DyslipidemiaPhase 4NCT02642159
Efficacy and Safety of Alirocumab Versus Usual Care on Top of Maximally Tolerated Statin Therapy in Patients With Type 2 Diabetes and Mixed Dyslipidemia (ODYSSEY DM-Dyslipidemia)
A Phase 4 study testing Alirocumab, Statins and Ezetimibe in people with Dyslipidemia, run by Sanofi at 119 sites in 15 countries.
Trial summary
Primary Objective: To demonstrate the superiority of alirocumab in comparison with usual care in the reduction of non-high-density lipoprotein cholesterol (non-HDL-C) in participants with type 2 diabetes and mixed dyslipidemia at high cardiovascular risk with non-HDL-C not adequately controlled with maximally… Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Dyslipidemia
- What is being tested?
- Alirocumab, Statins and Ezetimibe
- Type of treatment
- Pill or oral medicine, Injection or infusion
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 413 participants
- Where
- 119 sitesin 15 countries
- Study dates
- 15 Mar 2016to 15 May 2017
- Phase
- Phase 4
- 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 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Participants with type 2 diabetes and mixed dyslipidemia whose non-HDL-C was not adequately controlled with a stable, maximum dose/regimen of statin that was tolerated by the participant.
- 18 years of age or more.
- Documented history of atherosclerotic cardiovascular disease (ASCVD) or at least one additional cardiovascular risk factor.
- Non-HDL-C of 100 mg/dL or greater.
- Triglycerides greater than or equal to 150 mg/dL and less than 500 mg/dL.
- Stable anti-hyperglycemic agents for at least 3 months prior to the screening visit and between screening and randomization (including stable insulin dose defined as no variation more than 30% in daily insulin dose within the preceding 3 months, as judged by the Investigator).
- No change in weight of more than 5 kg within the prior 3 months.
- On stable dose of medications that are known to influence weight and/or lipids within the last 3 months.
Who cannot join
- Use of any lipid modifying therapies other than statins within the last 4 weeks (eg, ezetimibe, fenofibrate, nicotinic acid, omega-3 fatty acids, etc.) or use of over the counter products/nutraceuticals known to impact lipids (eg, red yeast rice) within the last 4 weeks.
- Currently drinking more than 2 standard alcoholic drinks per day.
- Body Mass Index (BMI) >45 kg/m² or currently enrolled in a weight loss program and still in active phase of weight loss.
- Glycosylated hemoglobin (HbA1c) 9% or greater.
- The above information was not intended to contain all considerations relevant to a participant's potential participation in a clinical trial.
Trial locations and contacts
119 sites in 15 countries.
119 sites in 15 countries
United States57 sites
Investigational Site Number 840-178
Albany, New York, 12206
Investigational Site Number 840-137
Bainbridge, Georgia, 39819
Investigational Site Number 840-136
Bend, Oregon, 97702
Investigational Site Number 840-107
Boca Raton, Florida, 33434
Investigational Site Number 840-170
Boynton Beach, Florida, 33472
Investigational Site Number 840-114
Bradenton, Florida, 34201
Investigational Site Number 840-147
Chattanooga, Tennessee, 37404
Investigational Site Number 840-126
Chesapeake, Virginia, 23321
Investigational Site Number 840-161
Chicago, Illinois, 60607
Investigational Site Number 840-128
Columbus, Georgia, 31904
Investigational Site Number 840-104
Columbus, Ohio, 43213
Investigational Site Number 840-184
Crystal Lake, Illinois, 60012
Investigational Site Number 840-153
Dallas, Texas, 75230
Investigational Site Number 840-174
Evanston, Illinois, 60201
Investigational Site Number 840-129
Fargo, North Dakota, 58103
Investigational Site Number 840-141
Fresno, California, 93720
Investigational Site Number 840-188
Greensboro, North Carolina, 27408
Investigational Site Number 840-143
Houston, Texas, 77095
Investigational Site Number 840-168
Houston, Texas, 77099
Investigational Site Number 840-152
Huntington Beach, California, 92648
Investigational Site Number 840-167
Idaho Falls, Idaho, 83404
Investigational Site Number 840-113
Jefferson City, Missouri, 65109
Investigational Site Number 840-159
Knoxville, Tennessee, 37920
Investigational Site Number 840-115
La Jolla, California, 92037
Investigational Site Number 840-101
Las Vegas, Nevada, 89119
Investigational Site Number 840-140
Las Vegas, Nevada, 89128
Investigational Site Number 840-163
Little Rock, Arkansas, 72205
Investigational Site Number 840-118
Los Angeles, California, 90057
Investigational Site Number 840-108
Louisville, Kentucky
Investigational Site Number 840-105
Marion, Ohio, 43302
Investigational Site Number 840-175
Maumee, Ohio, 43537
Investigational Site Number 840-190
Metairie, Louisiana, 70006
Investigational Site Number 840-131
Morehead City, North Carolina, 28557
Investigational Site Number 840-158
Morganton, North Carolina, 28655
Investigational Site Number 840-187
Murrells Inlet, South Carolina, 29576-9351
Investigational Site Number 840-181
New York, New York, 10016
Investigational Site Number 840-157
