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HypercholesterolemiaPhase 2CLEAR Path 1NCT05694260

A Clinical Study in Children With Heterozygous Familial Hypercholesterolemia (HeFH) Aged 6 to 17 Treated Once Daily With Bempedoic Acid Oral Dosing (CLEAR Path 1)

A Phase 2 study testing Bempedoic acid in people with Hypercholesterolemia, run by Esperion Therapeutics, Inc. at 24 sites in 6 countries.

Completed

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

Official record
Search all trials

Trial summary

Multiple-dose study to measure pharmacokinetics, pharmacodynamics and safety of bempedoic acid in pediatric participants 6 to 17 years of age with HeFH. Read more about this study

Who is it for?
Ages 6 to 17 years
Conditions the study is for
Hypercholesterolemia
What is being tested?
Bempedoic acid
Type of treatment
Pill or oral medicine
Could I receive a placebo?
No, everyone receives an active treatment
How many people
31 participants
Where
24 sitesin 6 countries
Study dates
12 Jan 2023to 4 Jun 2025
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 6 to 17 years
  • All sexes
  • No healthy volunteers
  • Child

Who may be able to join

  • Participant's parent(s)/guardian(s) must be willing to provide written informed consent and the participant must provide informed assent before any study-specific procedures are performed;
  • Participant must be aged 6-17 years old and willing to swallow tablets;
  • Participant must weigh at least 16 kilograms (kg);
  • Participant must have a diagnosis of HeFH prior to receiving the first dose of study medication at Treatment Visit T1 per Make Early Diagnosis to Prevent Early Deaths project (MEDPED) criteria by meeting at least one of the following clinical criteria:
  • Documented diagnosis of HeFH determined by positive genetic testing; or
  • Documented LDL-C or TC meeting one or more of the following criteria:
Show all 11Show fewer
  • LDL-C >200 milligrams per deciliter (mg/dL) (5.2 millimole per liter [mmol/L]) or TC >270 mg/dL (7.0 mmol/L), with no first- second- or third-degree relative with documented FH diagnosis (general population); or ii. LDL-C >155 mg/dL (4.0 mmol/L) or TC >220 mg/dL (5.7 mmol/L), and also having a first-degree relative with documented familial hypercholesterolemia (FH) diagnosis; or iii. LDL-C >165 mg/dL (4.3 mmol/L) or TC >230 mg/dL (5.9 mmol/L), and also having a second-degree relative with documented FH diagnosis; or iv. LDL-C >170 mg/dL (4.4 mmol/L) or TC >240 mg/dL (6.2 mmol/L), and also having a third-degree relative with documented FH diagnosis
  • Current treatment with approved stable lipid-modifying therapy (LMT), including an optimal dose of statin with or without other LMT(s), at stable dose for at least 4 weeks prior to Treatment Visit T1 (6 weeks for fibrates; however, gemfibrozil is not allowed in participants taking a statin as per coadministration instructions defined in the statin label). Participants must remain on that stable dose throughout the duration of the trial. Optimal dose of statin will be determined by the investigator using their medical judgment and available sources, including the participant's self-reported history of LMT. A participant's optimal dose of statin is defined as meeting one of the following criteria:
  • the highest approved dose of statin prescribed for the age of the participant based on regional practice or local guidelines; or
  • less than the highest approved dose of statin, including no statin, prescribed for the age of the participant based on regional practice or local guidelines (including no statin) if: i. the participant has previously taken 2 or more statin therapies at any dose and not able to tolerate or unresponsive due to their mutations (null); or ii. the participant has previously taken 1 or more statin therapies at any dose and is unwilling to attempt another statin at any dose or advised by a physician to not attempt another statin at any dose.
  • Participant/parent and investigator attestation to the participant's unwillingness to attempt and/or physician advice to not attempt additional statin therapy will be recorded.

