Syndrome
Interventions
Drug: Placebo
Registration Number
NCT02211209
Lead Sponsor
Ionis Pharmaceuticals, Inc.
Brief Summary

The purpose of this study is to evaluate the efficacy and safety of volanesorsen given for 52 weeks in participants with Familial Chylomicronemia Syndrome

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
67
Inclusion Criteria
  • History of chylomicronemia
  • A diagnosis of Familial Chylomicronemia Syndrome (Type 1 Hyperlipoproteinemia)
  • Fasting triglycerides (TG) ≥ 750 mg/dL (8.4 mmol/L) at Screening
Exclusion Criteria
  • Diabetes mellitus if newly diagnosed or if HbA1c ≥ 9.0%
  • Other types of severe hypertriglyceridemia
  • Active pancreatitis within 4 weeks of screening
  • Acute Coronary Syndrome within 6 months of screening
  • Major surgery within 3 months of screening
  • Treatment with Glybera therapy within 2 years of screening
  • Previous treatment with IONIS-APOCIIIRx
  • Have any other conditions in the opinion of the investigator which could interfere with the participant participating in or completing the study

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
PlaceboPlaceboVolanesorsen-matching placebo administered subcutaneously once-weekly for 52 weeks.
VolanesorsenVolanesorsenVolanesorsen 300 mg administered subcutaneously once-weekly for 52 weeks.
Primary Outcome Measures
NameTimeMethod
Percent Change in Fasting Triglycerides (TG) From Baseline to Month 3Baseline to 3 months

The Month 3 endpoint was defined as the average of Week 12 (Day 78) and Week 13 (Day 85) fasting assessments.

Secondary Outcome Measures
NameTimeMethod
Change From Baseline in Postprandial TG Area Under the Curve (AUC)(0-9h)Baseline to an on-treatment assessment between Week 13 and Week 19

Participants had 2 postprandial assessments - one at Baseline (completed at least 48 hours prior to first dose) and one at any time between Week 13 and 19, inclusive. Assessment timepoints include from 1-hr before to up to 9 hrs after ingestion of the meal at 1-hour interval. Postprandial AUC results were calculated using a linear trapezoidal rule for each postprandial measure in the subset of participants who had postprandial assessments 0-9 hour results at baseline and the postbaseline between Week 13 to 19.

Absolute Change From Baseline in Fasting TG at Month 3Baseline to 3 months

The Month 3 endpoint was defined as the average of Week 12 (Day 78) and Week 13 (Day 85) fasting assessments.

Treatment Response Rate Defined as Participants With Fasting Plasma TG < 750 mg/dL at Month 3Baseline to 3 months

The Month 3 endpoint was defined as the average of Week 12 (Day 78) and Week 13 (Day 85) fasting assessments. mg/dL = milligrams per deciliter

Treatment Response Rate Defined as Participants With Fasting TG ≥ 40% Reduction From Baseline at Month 3Baseline to 3 months

The Month 3 endpoint was defined as the average of Week 12 (Day 78) and Week 13 (Day 85) fasting assessments.

Frequency and Severity of Participant-reported Abdominal Pain During the Treatment PeriodBaseline to 12 months

Abdominal pain was measured according to the Bracket electronic patient-reported outcomes (ePRO) assessment. Scores were categorized as follows: no pain (pain score: 0), mild (pain score: 1-3), moderate (pain score: 4-6), or severe (pain score: 7-10). The yearly frequency was calculated as the number of episodes during the on-treatment period / (last dose date - first dose date + 28) \* 365.25. Missing data were imputed by using next observation carried back (NOCB) if there was a subsequent score available.

Frequency of the Composite of Episodes of Acute Pancreatitis and Participant-reported Moderate/Severe Abdominal Pain During the Treatment Period12 months

Moderate/severe abdominal pain was defined as having a pain score of 4-10 on the Bracket electronic patient-reported outcomes (ePRO) assessment. Scores were categorized as follows: no pain (pain score: 0), mild (pain score: 1-3), moderate (pain score: 4-6), or severe (pain score: 7-10). The yearly frequency was calculated as the number of episodes during the on-treatment period / (last dose date - first dose date + 28) \* 365.25.

Change From Baseline in Hepatosplenomegaly as Assessed by MRI at Week 52Baseline to Week 52

The Week 52 endpoint was defined as the average of Week 50 (Day 344)/Week 51 (Day 351) and Week 52 (Day 358) fasting assessments.

Trial Locations

Locations (1)

IONIS Investigative Site

🇬🇧

Peterborough, United Kingdom

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