New York, New York, 10029
Investigational Site Number 840-106
Northridge, California, 91325
Investigational Site Number 840-132
Ocoee, Florida, 34761
Investigational Site Number 840-148
Omaha, Nebraska, 68131-2137
Investigational Site Number 840-185
Orem, Utah, 84058
Investigational Site Number 840-179
Oviedo, Florida, 32765
Investigational Site Number 840-183
Paducah, Kentucky, 42003
Investigational Site Number 840-176
Port Hueneme, California, 93041
Investigational Site Number 840-171
Richmond, Virginia, 23249
Investigational Site Number 840-151
Rockville, Maryland, 20852
Investigational Site Number 840-142
Round Rock, Texas, 78681
Investigational Site Number 840-150
Salt Lake City, Utah, 84102
Investigational Site Number 840-138
Springfield, Illinois, 62711
Investigational Site Number 840-120
St Louis, Missouri, 63110
Investigational Site Number 840-169
Stockbridge, Georgia, 30281
Investigational Site Number 840-111
Summerville, South Carolina, 29485
Investigational Site Number 840-123
Tampa, Florida, 33634
Investigational Site Number 840-122
Tarzana, California, 91356
Investigational Site Number 840-133
Tomball, Texas, 77375
Investigational Site Number 840-156
Tustin, California, 92780-6953
Investigational Site Number 840-160
Van Nuys, California, 91405
Germany10 sites
Investigational Site Number 276112
Berlin, 13347
Investigational Site Number 276109
Berlin, 13353
Investigational Site Number 276104
Dippoldiswalde, 01744
Investigational Site Number 276101
Dresden, 01307
Investigational Site Number 276110
Essen, 45355
Investigational Site Number 276108
Essen, 45359
Investigational Site Number 276111
Goch, 47574
Investigational Site Number 276107
Karlsruhe, 76199
Investigational Site Number 276103
Künzing, 94550
Investigational Site Number 276102
Oldenburg in Holstein, 23758
Turkey (Türkiye)10 sites
Investigational Site Number 792105
Adana, 01250
Investigational Site Number 792106
Ankara, 06100
Investigational Site Number 792102
Ankara
Investigational Site Number 792108
Çorum
Investigational Site Number 792109
Hatay, 31030
Investigational Site Number 792104
Izmir, 35340
Investigational Site Number 792101
Izmir
Investigational Site Number 792110
Izmir
Investigational Site Number 792107
Kayseri, 38039
Investigational Site Number 792103
Samsun
Italy8 sites
Investigational Site Number 380104
Bergamo, 24127
Investigational Site Number 380107
Catanzaro, 88100
Investigational Site Number 380103
Naples, 80131
Investigational Site Number 380108
Padova, 35100
Investigational Site Number 380106
Partinico, 90047
Investigational Site Number 380101
Pisa, 56124
Investigational Site Number 380105
Roma, 00168
Investigational Site Number 380102
Torino, 10126
Brazil6 sites
Investigational Site Number 076103
Campinas, 13060080
Investigational Site Number 076104
Fortaleza, 60115-282
Investigational Site Number 076105
São Paulo, 01223-001
Investigational Site Number 076101
São Paulo, 04040-001
Investigational Site Number 076106
São Paulo, 05403-900
Investigational Site Number 076102
São Paulo
United Kingdom6 sites
Investigational Site Number 826104
Exeter, EX25DW
Investigational Site Number 826106
Manchester, m139wl
Investigational Site Number 826105
Middlesbrough, TS4 3BW
Investigational Site Number 826103
Stevenage, SG14AB
Investigational Site Number 826101
Torquay, TQ27AA
Investigational Site Number 826102
West Bromwich, B714HJ
Israel5 sites
Investigational Site Number 376101
Beersheba
Investigational Site Number 376103
Petah Tikva
Investigational Site Number 376104
Petah Tikva
Investigational Site Number 376102
Rehovot
Investigational Site Number 376106
Tel Aviv
Australia3 sites
Investigational Site Number 036102
Herston, 4006
Investigational Site Number 036104
Merewether, 2291
Investigational Site Number 036101
St Leonards, 2065
Finland3 sites
Investigational Site Number 246102
Oulu, 90100
Investigational Site Number 246101
Oulu, 90220
Investigational Site Number 246104
Tampere, 33520
Switzerland3 sites
Investigational Site Number 756101
Geneva, 1205
Investigational Site Number 756102
Olten, 4600
Investigational Site Number 756103
Reinach, 4153
Lebanon2 sites
Investigational Site Number 422101
Beirut
Investigational Site Number 422102
Hazmiyeh
Norway2 sites
Investigational Site Number 578101
Oslo, 0372
Investigational Site Number 578102
Oslo, 0407
Sweden2 sites
Investigational Site Number 752102
Gothenburg, 41345
Investigational Site Number 752101
Stockholm, 14186
United Arab Emirates1 site
Investigational Site Number 784101
Dubai, 4545
About this study
Official title: A Randomized, Open-Label, Parallel Group Study to Evaluate the Efficacy and Safety of Alirocumab Versus Usual Care in Patients With Type 2 Diabetes and Mixed Dyslipidemia at High Cardiovascular Risk With Non-HDL-C Not Adequately Controlled With Maximally Tolerated Statin Therapy
Primary Objective:
To demonstrate the superiority of alirocumab in comparison with usual care in the reduction of non-high-density lipoprotein cholesterol (non-HDL-C) in participants with type 2 diabetes and mixed dyslipidemia at high cardiovascular risk with non-HDL-C not adequately controlled with maximally tolerated statin therapy.
