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Elevated Lipoprotein(a)Phase 2NCT02160899

Safety, Tolerability, Pharmacokinetics, and Pharmacodynamics of ISIS-APO(a)Rx in Participants With High Lipoprotein(a)

A Phase 2 study testing ISIS-APO(a)Rx in people with Elevated Lipoprotein(a), run by Ionis Pharmaceuticals, Inc. at 13 sites in 5 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The purpose is to assess the safety, tolerability, pharmacokinetics, and pharmacodynamics of ISIS-APO(a)Rx given to participants with high lipoprotein(a) for 12 weeks. Read more about this study

Who is it for?
Ages 18 to 65 years
Conditions the study is for
Elevated Lipoprotein(a)
What is being tested?
ISIS-APO(a)Rx
Type of treatment
Injection or infusion
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
64 participants
Where
13 sitesin 5 countries
Study dates
Jun 2014to Nov 2015
Phase
Phase 2
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 65 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Males or females aged 18-65 inclusive
  • Females must be non-pregnant and non-lactating, and either surgically sterile (e.g., tubal occlusion, hysterectomy, bilateral salpingectomy, bilateral oophorectomy) or post-menopausal (defined as 12 months of spontaneous amenorrhea without an alternative medical cause and follicle-stimulating hormone (FSH) levels in the postmenopausal range for the laboratory involved)
  • Males must be surgically sterile, abstinent or if engaged in sexual relations with a female of child-bearing potential, the participant must be using an acceptable contraceptive method from the time of signing the informed consent form until at least 16 weeks after the last dose of Study Drug
  • Body mass index (BMI) ≤40 kg/m2
  • Lipoprotein(a) ≥50 and <175 mg/dL at time of screening (Cohort A)
  • Lipoprotein(a) ≥175 mg/dL at time of screening (Cohort B)

Who cannot join

  • Clinically significant abnormalities in medical history (e.g., documented previous myocardial infarction, percutaneous coronary intervention (PCI), or major surgery within 3 months of screening, planned surgery that would occur during the study) or physical examination at screening
  • Clinically significant abnormalities in screening laboratory values that would render a participant unsuitable for inclusion
  • Active infection requiring systemic antiviral or antimicrobial therapy that will not be completed prior to Study Day 1
  • Known history or positive test for human immunodeficiency virus (HIV), hepatitis C, or chronic hepatitis B
  • Malignancy within 5 years, except for basal or squamous cell carcinoma of the skin or carcinoma in situ of the cervix that has been successfully treated
  • History of bleeding diathesis or coagulopathy
Show all 13Show fewer
  • Recent history of, or current drug or alcohol abuse
  • Participant with Lp(a) ≥50 and <175 mg/dL may not receive concomitant niacin therapy during the period 8 weeks prior to screening through the end of the Post-Treatment Evaluation Period
  • Use of statins, ezetimibe or fibrates unless on a stable regimen for at least 8 weeks prior to dosing and will remain on a stable regimen for the duration of the study
  • Use of lipid or Lp(a)-specific apheresis within 4 weeks prior to Screening through the end of the Post-Treatment Evaluation Period
  • Use of concomitant drugs (including herbal or over-the-counter (OTC) medications other than ibuprofen, Benadryl or topical steroids) unless authorized by the Sponsor Medical Monitor
  • Blood donation of 50-499 mL within 30 days of screening or of >499 mL within 8 weeks of screening
  • Have any other conditions, which, in the opinion of the Investigator would make the participant unsuitable for inclusion, or could interfere with the participant participating in or completing the study

Trial locations and contacts

13 sites in 5 countries.

