The primary objective of this study is to assess the mean percentage change from baseline to week 16 in low-density lipoprotein cholesterol (LDL-C) measured using beta quantification with LY3015014 compared with placebo, in patients with primary…
ID
Source
Brief title
Condition
- Other condition
Synonym
Health condition
hypercholesterolaemia
Research involving
Sponsors and support
Intervention
Outcome measures
Primary outcome
The primary objective of this study is to assess the mean percentage change
from baseline to week 16 in low-density lipoprotein cholesterol (LDL-C)
measured using beta quantification with LY3015014 compared with placebo, in
patients with primary hypercholesterolemia (HC), when added to statin and diet
(or diet alone in statin-intolerant patients) with or without ezetimibe.
Secondary outcome
The secondary objectives of the study are:
* To assess the absolute change in LDL-C measured using beta quantification
from baseline to week 16
with LY3015014 compared with placebo
* To assess the dose-response, exposure-response and time-response
relationships for LDL-C over a
16-week time course for LY3015014
* To assess the proportion of patients achieving an LDL-C level lower than 100
mg/dL (2.6 mmol/L) and
lower than 70 mg/dL (1.8 mmol/L) for LY3015014 compared with placebo
* To assess effects of LY3015014 in subgroups based on disease classification,
region, diabetes status,
statin dose, ezetimibe use, baseline LDL-C and PCSK9 levels, and prior exposure
to PCSK9 antibodies,
on change in LDL-C
* To assess the effect of LY3015014 on other pharmacodynamics (PD) markers,
including mean percentage change in total cholesterol (TC), high-density
lipoprotein cholesterol (HDL-C), triglycerides (TG), non-HDL-C, TC/HDL-C,
apolipoprotein B (Apo B), apolipoprotein A-1 (Apo A-1), Apo B/A-1 ratio,
lipoprotein(a) (Lp[a]), and total and free PCSK9 levels
* To evaluate the pharmacokinetic (PK) properties of LY3015014 and to determine
within-subject and
between-subject variability
* To assess the safety and tolerability of LY3015014, including muscle, hepatic
and cardiovascular safety
* To evaluate the development of anti-drug antibodies for LY3015014
* To assess the incidence and severity of injection site reactions, including
discontinuations due to injection site reactions with LY3015014
* To evaluate the effects of LY3015014 on a marker of inflammation (that is,
high-sensitivity C-reactive
protein [hsCRP])
Exploratory Objective: To assess effects of demographic, laboratory, and
genetic variables on change in LDL-C and other efficacy and/or safety outcomes
with LY3015014.
Background summary
Proprotein convertase subtilisin/kexin type 9 (PCSK9) antibody (LY3015014) is a
humanized immunoglobulin G4 (IgG4) monoclonal antibody that has demonstrated an
ability to reduce LDL-C with and without a statin background in Phase 1
studies. Study I5S-MC-EFJE (Study
EFJE) will determine the percentage change in LDL-C following 16 weeks of
LY3015014 when added to standard of care background therapy consisting of a
statin and diet (or diet alone in statin-intolerant patients) with or without
ezetimibe in patients with primary hypercholesterolemia (HC). Fot this study,
statin intolerant patients are patients who cannot tolerate any dose of at
least 1 statin. Study EFJE will assess the safety and tolerability of 5 dose
regimens of LY3015014 administered subcutaneously, including 3 dose levels
every 4 weeks (20 mg [20Q4W], 120 mg [120Q4W], and 300 mg [300Q4W]), and 2 dose
levels every 8 weeks (100 mg [100Q8W] and 300 mg [300Q8W]); a placebo group
will also be included. Efficacy and safety data from this Phase 2 study will be
used to select an appropriate dose regimen for
Phase 3.
Study objective
The primary objective of this study is to assess the mean percentage change
from baseline to week 16 in low-density lipoprotein cholesterol (LDL-C)
measured using beta quantification with LY3015014 compared with placebo, in
patients with primary hypercholesterolemia (HC), when added to statin and diet
(or diet alone in statin-intolerant patients) with or without ezetimibe.
Study design
Study I5S-MC-EFJE (Study EFJE) is a Phase 2, outpatient, double-blind,
randomized, parallelgroup, placebo-controlled, dose-ranging study (3 dose
levels Q4W and 2 dose levels Q8W), including up to an 8-week Screening and
Run-in Phase, a 16-week Treatment Phase, and an 8-week Follow-up Phase.
Intervention
Investigational Product, Dosage, and Mode of Administration or Intervention:
PCSK9 antibody
(LY3015014) given as subcutaneous (SC) injection by site personnel during a
study visit.