Read more
Secondary Objectives:
- To demonstrate whether alirocumab is superior in comparison with usual care in its effects on other lipid parameters (ie, low-density lipoprotein cholesterol (LDL-C), apolipoprotein B (Apo B), total cholesterol (Total -C), lipoprotein a (Lp[a]), high-density lipoprotein cholesterol (HDL-C), triglycerides (TGs), triglyceride rich lipoproteins (TGRLs), apolipoprotein A-1 (Apo A-1), apolipoprotein C-III (Apo C-III), lipid subfractions by nuclear magnetic resonance (NMR) spectroscopy (ie, LDL-C particle size and LDL, very low-density lipoprotein [VLDL], HDL, and intermediate-density lipoprotein [IDL] particle number).
- To assess changes in glycemic parameters with alirocumab vs. usual care treatment.
- To demonstrate the safety and tolerability of alirocumab.
- To evaluate treatment acceptance of alirocumab.
- To evaluate proprotein convertase subtilisin kexin type 9 (PCSK9) concentrations and antibody development.
- To demonstrate the superiority of alirocumab vs. fenofibrate on non-HDL-C and other lipid parameters (subgroup analysis).
Read the detailed description
The maximum study duration was approximately 9 months per participant, including a 6 month treatment period, a screening period of up to 3 weeks, and an 8 week safety observation period.
For the purpose of scientific communication, a first-step analysis (both efficacy and safety) was performed at the Week 24 cut-off date. A second-step analysis was performed once all participants had completed the study to include a final update of the safety analysis.
- Conditions
- Dyslipidemia
- Being tested
- Alirocumab, Statins, Ezetimibe, Fenofibrate, Nicotinic acid
- Medical subject headings
- Dyslipidemias
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
AlirocumabDrug
Also called SAR236553, REGN727, Praluent
Solution for injection, one subcutaneous injection in the abdomen, thigh, or outer area of upper arm with a disposable auto-injector.
StatinsDrug
Statins at stable dose without other LMT as clinically indicated.
EzetimibeDrug
Pharmaceutical form: tablet Route of administration: oral
FenofibrateDrug
Pharmaceutical form: tablet Route of administration: oral
Nicotinic acidDrug
Pharmaceutical form: tablet Route of administration: oral
Omega-3 fatty acidsDrug
Pharmaceutical form: tablet Route of administration: oral
Antihyperglycemic DrugDrug
Insulin (injectable or inhaled) or other antihyperglycemic drugs as clinically indicated.
| Study group | Role | What they receive |
|---|---|---|
| Alirocumab 75 mg Q2W/Up to 150 mg Q2W | Experimental | Alirocumab 75 mg subcutaneous (SC) injection every 2 weeks (Q2W) added to insulin or other antihyperglycemic drugs, stable maximally tolerated dose of statin therapy without other lipid modifying therapy (LMT) for 24 weeks. Alirocumab dose up-titrated to 150 mg Q2W from Week 12 when non-high-density lipoprotein cholesterol (non-HDL-C) levels >=100 mg/dL (2.59 mmol/L) at Week 8. Receives: Drug: Alirocumab; Drug: Statins; Drug: Antihyperglycemic Drug |
| Usual Care | Active comparator | Participants on usual care continued on insulin or other antihyperglycemic drugs, stable maximally tolerated dose of statin therapy without additional LMT or with either ezetimibe, fenofibrate, omega-3 fatty acids or nicotinic acid as per Investigator's judgment for 24 weeks. Receives: Drug: Statins; Drug: Ezetimibe; Drug: Fenofibrate; Drug: Nicotinic acid; Drug: Omega-3 fatty acids; Drug: Antihyperglycemic Drug |
What is being measured
The primary outcome is the main question the study is designed to answer.
Percent Change From Baseline in Non-HDL-C at Week 24: Overall Intent-to-treat (ITT) Analysis
Adjusted Least-squares (LS) means and standard errors at Week 24 were obtained from a mixed-effect model with repeated measures (MMRM) to account for missing data. All available post-baseline data from Week 8 to Week 24 regardless of status on- or off-treatment were used in the model (ITT analysis).
