LDL-C Assessment With PCSK9 Monoclonal Antibody Inhibition Combined With Statin Therapy-2



Status:Completed
Conditions:High Cholesterol
Therapuetic Areas:Cardiology / Vascular Diseases
Healthy:No
Age Range:18 - 80
Updated:3/8/2019
Start Date:January 15, 2013

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A Double-blind, Randomized, Placebo and Ezetimibe Controlled, Multicenter Study to Evaluate Safety, Tolerability and Efficacy of AMG 145 on LDL-C in Combination With Statin Therapy in Subjects With Primary Hypercholesterolemia and Mixed Dyslipidemia

The primary objective was to evaluate the effect of 12 weeks of evolocumab administered
subcutaneously every 2 weeks (Q2W) and monthly (QM) when used in combination with a statin,
compared with placebo, on percent change from baseline in low-density lipoprotein cholesterol
(LDL-C) in patients with primary hypercholesterolemia and mixed dyslipidemia.

Prior to the first randomization, participants entered a screening period to determine
eligibility. During screening, all participants received subcutaneous placebo corresponding
to the once monthly dose volume. Participants who completed the screening period and met
eligibility criteria were randomized to 1 of 5 open-label statin cohorts (atorvastatin 10 mg
or 80 mg, rosuvastatin 5 mg or 40 mg, or simvastatin 40 mg) for a 4 week lipid stabilization
period based on statin therapy at the time of study entry (no statin use vs non-intensive
statin use vs intensive statin use).

After the 4-week lipid-stabilization period, eligible patients taking rosuvastatin or
simvastatin during the lipid-stabilization phase were then randomized to 1 of 4 treatment
groups: evolocumab (140 mg, subcutaneous, every 2 weeks) or matching placebo (subcutaneous,
every 2 weeks), or evolocumab (420 mg, subcutaneous, monthly) or matching placebo
(subcutaneous, monthly). Patients taking atorvastatin during the lipid-stabilization phase
were then randomized to 1 of 6 treatment groups: evolocumab (140 mg, subcutaneous, every 2
weeks) and placebo (oral, daily), evolocumab (420 mg, subcutaneous, monthly) and placebo
(oral, daily), placebo (subcutaneous, every 2 weeks) and placebo (oral, daily) or ezetimibe
(10 mg, oral, daily), or placebo (subcutaneous, monthly) and placebo (oral, daily) or
ezetimibe (10 mg, oral, daily).

A participant was considered randomized into the study after successfully completing the
screening period, meeting all inclusion/exclusion criteria, and undergoing both randomization
procedures.

Participants randomized to simvastatin who were taking verapamil or diltiazem prior to
randomization received simvastatin 10 mg once daily (QD) while participants who were taking
amlodipine, amiodarone or ranolazine prior to randomization received simvastatin 20 mg QD.
All other participants randomized to simvastatin received simvastatin 40 mg QD.

Inclusion Criteria:

- Male or female ≥ 18 to ≤ 80 years of age

- Subjects not taking a statin must have fasting LDL-C of at least 150 mg/dL (4.0
mmol/L)

- Subjects already on a non-intensive statin must have fasting LDL-C at screening ≥ 100
mg/dL (2.6 mmol/L)

- Subjects already on a intensive statin must have fasting LDL-C at screening ≥ 80 mg/dL
(2.1 mmol/L)

- Fasting triglycerides ≤ 400 mg/dL (4.5 mmol/L)

Exclusion Criteria:

- Statin intolerance

- New York Heart association (NYHA) III or IV heart failure

- Uncontrolled hypertension

- Uncontrolled cardiac arrhythmia

- Type 1 diabetes, poorly controlled type 2 diabetes

- Uncontrolled hypothyroidism or hyperthyroidism
We found this trial at
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