13 sites in 5 countries

Netherlands4 sites
  • University of Amsterdam - Dept. of Vascular Medicine F4-109

    Amsterdam, 1105 AZ

  • Academic Hospital Maastricht

    Maastricht, 6229 HX

  • Sint Franciscus Gasthuis

    Rotterdam, 3045 PM

  • University Medical Center Utrecht

    Utrecht, 3584 CX

Other trials in Netherlands

Germany3 sites
  • Charite - University Hospital Berlin - Campus Virchow - Hospital

    Berlin, 13353

  • Uniklinik Koeln, Zentrum fuer Endokrinologie, Diabetologie und Praeventivmedizin (ZEDP)

    Cologne, 50937

  • Otto-von Guericke Universitaet, Uniklinik Magdeburg

    Magdeburg, 39120

Other trials in Germany

United Kingdom3 sites
  • Heart of England NHS Foundation Trust

    Birmingham, B9 5SS

  • Barlow Medical Centre

    Manchester, M20 2RN

  • Newcastle Upon Tyne Hospitals

    Newcastle upon Tyne, NE1 4LP

Other trials in United Kingdom

Canada2 sites
  • Chicoutimi Hospital

    Chicoutimi, Quebec, G7H 5H6

  • Clinique des Maladies Lipidiques de Quebec Inc.

    Québec, G1V4M6

Other trials in Canada

Denmark1 site
  • Herlev University Hospital

    Herlev, 2730

Other trials in Denmark

About this study

Official title: A Randomized, Double Blind, Placebo-Controlled, Dose Titration, Phase 2 Study to Assess the Safety, Tolerability, Pharmacokinetics, and Pharmacodynamics of ISIS 494372 Administered Subcutaneously to Patients With High Lipoprotein(a)

The purpose is to assess the safety, tolerability, pharmacokinetics, and pharmacodynamics of ISIS-APO(a)Rx given to participants with high lipoprotein(a) for 12 weeks.

Read the detailed description

Lipoprotein(a) [Lp(a)] is a genetic variant of low-density lipoprotein (LDL) in which the apolipoprotein B (apoB) -100 component of LDL is linked by a disulfide bond to apolipoprotein(a) [apo(a)], the distinct protein component of Lp(a) that is mainly responsible for its signature structural and functional properties. Lp(a) is now recognized as an important genetic risk factor for coronary artery disease, stroke and aortic stenosis.

The purpose of this study is to determine if ISIS-APO(a)Rx can reduce the production of apolipoprotein(a), or apo(a). This study will enroll 50 participants with Lipoprotein(a) ≥50 and <175 mg/dL and 10 participants with Lipoprotein(a) ≥175 mg/dL.

Being tested
ISIS-APO(a)Rx, Placebo
Keywords
High Lipoprotein(a)

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • ISIS-APO(a)RxDrug

    Also called ISIS 494372

    ISIS-APO(a)Rx subcutaneously: 100 mg on Days 1, 8, 15, and 22; 200 mg on Days 29, 36, 43, and 50 unless down-titrated; and 300 mg on Days 57, 64, 71, and 78 unless down-titrated.

  • PlaceboDrug

    Normal saline as Placebo, subcutaneously on Days 1, 8, 15, 22, 29, 36, 43, 50, 57, 64, 71, and 78.