Who cannot join

  • Participant has a diagnosis of homozygous familial hypercholesterolemia (HoFH) or compound HeFH;
  • Participant has a fasting triglyceride (TG) level ≥400 mg/dL (4.5 mmol/L);
  • Participant has uncontrolled hypothyroidism, including a value for thyroid-stimulating hormone (TSH) < lower limit of normal (LLN) or >1.5 × the upper limit of normal (ULN);
  • Participant has liver disease or dysfunction, including:
  • positive serology for hepatitis B surface antigen (HBsAg) and/or hepatitis C virus antibodies (HCV-AB), or
  • serum alanine aminotransferase (ALT) or aspartate aminotransferase (AST) value ≥2 × ULN and/or serum total bilirubin (TB) value ≥2 × ULN. If the serum TB value is ≥1.2 × ULN, a reflex indirect (unconjugated) bilirubin will be obtained and, if consistent with Gilbert's disease or if the participant has a history of Gilbert's disease, the participant may be enrolled in the study.
  • Participant has renal dysfunction or glomerulonephritis, including an estimated glomerular filtration rate (eGFR) <75 milliliters/minute/1.73 square meter (mL/min/1.73 m^2).
  • Other protocol defined inclusion and exclusion criteria.

Trial locations and contacts

24 sites in 6 countries.

24 sites in 6 countries

United States8 sites
  • Excel Medical Clinical Trials, LLC

    Boca Raton, Florida, 33434

  • Cincinnati Children's Hospital Medical Center

    Cincinnati, Ohio, 45229

  • Cardiology Care for Children

    Lancaster, Pennsylvania, 17601

  • Cedars-Sinai Medical Center

    Los Angeles, California, 90048

  • University of Utah and Primary Children's Hospital

    Salt Lake City, Utah, 84113

  • Washington University School of Medicine, Division of Endocrinology, Metabolism and Lipid Research

    St Louis, Missouri, 63110

  • Providere Research Inc

    West Covina, California, 91790

  • Wake Forest University Health Sciences

    Winston-Salem, North Carolina, 27157

Other trials in United States

Spain7 sites
  • Hospital Abente y Lago

    A Coruña, Galicia, 15001

  • Corporacio Sanitaria Parc Tauli - Hospital de Sabadell

    Barcelona, 8208

  • Hospital Sant Joan de Deu

    Barcelona, 8950

  • Hospital Universitario de Jerez de la Frontera

    Cadiz, 11407

  • Hospital Universitario Reina Sofia

    Córdoba, 14004

  • Hospital Universitario Ramon y Cajal

    Madrid, 28034

  • Hospital Universitario 12 de Octubre

    Madrid

Other trials in Spain

Canada3 sites
  • Ecogene-21

    Chicoutimi, Quebec, G7H 5H6

  • University of Alberta Hospital - Stollery Children's Hospital

    Edmonton, Alberta, T6G 2B7

  • McMaster University Medical Center

    Hamilton, Ontario, L8N 3Z5

Other trials in Canada

Denmark2 sites
  • Rigshospitalet

    Copenhagen, 2100

  • Viborg Regional Hospital

    Viborg

Other trials in Denmark

Germany2 sites
  • Universitaetsklinikum Frankfurt - Klinikum der Johann Wolfgang Goethe Universitaet

    Frankfurt am Main

  • Kinder- und Jugendkrankenhaus AUF DER BULT

    Hanover

Other trials in Germany

Netherlands2 sites
  • Amsterdam UMC - Locatie AMC

    Amsterdam, 1105 AZ

  • Erasmus MC

    Rotterdam, 3015 G

Other trials in Netherlands

About this study

Official title: An Open-Label Study to Evaluate the Pharmacokinetics, Pharmacodynamics, and Safety of Bempedoic Acid in Pediatric Patients (6 to 17 Years of Age) With Heterozygous Familial Hypercholesterolemia

Multiple-dose study to measure pharmacokinetics, pharmacodynamics and safety of bempedoic acid in pediatric participants 6 to 17 years of age with HeFH.

Read the detailed description

Dose-selection based on body weight will be determined for use in pediatric clinical development.