Measured: From Baseline to Week 24
Percent Change From Baseline in Non-HDL-C at Week 24: ITT- Intent to Prescribe Fenofibrate Stratum
Adjusted LS means and standard errors at Week 24 from MMRM model including all available post-baseline data from Week 8 to Week 24 regardless of status on- or off-treatment in the intent to prescribe fenofibrate stratum. The usual care here corresponds to fenofibrate.
Measured: From Baseline to Week 24
Secondary outcomes (21)
Percent Change From Baseline in Measured Low-Density Lipoprotein Cholesterol (LDL-C) at Week 24: Overall ITT Analysis
Measured LDL-C values via beta quantification method. Adjusted LS means and standard errors at Week 24 from MMRM model including available post-baseline data from Week 8 to Week 24 regardless of status on- or off-treatment.
Measured: From Baseline to Week 24
Percent Change From Baseline in Measured LDL-C at Week 24: ITT- Intent to Prescribe Fenofibrate Stratum
Measured LDL-C values via beta quantification method. Adjusted LS means and standard errors at Week 24 from MMRM model including available post-baseline data from Week 8 to Week 24 regardless of status on- or off-treatment in the intent to prescribe fenofibrate stratum. The usual care here corresponds to fenofibrate.
Measured: From Baseline to Week 24
Percent Change From Baseline in Non-HDL-C at Week 12: Overall ITT Analysis
Adjusted LS means and standard errors at Week 12 from MMRM model including all available post-baseline data from Week 8 to Week 24 regardless of status on- or off-treatment.
Measured: From Baseline to Week 24
Percent Change From Baseline in Non-HDL-C at Week 12: ITT- Intent to Prescribe Fenofibrate Stratum
Adjusted LS means and standard errors at Week 12 from MMRM model including all available post-baseline data from Week 8 to Week 24 regardless of status on- or off-treatment in the intent to prescribe fenofibrate stratum. The usual care here corresponds to fenofibrate.
Measured: From Baseline to Week 24
Percent Change From Baseline in Measured LDL-C at Week 12: Overall ITT Analysis
Measured LDL-C values via beta quantification method. Adjusted LS means and standard errors at Week 12 from MMRM model including available post-baseline data from Week 8 to Week 24 regardless of status on- or off-treatment.
Measured: From Baseline to Week 24
Percent Change From Baseline in Measured LDL-C at Week 12: ITT- Intent to Prescribe Fenofibrate Stratum
Measured LDL-C values via beta quantification method. Adjusted LS means and standard errors at Week 12 from MMRM model including available post-baseline data from Week 8 to Week 24 regardless of status on- or off-treatment in the intent to prescribe fenofibrate stratum. The usual care here corresponds to fenofibrate.
Measured: From Baseline to Week 24
Percent Change From Baseline in Apolipoprotein B (Apo-B) at Week 24: Overall ITT Analysis
Adjusted LS means and standard errors at Week 24 from MMRM model including all available post-baseline data from Week 8 to Week 24 regardless of status on- or off-treatment.
Measured: From Baseline to Week 24
Percent Change From Baseline in Apo B at Week 24: ITT- Intent to Prescribe Fenofibrate Stratum
Adjusted LS means and standard errors at Week 24 from MMRM model including all available post-baseline data from Week 8 to Week 24 regardless of status on- or off-treatment in the intent to prescribe fenofibrate stratum. The usual care here corresponds to fenofibrate.
Measured: From Baseline to Week 24
Percent Change From Baseline in Total Cholesterol (Total-C) at Week 24 : Overall ITT Analysis
Adjusted LS means and standard errors at Week 24 from MMRM model including all available post-baseline data from Week 8 to Week 24 regardless of status on- or off-treatment.
Measured: From Baseline to Week 24
Percent Change From Baseline in Total-C at Week 24: ITT- Intent to Prescribe Fenofibrate Stratum
Adjusted LS means and standard errors at Week 24 from MMRM model including all available post-baseline data from Week 8 to Week 24 regardless of status on- or off-treatment in the intent to prescribe fenofibrate stratum. The usual care here corresponds to fenofibrate.
Measured: From Baseline to Week 24
Percent Change From Baseline in Lipoprotein(a) at Week 24 : Overall ITT Analysis
Adjusted means and standard errors at Week 24 were obtained from multiple imputation approach followed by robust regression model for handling of missing data. All available post-baseline data from Week 8 to Week 24 regardless of status on- or off-treatment were included in the imputation model.
Measured: From Baseline to Week 24
Percent Change From Baseline in Lipoprotein(a) at Week 24: ITT- Intent to Prescribe Fenofibrate Stratum
Adjusted means and standard errors at Week 24 from multiple imputation approach followed by robust regression model including all available post-baseline data from Week 8 to Week 24 regardless of status on- or off-treatment in the intent to prescribe fenofibrate stratum. The usual care here corresponds to fenofibrate.
Measured: From Baseline to Week 24
Percent Change From Baseline in Fasting Triglycerides at Week 24: Overall ITT Analysis
Adjusted means and standard errors at Week 24 from multiple imputation approach followed by robust regression model including all available post-baseline data from Week 8 to Week 24 regardless of status on- or off-treatment.
