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HypercholesterolemiaPhase 3GAUSS-4NCT02634580

Goal Achievement After Utilizing an Anti-PCSK9 Antibody in Statin Intolerant Subjects-4

A Phase 3 study testing Evolocumab and Ezetimibe in people with Hypercholesterolemia, run by Amgen at 35 sites in Japan.

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 primary objective of the study was to evaluate the effect of 12 weeks of subcutaneous (SC) evolocumab compared with ezetimibe, on percent change from baseline in low-density lipoprotein cholesterol (LDL-C) in hypercholesterolemic adults unable to tolerate an effective dose of a statin. Read more about this study

Who is it for?
Ages 20 to 80 years
Conditions the study is for
Hypercholesterolemia
What is being tested?
Evolocumab and Ezetimibe
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
61 participants
Where
35 sitesJapan
Study dates
27 Feb 2016to 26 May 2018
Phase
Phase 3
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 20 to 80 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Male or female ≥ 20 to ≤ 80 years of age
  • Japanese by self-identification
  • Not on a statin or on a low dose statin with stable dose for at least 4 weeks.
  • Subject not at LDL-C goal
  • History of statin intolerance to at least 2 statins
  • Lipid lowering therapy has been stable prior to screening for at least 4 weeks
  • Fasting triglycerides ≤ 400 mg/dL

Who cannot join

  • New York Heart Association (NYHA) III or IV heart failure
  • Uncontrolled cardiac arrhythmia
  • Uncontrolled hypertension
  • Type 1 diabetes
  • Poorly controlled type 2 diabetes
  • Uncontrolled hypothyroidism or hyperthyroidism

Trial locations and contacts

35 sites in 1 country.

35 sites in 1 country

Japan35 sites
  • Research Site

    Bunkyo-ku, Tokyo, 113-8655

  • Research Site

    Chiba, Chiba, 260-8677

  • Research Site

    Chikushino-shi, Fukuoka, 818-8516

  • Research Site

    Chuo-ku, Tokyo, 103-0027

  • Research Site

    Fujimi-shi, Saitama, 354-0031

  • Research Site

    Hamamatsu, Shizuoka, 430-0929

  • Research Site

    Higashiyamato-shi, Tokyo, 207-0014

  • Research Site

    Hiroshima, Hiroshima, 734-8551

  • Research Site

    Iruma-gun, Saitama, 350-0495

  • Research Site

    Kagoshima, Kagoshima-ken, 890-8520

  • Research Site

    Kahoku-gun, Ishikawa-ken, 920-0293

  • Research Site

    Kanazawa, Ishikawa-ken, 920-8650

  • Research Site

    Kawaguchi-shi, Saitama, 332-0012

  • Research Site

    Kisarazu-shi, Chiba, 292-8535

  • Research Site

    Kobe, Hyōgo, 650-0017

  • Research Site

    Koga-shi, Fukuoka, 811-3195

  • Research Site

    Koga-shi, Ibaraki, 306-0041

  • Research Site

    Komatsu-shi, Ishikawa-ken, 923-8560

  • Research Site

    Kumamoto, Kumamoto, 860-8556

  • Research Site

    Kumamoto, Kumamoto, 862-0976

  • Research Site

    Kyoto, Kyoto, 606-8507

  • Research Site

    Matsudo-shi, Chiba, 271-0077

  • Research Site

    Morioka, Iwate, 020-0866

  • Research Site

    Morioka, Iwate, 020-8505

  • Research Site

    Musashino-shi, Tokyo, 180-0022

  • Research Site

    Nagoya, Aichi-ken, 466-8560

  • Research Site

    Nagoya, Aichi-ken, 466-8650

  • Research Site

    Nakagami-gun, Okinawa, 901-2393

  • Research Site

    Ohsaki-shi, Miyagi, 989-6143

  • Research Site

    Osaka, Osaka, 530-0001

  • Research Site

    Osaka, Osaka, 553-0003

  • Research Site

    Shinagawa-ku, Tokyo, 142-8666

  • Research Site

    Sukagawa-shi, Fukushima, 962-0001

  • Research Site

    Sukagawa-shi, Fukushima, 962-8503

  • Research Site

    Yokohama, Kanagawa, 245-8575

Other trials in Japan

About this study

Official title: A Double-blind, Randomized, Multicenter Study to Evaluate the Safety and Efficacy of Evolocumab, Compared With Ezetimibe, in Hypercholesterolemic Japanese Subjects Unable to Tolerate an Effective Dose of a HMG-CoA Reductase Inhibitor Due to Muscle Related Side Effects

The primary objective of the study was to evaluate the effect of 12 weeks of subcutaneous (SC) evolocumab compared with ezetimibe, on percent change from baseline in low-density lipoprotein cholesterol (LDL-C) in hypercholesterolemic adults unable to tolerate an effective dose of a statin.