Being tested
Bempedoic acid
Keywords
Pediatric, Heterozygous familial hypercholesterolemia, Low-density lipoprotein cholesterol (LDL-cholesterol), Bempedoic acid, ETC-1002, Adenosine triphosphate citrate lyase
Medical subject headings
Hypercholesterolemia

What participants receive

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

  • Bempedoic acidDrug

    Also called ETC-1002

    Once daily oral dosing with oral tablets.

Study groups in NCT05694260
Study groupRoleWhat they receive
Cohort 1ExperimentalParticipants at 16 to <30 kilograms (kg) body weight at screening receiving once daily 60 milligrams (mg) bempedoic acid for 8 weeks followed by 90 mg bempedoic acid for 8 weeks.
Receives: Drug: Bempedoic acid
Cohort 2ExperimentalParticipants at 30 to 60 kg body weight at screening receiving once daily120 mg bempedoic acid for 8 weeks followed by 150 mg bempedoic acid for 8 weeks.
Receives: Drug: Bempedoic acid
Cohort 3ExperimentalParticipants at greater than 60 kg body weight at screening receiving once daily 180 mg bempedoic acid for 8 weeks.
Receives: Drug: Bempedoic acid

What is being measured

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

  1. Observed Trough Plasma Concentration of ETC-1002 Following 8 Weeks of Steady State Dosing of Bempedoic Acid

    Blood plasma samples were collected and analyzed to determine the plasma trough concentration of ETC-1002 following 8 weeks of steady-state dosing of bempedoic acid. The data presented here is for participants who received tablet formulation only.

    Measured: Week 8 pre-dose

  2. Model-based Steady State Area Under the Concentration-time Curve Over 24 Hours (AUC,24ss) of ETC-1002

    Blood plasma samples were collected and analyzed to determine the AUC,24ss of ETC-1002 over 24 hours. The data presented here is for participants who received tablet formulation only.

    Measured: 24 hours

  3. Model-based Steady State Average Plasma Concentration (Cavg,ss) of ETC-1002

    Blood plasma samples were collected and analyzed to determine the Cavg,ss of ETC-1002. Cavg was calculated by empirical Bayesian estimated pediatric exposure over 24 hours divided by 24 (AUC24hr.ss / 24). The data presented here is for participants who received tablet formulation only.

    Measured: Week 8, 24 hours post-dose at steady state

  4. Model-based Steady State Maximum Plasma Concentration (Cmax,ss) of ETC-1002

    Blood plasma samples were collected and analyzed to determine the Cmax,ss of ETC-1002. The data presented here is for participants who received tablet formulation only.

    Measured: Day 1: 1-hour and 4 hours post-dose; Week 4 pre-dose; Week 8 pre-dose

Secondary outcomes (15)
  1. Observed Trough Plasma Concentration of ESP15228

    Blood plasma samples were collected and analyzed to determine the trough plasma concentration of active metabolite ESP15228 following 8 weeks of steady-state dosing of bempedoic acid. The data presented here is for participants who received tablet formulation only.

    Measured: Week 8 pre-dose

  2. Observed Plasma Concentration at 4 Hours (C4hr) of ETC-1002

    Blood plasma samples were collected and analyzed to determine the trough plasma concentration of ETC-1002 4 hours post-dose. The data presented here is for participants who received tablet formulation only.

    Measured: Day 1: 4 hours post-dose

  3. Observed C4hr of ESP15228

    Blood plasma samples were collected and analyzed to determine the trough plasma concentration of active metabolite ESP15228 4 hours post-dose on Day 1. The data presented here is for participants who received tablet formulation only.

    Measured: Day 1: 4 hours post-dose

  4. Simulated Percent Change From Baseline in Exposure/ Low-Density Lipoprotein-Cholesterol (LDL-C)

    Blood samples were collected for the analysis of and exposure/LDL-C-lowering response relationship.