Measured: From Baseline to Week 24
Percent Change From Baseline in Fasting Triglycerides at Week 24: ITT- Intent to Prescribe Fenofibrate Stratum
Adjusted means and standard errors at Week 24 from multiple imputation approach followed by robust regression model including all available post-baseline data from Week 8 to Week 24 regardless of status on- or off-treatment in the intent to prescribe fenofibrate stratum. The usual care here corresponds to fenofibrate.
Measured: From Baseline to Week 24
Percent Change From Baseline in HDL-C at Week 24 : Overall ITT Analysis
Adjusted LS means and standard errors at Week 24 from MMRM model including all available post-baseline data from Week 8 to Week 24 regardless of status on- or off-treatment.
Measured: From Baseline to Week 24
Percent Change From Baseline in HDL-C at Week 24: ITT- Intent to Prescribe Fenofibrate Stratum
Adjusted LS means and standard errors at Week 24 from MMRM model including all available post-baseline data from Week 8 to Week 24 regardless of status on- or off-treatment in the intent to prescribe fenofibrate stratum. The usual care here corresponds to fenofibrate.
Measured: From Baseline to Week 24
Percent Change From Baseline in LDL-C Particle Number at Week 24: Overall ITT Analysis
LDL-C particle number was calculated from lipid subfractions by nuclear magnetic resonance (NMR) spectroscopy. Adjusted LS means and standard errors at Week 24 from MMRM model including all available post-baseline data from Week 8 to Week 24 regardless of status on- or off-treatment.
Measured: From Baseline to Week 24
Percent Change From Baseline in LDL-C Particle Number at Week 24: ITT- Intent to Prescribe Fenofibrate Stratum
LDL-C particle number was calculated from lipid subfractions by NMR spectroscopy. Adjusted LS means and standard errors at Week 24 from MMRM model including all available post-baseline data from Week 8 to Week 24 regardless of status on- or off-treatment in the intent to prescribe fenofibrate stratum. The usual care here corresponds to fenofibrate.
Measured: From Baseline to Week 24
Absolute Change From Baseline in Hemoglobin A1c (HbA1c) at Week 12 and 24 : Overall ITT Analysis
Absolute change = HbA1c value at specified week minus HbA1c value at baseline.
Measured: Baseline, Week 12 and 24
Absolute Change From Baseline in Fasting Plasma Glucose (FPG) at Week 12 and 24 : Overall ITT Analysis
Absolute change = FPG value at specified week minus FPG value at baseline.
Measured: Baseline, Week 12 and 24
Absolute Change From Baseline in Number of Glucose-Lowering Treatments at Week 12 and 24 : Overall ITT Analysis
Glucose lowering treatment was calculated for non-insulin treatments as one for each unique treatment received and for insulin treatment as one in total for all participants who have taken one or more treatments. Absolute change = number of glucose-lowering treatments at specified week minus baseline value.
Measured: Baseline, Week 12 and 24
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted30 Dec 2015 (estimated)
- Study start15 Mar 2016
- Primary completion22 Mar 2017
- Study completion15 May 2017
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Publications (5)Papers the sponsor has linked to this study.
- Other trials for DyslipidemiaStudies of the same condition, open and under way.
- More trials run by SanofiThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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 4
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 413 participants (actual)
Sponsor and investigators
- Lead sponsor
- Sanofi
- Sponsor type
- Industry (pharma, biotech, devices)
- Collaborators
- Regeneron Pharmaceuticals
- Responsible party
- Sponsor
- Investigators
- Clinical Sciences & Operations, Study director, Sanofi
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT02642159
- Sponsor's protocol ID
- LPS14354
- Other IDs
- 2015-001934-19, U1111-1172-5262, 2015
- Status last verified
- Mar 2018
- First submitted
- 24 Dec 2015
- Last updated
- 1 May 2018
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- No
Publications
Schmidt AF, Carter JL, Pearce LS, Wilkins JT, Overington JP, Hingorani AD, Casas JP. PCSK9 monoclonal antibodies for the primary and secondary prevention of cardiovascular disease. Cochrane Database Syst Rev. 2020 Oct 20;10(10):CD011748. doi: 10.1002/14651858.CD011748.pub3.
PubMed 33078867Colhoun HM, Leiter LA, Muller-Wieland D, Cariou B, Ray KK, Tinahones FJ, Domenger C, Letierce A, Israel M, Samuel R, Del Prato S. Effect of alirocumab on individuals with type 2 diabetes, high triglycerides, and low high-density lipoprotein cholesterol. Cardiovasc Diabetol. 2020 Feb 8;19(1):14. doi: 10.1186/s12933-020-0991-1.
PubMed 32035487Ray KK, Del Prato S, Muller-Wieland D, Cariou B, Colhoun HM, Tinahones FJ, Domenger C, Letierce A, Mandel J, Samuel R, Bujas-Bobanovic M, Leiter LA. Alirocumab therapy in individuals with type 2 diabetes mellitus and atherosclerotic cardiovascular disease: analysis of the ODYSSEY DM-DYSLIPIDEMIA and DM-INSULIN studies. Cardiovasc Diabetol. 2019 Nov 9;18(1):149. doi: 10.1186/s12933-019-0951-9.