Read the detailed description

After screening participants who met all inclusion/exclusion criteria were randomized with an allocation ratio of 2:2:1:1 into 4 groups: evolocumab (AMG 145) 420 mg administered by subcutaneous injection monthly and placebo pill daily; evolocumab 140 mg administered by subcutaneous injection every two weeks and placebo pill by mouth daily; placebo 420 mg administered by subcutaneous injection monthly and ezetimibe 10 mg pill daily; placebo 140 mg administered subcutaneous injection every two weeks and ezetimibe 10 mg pill daily. Randomization was stratified by screening LDL-C level and baseline statin use. Participants on low or atypical statin dose therapy must have been on a stable dose for at least 4 weeks prior to screening and throughout the blinded portion of the study; the dose could not be adjusted during screening and for the duration of the study. After Week 12, ezetimibe was discontinued and participants moved to an open-label dose of evolocumab administered by subcutaneous injection either every two weeks or monthly and their standard of care.

Being tested
Evolocumab, Ezetimibe, Placebo to Evolocumab, Placebo Ezetimibe
Keywords
Japanese, High cholesterol, Treatment of high cholesterol, Lowering cholesterol, Lowering high cholesterol, Hypercholesterolemia, Statin intolerant
Medical subject headings
Hypercholesterolemia

What participants receive

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

  • EvolocumabBiological

    Also called AMG 145, Repatha

    Administered by subcutaneous injection

  • EzetimibeDrug

    Also called Zetia

    Tablet for oral administration

  • Placebo to EvolocumabDrug

    Administered by subcutaneous injection

  • Placebo EzetimibeDrug

    Tablet for oral administration

Study groups in NCT02634580
Study groupRoleWhat they receive
Ezetimibe (Q2W)Active comparatorParticipants received placebo subcutaneous injection once every 2 weeks and 10 mg ezetimibe orally once a day for 12 weeks. From week 12 participants received open-label evolocumab 140 mg subcutaneously once every 2 weeks until week 48.
Receives: Biological: Evolocumab; Drug: Ezetimibe; Drug: Placebo to Evolocumab
Ezetimibe (QM)Active comparatorParticipants received placebo subcutaneous injection once a month and 10 mg ezetimibe orally once a day for 12 weeks. From week 12 participants received open-label evolocumab 420 mg subcutaneously once a month until week 48.
Receives: Biological: Evolocumab; Drug: Ezetimibe; Drug: Placebo to Evolocumab
Evolocumab Q2WExperimentalParticipants received 140 mg evolocumab by subcutaneous injection once every 2 weeks and placebo tablets once a day for 12 weeks. From week 12 participants received open-label evolocumab 140 mg subcutaneously once every 2 weeks until week 48.
Receives: Biological: Evolocumab; Drug: Placebo Ezetimibe
Evolocumab QMExperimentalParticipants received 420 mg evolocumab by subcutaneous injection once a month and placebo tablets once a day for 12 weeks. From week 12 participants received open-label evolocumab 420 mg subcutaneously once a month until week 48.
Receives: Biological: Evolocumab; Drug: Placebo Ezetimibe

What is being measured

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

  1. Percent Change From Baseline in Low-Density Lipoprotein Cholesterol (LDL-C) at the Mean of Weeks 10 and 12

    For all efficacy endpoints the two dosing regimens (every 2 weeks and every month) for each treatment were pooled for analysis.

    Measured: Baseline and Weeks 10 and 12

  2. Percent Change From Baseline in Low-Density Lipoprotein Cholesterol (LDL-C) at Week 12

    Measured: Baseline and week 12

Secondary outcomes (22)
  1. Change From Baseline in LDL-C at the Mean of Weeks 10 and 12

    Measured: Baseline and weeks 10 and 12

  2. Change From Baseline in LDL-C at Week 12

    Measured: Baseline and week 12

  3. Percentage of Participants Who Achieved a Mean LDL-C at Weeks 10 and 12 of Less Than 70 mg/dL

    Mean low density lipoprotein-cholesterol response was defined as LDL-C < 70 mg/dL [1.8 mol/L].