    Measured: Baseline and Week 12

  5. Observed Percent Change From Baseline in LDL-C

    Blood samples were collected for analysis of LDL-C levels. Baseline is defined as the last assessment measurements before the first dose of investigational medical product (IMP). Percent change from baseline was calculated as the ([post-Baseline value minus the Baseline value] divided by the Baseline value) x 100. The treatment period for participants in cohort 1 (60 mg), cohort 2 (120 mg), and cohort 3 was weeks 1-8. The treatment period for participants in cohort 1 (90 mg) and cohort 2 (150 mg) was weeks 8-16.

    Measured: Baseline and 8 Weeks post-treatment

  6. Observed Absolute Change From Baseline in LDL-C (mg/dl)

    Blood samples were collected for analysis of LDL-C levels. Baseline is defined as the last assessment measurements before the first dose of IMP. Change from baseline is defined as post- dose visit value minus baseline value. The treatment period for participants in cohort 1 (60 mg), cohort 2 (120 mg), and cohort 3 was weeks 1-8. The treatment period for participants in cohort 1 (90 mg) and cohort 2 (150 mg) was weeks 8-16.

    Measured: Baseline and 8 Weeks post-treatment

  7. Observed Percent Change From Baseline in Non-high-density Lipoprotein Cholesterol (Non-HDL-C)

    Blood samples were collected for analysis of Non-HDL-C levels. Baseline is defined as the last assessment measurements before the first dose of IMP. Percent change from Baseline was calculated as the ([post-Baseline value minus the Baseline value] divided by the Baseline value) x 100. The treatment period for participants in cohort 1 (60 mg), cohort 2 (120 mg), and cohort 3 was weeks 1-8. The treatment period for participants in cohort 1 (90 mg) and cohort 2 (150 mg) was weeks 8-16.

    Measured: Baseline and 8 Weeks post-treatment

  8. Observed Absolute Change From Baseline in Non-HDL-C (mg/dL)

    Blood samples were collected for analysis of Non-HDL-C levels. Baseline is defined as the last assessment measurements before the first dose of IMP. Change from Baseline is defined as post- dose visit value minus Baseline value. The treatment period for participants in cohort 1 (60 mg), cohort 2 (120 mg), and cohort 3 was weeks 1-8. The treatment period for participants in cohort 1 (90 mg) and cohort 2 (150 mg) was weeks 8-16.

    Measured: Baseline and 8 Weeks post-treatment

  9. Observed Percent Change From Baseline in Total Cholesterol (TC)

    Blood samples were collected for analysis of total cholesterol levels. Baseline is defined as the last assessment measurements before the first dose of IMP. Percent change from Baseline was calculated as the ([post-Baseline value minus the Baseline value] divided by the Baseline value) x 100. The treatment period for participants in cohort 1 (60 mg), cohort 2 (120 mg), and cohort 3 was weeks 1-8. The treatment period for participants in cohort 1 (90 mg) and cohort 2 (150 mg) was weeks 8-16.

    Measured: Baseline and 8 Weeks post-treatment

  10. Observed Absolute Change From Baseline in TC (mg/dL)

    Blood samples were collected for analysis of TC levels. Baseline is defined as the last assessment measurements before the first dose of IMP. Change from Baseline is defined as post- dose visit value minus Baseline value. The treatment period for participants in cohort 1 (60 mg), cohort 2 (120 mg), and cohort 3 was weeks 1-8. The treatment period for participants in cohort 1 (90 mg) and cohort 2 (150 mg) was weeks 8-16.

    Measured: Baseline and 8 Weeks post-treatment

  11. Observed Percent Change From Baseline in High-sensitivity C-reactive Protein (hsCRP)

    Blood samples were collected for analysis of hsCRP. Baseline is defined as the last assessment measurements before the first dose of IMP. Percent change from Baseline was calculated as the ([post-Baseline value minus the Baseline value] divided by the Baseline value) x 100. The treatment period for participants in cohort 1 (60 mg), cohort 2 (120 mg), and cohort 3 was weeks 1-8. The treatment period for participants in cohort 1 (90 mg) and cohort 2 (150 mg) was weeks 8-16.