PubMed 31706300Ray KK, Leiter LA, Muller-Wieland D, Cariou B, Colhoun HM, Henry RR, Tinahones FJ, Bujas-Bobanovic M, Domenger C, Letierce A, Samuel R, Del Prato S. Alirocumab vs usual lipid-lowering care as add-on to statin therapy in individuals with type 2 diabetes and mixed dyslipidaemia: The ODYSSEY DM-DYSLIPIDEMIA randomized trial. Diabetes Obes Metab. 2018 Jun;20(6):1479-1489. doi: 10.1111/dom.13257. Epub 2018 Mar 23.
PubMed 29436756Muller-Wieland D, Leiter LA, Cariou B, Letierce A, Colhoun HM, Del Prato S, Henry RR, Tinahones FJ, Aurand L, Maroni J, Ray KK, Bujas-Bobanovic M. Design and rationale of the ODYSSEY DM-DYSLIPIDEMIA trial: lipid-lowering efficacy and safety of alirocumab in individuals with type 2 diabetes and mixed dyslipidaemia at high cardiovascular risk. Cardiovasc Diabetol. 2017 May 25;16(1):70. doi: 10.1186/s12933-017-0552-4.
PubMed 28545518
Study at a glance
From the registry record, last updated by the sponsor on 1 May 2018. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Randomized, Open-Label, Parallel Group Study to Evaluate the Efficacy and Safety of Alirocumab Versus Usual Care in Patients With Type 2 Diabetes and Mixed Dyslipidemia at High Cardiovascular Risk With Non-HDL-C Not Adequately Controlled With Maximally Tolerated Statin Therapy
- ClinicalTrials.gov ID
- NCT02642159
- Acronym / sponsor ID
- LPS14354
- Conditions
- Dyslipidemia
- Phase
- Phase 4
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 413 participants (actual)
- Lead sponsor
- SanofiIndustry (pharma, biotech, devices)
- Collaborators
- Regeneron Pharmaceuticals
- Study start
- 15 Mar 2016
- Primary completion
- 22 Mar 2017 (actual)
- Study completion
- 15 May 2017 (actual)
- First posted
- 30 Dec 2015 (estimated)
- Results
- Posted 1 May 2018
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Primary Objective:
To demonstrate the superiority of alirocumab in comparison with usual care in the reduction of non-high-density lipoprotein cholesterol (non-HDL-C) in participants with type 2 diabetes and mixed dyslipidemia at high cardiovascular risk with non-HDL-C not adequately controlled with maximally tolerated statin therapy.
Secondary Objectives:
- To demonstrate whether alirocumab is superior in comparison with usual care in its effects on other lipid parameters (ie, low-density lipoprotein cholesterol (LDL-C), apolipoprotein B (Apo B), total cholesterol (Total -C), lipoprotein a (Lp[a]), high-density lipoprotein cholesterol (HDL-C), triglycerides (TGs), triglyceride rich lipoproteins (TGRLs), apolipoprotein A-1 (Apo A-1), apolipoprotein C-III (Apo C-III), lipid subfractions by nuclear magnetic resonance (NMR) spectroscopy (ie, LDL-C particle size and LDL, very low-density lipoprotein [VLDL], HDL, and intermediate-density lipoprotein [IDL] particle number).
- To assess changes in glycemic parameters with alirocumab vs. usual care treatment.
- To demonstrate the safety and tolerability of alirocumab.
- To evaluate treatment acceptance of alirocumab.
- To evaluate proprotein convertase subtilisin kexin type 9 (PCSK9) concentrations and antibody development.
- To demonstrate the superiority of alirocumab vs. fenofibrate on non-HDL-C and other lipid parameters (subgroup analysis).
Detailed description
The maximum study duration was approximately 9 months per participant, including a 6 month treatment period, a screening period of up to 3 weeks, and an 8 week safety observation period.
For the purpose of scientific communication, a first-step analysis (both efficacy and safety) was performed at the Week 24 cut-off date. A second-step analysis was performed once all participants had completed the study to include a final update of the safety analysis.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Alirocumab 75 mg Q2W/Up to 150 mg Q2W | Experimental | Drug: Alirocumab, Drug: Statins, Drug: Antihyperglycemic DrugAlirocumab 75 mg subcutaneous (SC) injection every 2 weeks (Q2W) added to insulin or other antihyperglycemic drugs, stable maximally tolerated dose of statin therapy without other lipid modifying therapy (LMT) for 24 weeks. Alirocumab dose up-titrated to 150 mg Q2W from Week 12 when non-high-density lipoprotein cholesterol (non-HDL-C) levels >=100 mg/dL (2.59 mmol/L) at Week 8. |
| Usual Care | Active comparator | Drug: Statins, Drug: Ezetimibe, Drug: Fenofibrate, Drug: Nicotinic acid, Drug: Omega-3 fatty acids, Drug: Antihyperglycemic DrugParticipants on usual care continued on insulin or other antihyperglycemic drugs, stable maximally tolerated dose of statin therapy without additional LMT or with either ezetimibe, fenofibrate, omega-3 fatty acids or nicotinic acid as per Investigator's judgment for 24 weeks. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (8 listed)
- Participants with type 2 diabetes and mixed dyslipidemia whose non-HDL-C was not adequately controlled with a stable, maximum dose/regimen of statin that was tolerated by the participant.