Three Q4 week dose groups: 20 mg (20Q4W), 120 mg (120Q4W), 300 mg (300Q4W)
Two Q8 week dose groups: 100 mg (100Q8W), 300 mg (300Q8W)
Planned Duration of Treatment: Approximately 25 to 32 weeks
Screening and Run-in Phase: Up to 8 weeks
Treatment Phase: 16 weeks
Observation Phase: 8 weeks
Reference Therapy, Dose, and Mode of Administration: Placebo (0.9% normal
saline for injection) of similar volume as active drug. Placebo will be
administered subcutaneously by site personnel during a study visit.
Study burden and risks
There are risks involveld with the study drug. There are also risks involved
with the treatment. The study drug and the combination with the standard
treatment can also involve other, unknown risks. Risks involved with the study
drug LY3015014 and the study procedures are listed in the risk appendix of the
patient information form.
Lilly Corporate Center N/A
Indianapolis IN46285
US
Lilly Corporate Center N/A
Indianapolis IN46285
US
Listed location countries
Age
Inclusion criteria
[1] Are men or women *18 years of age and *80 years of age.;[2] Diagnosed with primary HC defined as LDL-C *100 mg/dL (2.6 mmol/L) and TG *450 mg/dL (5.1 mmol/L).
o A subset of patients (up to approximately 20%) with an LDL-C *80 mg/dL to <100 mg/dL (*2.1 mmol/L to <2.6 mmol/L) will also be allowed.
o Includes at least approximately 20% HeFH patients with probable or definite diagnosis
based on clinical criteria or genotype (see Manual of Operations [MOO]) and polygenic
(non-familial) HC patients.;[3] Are on a stable diet and stable daily dose of atorvastatin, simvastatin (*40 mg/day),
rosuvastatin, pravastatin, lovastatin, fluvastatin, or pitavastatin for at least 6 weeks and further adjustments of statin dose are not deemed clinically indicated by the investigator, or up to
approximately 20% of patients with history of statin intolerance (i.e. patients who cannot tolerate any dose of at least 1 statin) who are not on statin treatment for at least 6 weeks, with
or without a stable dose of ezetimibe for at least 6 weeks.;[4a] Male patients with partner of childbearing potential: agree to use barrier protection
during sexual intercourse during the study and for 3 months following the
administration of the last dose of investigational product.;[4b] Female patients, including:
1) Women not of childbearing potential due to surgical sterilization (hysterectomy or bilateral oophorectomy or tubal ligation) or menopause.Women with an intact uterus are deemed postmenopausal if they have acessation of menses for at least 1 year, or 6 to 12 months of spontaneous amenorrhea with follicle stimulating hormone >40 mIU/mL (>40 IU/L); not
taking hormones or oral contraceptives within 1 year.
2) Women of childbearing potential who have a negative urine or serum pregnancy test, are not breast feeding, and agree to use a reliable method of birth control up to at least 3 months following the last dose of study drug, where reliable is defined as birth control that results in a low failure rate (that is, <1% per year) when used consistently and correctly. For example:
* Combination oral contraceptive pill
* Implantable contraceptives
* Injectable contraceptives
* Intrauterine device
* Intrauterine system * for example, Mirena progestin-releasing coil
* Contraceptive patch
See MOO for additional information regarding reliable methods of birth control.
[5] Have given informed consent to participate in the study.
Exclusion criteria
[6] Have secondary HC or homozygous familial HC. ;[7] Have had myocardial infarction (MI), unstable angina (UA), percutaneous coronary intervention, coronary artery bypass graft, stroke, or deep vein thrombosis/pulmonary embolism within 3 months of screening, or have planned cardiovascular surgery or percutaneous coronary intervention.;[8] Have symptoms consistent with moderate or severe heart failure or are receiving treatment for symptomatic congestive heart failure (CHF) or known left ventricular ejection fraction (LVEF) <30%.;[9] Uncontrolled hypertension characterized by a systolic blood pressure >160 mmHg or diastolic blood pressure >100 mmHg.;[10] Have diabetes mellitus (type 1 or 2) that requires or is likely to require any injectable glucose lowering therapy (including insulins) during the course of the study or have hemoglobin A1c (HbA1c) *8.5%.;[11] Have thyroid-stimulating hormone (TSH) levels outside normal reference range for the central laboratory. Patients who are clinically euthyroid and on stable thyroid replacement therapy for at least 2 months prior to screening and who are anticipated to remain on this dose throughout the trial period are acceptable exceptions to this criterion.
Design
Recruitment
Medical products/devices used
Followed up by the following (possibly more current) registration
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Other (possibly less up-to-date) registrations in this register
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In other registers
Register | ID |
---|---|
EudraCT | EUCTR2013-000622-55-NL |
CCMO | NL44019.018.13 |