    Measured: Baseline and 8 Weeks post-treatment

  12. Observed Absolute Change From Baseline in hsCRP (mg/L)

    Blood samples were collected for analysis of hsCRP levels. Baseline is defined as the last assessment measurements before the first dose of IMP. Change from Baseline is defined as post- dose visit value minus Baseline value. The treatment period for participants in cohort 1 (60 mg), cohort 2 (120 mg), and cohort 3 was weeks 1-8. The treatment period for participants in cohort 1 (90 mg) and cohort 2 (150 mg) was weeks 8-16.

    Measured: Baseline and 8 Weeks post-treatment

  13. Acceptability of Taste of Liquid Formulation Using a Dosing Acceptability Questionnaire

    Participant acceptance is defined as the overall ability of the participant to use a medicine as intended. The acceptability of overall flavor of IMP was recorded using a dosing acceptability questionnaire, where participants were asked 'Yes' or 'No', whether the flavor of the medication was acceptable. At Week 8 (Phone) participants in cohorts 1 and 2 were contacted by phone to collect questionnaire information. The number of participants who have responded at each time point have been presented.

    Measured: Days 1 and 2; Weeks 2, 4, 8, 8 (Phone), 10, 12, and 16

  14. Acceptability of Ease of Swallowing Tablet Formulation Using a Dosing Acceptability Questionnaire

    Participant acceptance is defined as the overall ability of the participant to use a medicine as intended. Acceptability of ease of swallowing was recorded using a dosing acceptability questionnaire where participants were asked if they were able to swallow the entire dose or not, by ticking 'yes' or 'no'. At Week 8 (Phone) participants in cohorts 1 and 2 were contacted by phone to collect questionnaire information. The number of participants who responded at each time point have been presented.

    Measured: Days 1 and 2; Weeks 2, 4, 8, 8 (Phone), 10, 12, and 16

  15. Number of Participants Reporting Serious Adverse Events (SAEs) and Non-SAEs

    An AE is the development of an undesirable medical condition or the deterioration of a pre-existing medical condition following or during exposure to a pharmaceutical product, whether or not considered causally related to the product. A serious AE is an AE occurring during any study phase (i.e., baseline, treatment, washout, or follow-up), and at any dose of the study medication that fulfills one or more of the following: results in death, is immediately life-threatening, requires in-patient hospitalization or prolongation of existing hospitalization, results in persistent or significant disability or incapacity, results in a congenital abnormality or birth defect, is an important medical event that may jeopardize the participant or may require medical intervention to prevent one of the outcomes listed above.

    Measured: Up to Week 16

Timeline

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

  1. First posted23 Jan 2023
  2. Study start12 Jan 2023
  3. Primary completion4 Jun 2025
  4. Study completion4 Jun 2025

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
Non-randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
31 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05694260
Sponsor's protocol ID
1002-041
Acronym
CLEAR Path 1
Status last verified
Jul 2026
First submitted
12 Jan 2023
Last updated
17 Jul 2026
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
No: The Investigator must ensure that the participant's confidentiality is maintained. The names and identities of all research participants will be kept in strict confidence and will not appear on eCRFs or other records that are provided to or retained by the Sponsor (or designee). If a participant's name appears on any document, it must be redacted and replaced with the participant identifier before a copy of the document is supplied to the Sponsor (or designee). The ICF must include appropriate statements explaining that participant data will be confidential and the actions that will be taken to ensure participant confidentiality. Any other confidentiality requirements specified by the site, IRB or IEC, or national or local regulations will be adhered to and detailed appropriately in the ICF.

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Bempedoic acid in people with Hypercholesterolemia, run by Esperion Therapeutics, Inc. at 24 sites in 6 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 11 inclusion and 8 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 17 Jul 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 24 sites in United States, Spain, Canada, Denmark, Germany and 1 more country. 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 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 17 Jul 2026). 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?

Observed Trough Plasma Concentration of ETC-1002 Following 8 Weeks of Steady State Dosing of Bempedoic Acid (time frame: Week 8 pre-dose). The study lists 4 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 17 Jul 2026.

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