- 18 years of age or more.
- Documented history of atherosclerotic cardiovascular disease (ASCVD) or at least one additional cardiovascular risk factor.
- Non-HDL-C of 100 mg/dL or greater.
- Triglycerides greater than or equal to 150 mg/dL and less than 500 mg/dL.
Key exclusion criteria (5 listed)
- Use of any lipid modifying therapies other than statins within the last 4 weeks (eg, ezetimibe, fenofibrate, nicotinic acid, omega-3 fatty acids, etc.) or use of over the counter products/nutraceuticals known to impact lipids (eg, red yeast rice) within the last 4 weeks.
- Currently drinking more than 2 standard alcoholic drinks per day.
- Body Mass Index (BMI) >45 kg/m² or currently enrolled in a weight loss program and still in active phase of weight loss.
- Glycosylated hemoglobin (HbA1c) 9% or greater.
- The above information was not intended to contain all considerations relevant to a participant's potential participation in a clinical trial.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| AlirocumabAlso: SAR236553, REGN727, PraluentSolution for injection, one subcutaneous injection in the abdomen, thigh, or outer area of upper arm with a disposable auto-injector. | Drug | Alirocumab 75 mg Q2W/Up to 150 mg Q2W |
| StatinsStatins at stable dose without other LMT as clinically indicated. | Drug | Alirocumab 75 mg Q2W/Up to 150 mg Q2W, Usual Care |
| EzetimibePharmaceutical form: tablet Route of administration: oral | Drug | Usual Care |
| FenofibratePharmaceutical form: tablet Route of administration: oral | Drug | Usual Care |
| Nicotinic acidPharmaceutical form: tablet Route of administration: oral | Drug | Usual Care |
| Omega-3 fatty acidsPharmaceutical form: tablet Route of administration: oral | Drug | Usual Care |
| Antihyperglycemic DrugInsulin (injectable or inhaled) or other antihyperglycemic drugs as clinically indicated. | Drug | Alirocumab 75 mg Q2W/Up to 150 mg Q2W, Usual Care |
Primary outcome
Percent Change From Baseline in Non-HDL-C at Week 24: Overall Intent-to-treat (ITT) Analysis
Time frame: From Baseline to Week 24
Adjusted Least-squares (LS) means and standard errors at Week 24 were obtained from a mixed-effect model with repeated measures (MMRM) to account for missing data. All available post-baseline data from Week 8 to Week 24 regardless of status on- or off-treatment were used in the model (ITT analysis).
Percent Change From Baseline in Non-HDL-C at Week 24: ITT- Intent to Prescribe Fenofibrate Stratum
Time frame: From Baseline to Week 24
Adjusted LS means and standard errors at Week 24 from MMRM model including all available post-baseline data from Week 8 to Week 24 regardless of status on- or off-treatment in the intent to prescribe fenofibrate stratum. The usual care here corresponds to fenofibrate.
21 secondary outcomes
Percent Change From Baseline in Measured Low-Density Lipoprotein Cholesterol (LDL-C) at Week 24: Overall ITT Analysis
Time frame: From Baseline to Week 24
Percent Change From Baseline in Measured LDL-C at Week 24: ITT- Intent to Prescribe Fenofibrate Stratum
Time frame: From Baseline to Week 24
Percent Change From Baseline in Non-HDL-C at Week 12: Overall ITT Analysis
Time frame: From Baseline to Week 24
Percent Change From Baseline in Non-HDL-C at Week 12: ITT- Intent to Prescribe Fenofibrate Stratum
Time frame: From Baseline to Week 24
Percent Change From Baseline in Measured LDL-C at Week 12: Overall ITT Analysis
Time frame: From Baseline to Week 24
Percent Change From Baseline in Measured LDL-C at Week 12: ITT- Intent to Prescribe Fenofibrate Stratum
Time frame: From Baseline to Week 24
Percent Change From Baseline in Apolipoprotein B (Apo-B) at Week 24: Overall ITT Analysis
Time frame: From Baseline to Week 24
Percent Change From Baseline in Apo B at Week 24: ITT- Intent to Prescribe Fenofibrate Stratum
Time frame: From Baseline to Week 24
Percent Change From Baseline in Total Cholesterol (Total-C) at Week 24 : Overall ITT Analysis
Time frame: From Baseline to Week 24
Percent Change From Baseline in Total-C at Week 24: ITT- Intent to Prescribe Fenofibrate Stratum
Time frame: From Baseline to Week 24
Percent Change From Baseline in Lipoprotein(a) at Week 24 : Overall ITT Analysis
Time frame: From Baseline to Week 24
Percent Change From Baseline in Lipoprotein(a) at Week 24: ITT- Intent to Prescribe Fenofibrate Stratum
Time frame: From Baseline to Week 24