Study groups in NCT02160899
Study groupRoleWhat they receive
Cohort A: PlaceboPlacebo comparatorParticipants will receive placebo (normal saline) subcutaneously on Days 1, 8, 15, 22, 29, 36, 43, 50, 57, 64, 71, and 78.
Receives: Drug: Placebo
Cohort A: ISIS-APO(a)Rx < 2000 mgExperimentalParticipants will receive ISIS-APO(a)Rx subcutaneously: 100 mg on Days 1, 8, 15, and 22; 200 mg on Days 29, 36, 43, and 50 unless down-titrated; and 300 mg on Days 57, 64, 71, and 78 unless down-titrated.
Receives: Drug: ISIS-APO(a)Rx
Cohort A: ISIS-APO(a)Rx >= 2000 mgExperimentalParticipants will receive ISIS-APO(a)Rx subcutaneously: 100 mg on Days 1, 8, 15, and 22; 200 mg on Days 29, 36, 43, and 50 unless down-titrated; and 300 mg on Days 57, 64, 71, and 78 unless down-titrated.
Receives: Drug: ISIS-APO(a)Rx
Cohort B: PlaceboPlacebo comparatorParticipants will receive placebo (normal saline) subcutaneously on Days 1, 8, 15, 22, 29, 36, 43, 50, 57, 64, 71, and 78.
Receives: Drug: Placebo
Cohort B: ISIS-APO(a)Rx < 2000 mgExperimentalParticipants will receive ISIS-APO(a)Rx subcutaneously: 100 mg on Days 1, 8, 15, and 22; 200 mg on Days 29, 36, 43, and 50 unless down-titrated; and 300 mg on Days 57, 64, 71, and 78 unless down-titrated.
Receives: Drug: ISIS-APO(a)Rx
Cohort B: ISIS-APO(a)Rx >= 2000 mgExperimentalParticipants will receive ISIS-APO(a)Rx subcutaneously: 100 mg on Days 1, 8, 15, and 22; 200 mg on Days 29, 36, 43, and 50 unless down-titrated; and 300 mg on Days 57, 64, 71, and 78 unless down-titrated.
Receives: Drug: ISIS-APO(a)Rx

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Percent Change From Baseline in Lipoprotein Lp(a) Plasma Concentration at Day 85/Day 99

    Data are reported for evaluable participants.

    Measured: Day 85/Day 99

  2. Number of Participants With at Least One Treatment-emergent Adverse Event (TEAE)

    An adverse event is any unfavorable and unintended sign (including a clinically significant abnormal laboratory finding, for example), symptom, or disease temporally associated with the study or use of investigational drug product, whether or not the AE is considered related to the investigational drug product.

    Measured: Up to approximately 32 weeks

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted11 Jun 2014 (estimated)
  2. Study startJun 2014
  3. Primary completionNov 2015
  4. Study completionNov 2015

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Double blind
Who is masked
Participant, Investigator
Enrolment
64 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02160899
Sponsor's protocol ID
ISIS 494372-CS3
Status last verified
Dec 2019
First submitted
5 Jun 2014
Last updated
20 Dec 2019
Data monitoring committee
No

Publications

  • Viney NJ, van Capelleveen JC, Geary RS, Xia S, Tami JA, Yu RZ, Marcovina SM, Hughes SG, Graham MJ, Crooke RM, Crooke ST, Witztum JL, Stroes ES, Tsimikas S. Antisense oligonucleotides targeting apolipoprotein(a) in people with raised lipoprotein(a): two randomised, double-blind, placebo-controlled, dose-ranging trials. Lancet. 2016 Nov 5;388(10057):2239-2253. doi: 10.1016/S0140-6736(16)31009-1. Epub 2016 Sep 21.

    PubMed 27665230
  • Tragante V, Asselbergs FW, Swerdlow DI, Palmer TM, Moore JH, de Bakker PIW, Keating BJ, Holmes MV. Harnessing publicly available genetic data to prioritize lipid modifying therapeutic targets for prevention of coronary heart disease based on dysglycemic risk. Hum Genet. 2016 May;135(5):453-467. doi: 10.1007/s00439-016-1647-9. Epub 2016 Mar 5.

    PubMed 26946290

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing ISIS-APO(a)Rx in people with Elevated Lipoprotein(a), run by Ionis Pharmaceuticals, Inc. at 13 sites in 5 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 6 inclusion and 13 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 20 Dec 2019. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 13 sites in Netherlands, Germany, United Kingdom, Canada, Denmark. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 20 Dec 2019). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Percent Change From Baseline in Lipoprotein Lp(a) Plasma Concentration at Day 85/Day 99 (time frame: Day 85/Day 99). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT02160899, which also lists 2 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 20 Dec 2019.

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