    Measured: Weeks 10 and 12

  4. Percentage of Participants Who Achieved a LDL-C of Less Than 70 mg/dL at Week 12

    Measured: Week 12

  5. Percent Change From Baseline in Total Cholesterol at the Mean of Weeks 10 and 12

    Measured: Baseline and weeks 10 and 12

  6. Percent Change From Baseline in Total Cholesterol at Week 12

    Measured: Baseline and week 12

  7. Percent Change From Baseline in Non-HDL-C at the Mean of Weeks 10 and 12

    Measured: Baseline and weeks 10 and 12

  8. Percent Change From Baseline in Non-HDL-C at Week 12

    Measured: Baseline and week 12

  9. Percent Change From Baseline in Apolipoprotein B at the Mean of Weeks 10 and 12

    Measured: Baseline and Weeks 10 and 12

  10. Percent Change From Baseline in Apolipoprotein B at Week 12

    Measured: Baseline and week 12

  11. Percent Change From Baseline in the Total Cholesterol/HDL-C Ratio at the Mean of Weeks 10 and 12

    Measured: Baseline and weeks 10 and 12

  12. Percent Change From Baseline in the Total Cholesterol/HDL-C Ratio at Week 12

    Measured: Baseline and week 12

  13. Percent Change From Baseline in Apolipoprotein B/Apolipoprotein A-1 Ratio at the Mean of Weeks 10 and 12

    Measured: Baseline and weeks 10 and 12

  14. Percent Change From Baseline in Apolipoprotein B/Apolipoprotein A-1 Ratio at Week 12

    Measured: Baseline and week 12

  15. Percent Change From Baseline in Lipoprotein(a) at the Mean of Weeks 10 and 12

    Measured: Baseline and weeks 10 and 12

  16. Percent Change From Baseline in Lipoprotein(a) at Week 12

    Measured: Baseline and week 12

  17. Percent Change From Baseline in Triglycerides at the Mean of Weeks 10 and 12

    Measured: Baseline and weeks 10 and 12

  18. Percent Change From Baseline in Triglycerides at Week 12

    Measured: Baseline and week 12

  19. Percent Change From Baseline in HDL-C at the Mean of Weeks 10 and 12

    Measured: Baseline and weeks 10 and 12

  20. Percent Change From Baseline in HDL-C at Week 12

    Measured: Baseline and week 12

  21. Percent Change From Baseline in VLDL-C at the Mean of Weeks 10 and 12

    Measured: Baseline and weeks 10 and 12

  22. Percent Change From Baseline in VLDL-C at Week 12

    Measured: Baseline and week 12

Timeline

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

  1. First posted18 Dec 2015 (estimated)
  2. Study start27 Feb 2016
  3. Primary completion10 Aug 2017
  4. Study completion26 May 2018

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 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
61 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02634580
Sponsor's protocol ID
20140234
Acronym
GAUSS-4
Status last verified
Oct 2020
First submitted
16 Dec 2015
Last updated
10 Nov 2020
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No

Publications

  • Koba S, Inoue I, Cyrille M, Lu C, Inomata H, Shimauchi J, Kajinami K. Evolocumab vs. Ezetimibe in Statin-Intolerant Hyperlipidemic Japanese Patients: Phase 3 GAUSS-4 Trial. J Atheroscler Thromb. 2020 May 1;27(5):471-484. doi: 10.5551/jat.50963. Epub 2019 Nov 21.

    PubMed 31748467

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Evolocumab and Ezetimibe in people with Hypercholesterolemia, run by Amgen at 35 sites in Japan.

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 7 inclusion and 6 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 10 Nov 2020. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 35 sites in Japan. 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. 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 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

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 31 Aug 2018). 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 Low-Density Lipoprotein Cholesterol (LDL-C) at the Mean of Weeks 10 and 12 (time frame: Baseline and Weeks 10 and 12). 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 NCT02634580, which also lists 1 linked publication.

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 10 Nov 2020.

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