Percent Change From Baseline in Fasting Triglycerides at Week 24: Overall ITT Analysis
Time frame: From Baseline to Week 24
Percent Change From Baseline in Fasting Triglycerides at Week 24: ITT- Intent to Prescribe Fenofibrate Stratum
Time frame: From Baseline to Week 24
Percent Change From Baseline in HDL-C at Week 24 : Overall ITT Analysis
Time frame: From Baseline to Week 24
Percent Change From Baseline in HDL-C at Week 24: ITT- Intent to Prescribe Fenofibrate Stratum
Time frame: From Baseline to Week 24
Percent Change From Baseline in LDL-C Particle Number at Week 24: Overall ITT Analysis
Time frame: From Baseline to Week 24
Percent Change From Baseline in LDL-C Particle Number at Week 24: ITT- Intent to Prescribe Fenofibrate Stratum
Time frame: From Baseline to Week 24
Absolute Change From Baseline in Hemoglobin A1c (HbA1c) at Week 12 and 24 : Overall ITT Analysis
Time frame: Baseline, Week 12 and 24
Absolute Change From Baseline in Fasting Plasma Glucose (FPG) at Week 12 and 24 : Overall ITT Analysis
Time frame: Baseline, Week 12 and 24
Absolute Change From Baseline in Number of Glucose-Lowering Treatments at Week 12 and 24 : Overall ITT Analysis
Time frame: Baseline, Week 12 and 24
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 1 May 2018.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Derived from this study: PubMed 33078867Schmidt AF, Carter JL, Pearce LS, Wilkins JT, Overington JP, Hingorani AD, Casas JP. PCSK9 monoclonal antibodies for the primary and secondary prevention of cardiovascular disease. Cochrane Database Syst Rev. 2020 Oct 20;10(10):CD011748. doi: 10.1002/14651858.CD011748.pub3.
- Derived from this study: PubMed 32035487Colhoun HM, Leiter LA, Muller-Wieland D, Cariou B, Ray KK, Tinahones FJ, Domenger C, Letierce A, Israel M, Samuel R, Del Prato S. Effect of alirocumab on individuals with type 2 diabetes, high triglycerides, and low high-density lipoprotein cholesterol. Cardiovasc Diabetol. 2020 Feb 8;19(1):14. doi: 10.1186/s12933-020-0991-1.
- Derived from this study: PubMed 31706300Ray KK, Del Prato S, Muller-Wieland D, Cariou B, Colhoun HM, Tinahones FJ, Domenger C, Letierce A, Mandel J, Samuel R, Bujas-Bobanovic M, Leiter LA. Alirocumab therapy in individuals with type 2 diabetes mellitus and atherosclerotic cardiovascular disease: analysis of the ODYSSEY DM-DYSLIPIDEMIA and DM-INSULIN studies. Cardiovasc Diabetol. 2019 Nov 9;18(1):149. doi: 10.1186/s12933-019-0951-9.
- Derived from this study: PubMed 29436756Ray KK, Leiter LA, Muller-Wieland D, Cariou B, Colhoun HM, Henry RR, Tinahones FJ, Bujas-Bobanovic M, Domenger C, Letierce A, Samuel R, Del Prato S. Alirocumab vs usual lipid-lowering care as add-on to statin therapy in individuals with type 2 diabetes and mixed dyslipidaemia: The ODYSSEY DM-DYSLIPIDEMIA randomized trial. Diabetes Obes Metab. 2018 Jun;20(6):1479-1489. doi: 10.1111/dom.13257. Epub 2018 Mar 23.
- Derived from this study: PubMed 28545518Muller-Wieland D, Leiter LA, Cariou B, Letierce A, Colhoun HM, Del Prato S, Henry RR, Tinahones FJ, Aurand L, Maroni J, Ray KK, Bujas-Bobanovic M. Design and rationale of the ODYSSEY DM-DYSLIPIDEMIA trial: lipid-lowering efficacy and safety of alirocumab in individuals with type 2 diabetes and mixed dyslipidaemia at high cardiovascular risk. Cardiovasc Diabetol. 2017 May 25;16(1):70. doi: 10.1186/s12933-017-0552-4.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Clinical Sciences & Operations study director
Sanofi
119 sites in 15 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 4 study testing Alirocumab, Statins and Ezetimibe in people with Dyslipidemia, run by Sanofi at 119 sites in 15 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 8 inclusion and 5 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 1 May 2018. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 119 sites in United States, Germany, Turkey (Türkiye), Italy, Brazil and 10 more countries. 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 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.
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 1 May 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 Non-HDL-C at Week 24: Overall Intent-to-treat (ITT) Analysis (time frame: From Baseline to Week 24). 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 NCT02642159, which also lists 5 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 1 May 2018.