Epanova® for Lowering Very High Triglycerides II (EVOLVE II) (EVOLVEII)
Primary Purpose
Hypertriglyceridemia
Status
Completed
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
Epanova
Olive Oil
Sponsored by
About this trial
This is an interventional treatment trial for Hypertriglyceridemia focused on measuring Hypertriglyceridemia, Dyslipidemia, Eicosapentaenoic acid, EPA, Docosahexaenoic acid, DHA
Eligibility Criteria
Inclusion Criteria:
- Understanding of the study procedures, willingness to adhere to the study schedule, and agreement to participate in the study by giving written informed consent prior to screening;
- Willing to use an appropriate and effective method of contraception;
- Qualifying (average of Visit 1 or 1a + Visit 2 + Visit 2a [repeat measurement]) serum TG ≥500 mg/dL (6 mMol/L) and <2500 mg/dL (28 mMol/L);
- Body mass index ≥20 kg/m2;
- Untreated dyslipidemia or dyslipidemia treated with a statin, CAI, or statin-CAI combination that has been stable for 6 weeks prior to randomization; and
- Willingness to maintain current physical activity level and follow the TLC diet throughout the study.
Exclusion Criteria:
- Allergy or intolerance to omega-3 fatty acids, omega-3-acid ethyl esters, or fish;
- Known lipoprotein lipase impairment;
- Known non-responder to omega-3 or fenofibrate therapy;
- Use of any prescription medications containing EPA and/or DHA (eg, Lovaza® or Vascepa®) within 8 weeks prior to randomization. Up to 1 g capsule/day of an omega-3 dietary supplement will be permitted;
- Unable to discontinue use of bile acid sequestrants, fibrates or niacin (other than niacin-containing vitamins <200 mg), or any supplement used to alter lipid metabolism including but not limited to dietary fiber supplements, red rice yeast supplements, garlic supplements, soy isoflavone supplements, sterol/stanol products, or policosanols at screening;
- Use of tamoxifen, estrogens, or progestins that has not been stable for >4 weeks at screening or is unstable prior to randomization;
- Use of oral or injected corticosteroids or anabolic steroids prior to randomization;
- History of hospitalization for pancreatitis in the last 5 years;
- Uncontrolled diabetes (hemoglobin A1c [HbA1c] >10%);
- Uncontrolled hypothyroidism or thyroid-stimulating hormone (TSH) >5 mIU/L;
- History of cancer (other than basal cell carcinoma) in the past 2 years;
- Cardiovascular event (ie, myocardial infarction, acute coronary syndrome, new onset angina, stroke, transient heart attack, unstable congestive heart failure requiring a change in treatment), revascularization procedure or vascular surgery within 6 months of randomization;
- Use of simvastatin 80 mg or Vytorin 10/80 mg;
- Recent history (within 6 months of randomization) of significant nephrotic syndrome, pulmonary, hepatic, biliary, gastrointestinal, or immunologic disease;
- Poorly controlled hypertension (systolic blood pressure ≥180 mmHg and/or diastolic blood pressure ≥110 mmHg);
- Alanine aminotransferase (ALT) or aspartate aminotransferase (AST) >3 × the upper limit of normal (ULN); if ALT/AST is >3 × ULN, the levels have been stable for 3 months and are <5 × ULN;
- Exposure to any investigational product within 4 weeks of randomization; or
- Any condition or therapy which, in the opinion of the Investigator, might pose a risk to the subject or make participation in the study not in the subject's best interest.
Sites / Locations
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Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Placebo Comparator
Arm Label
Epanova 2 g/day
Olive Oil 2 g/day
Arm Description
Arm 1
Arm 2
Outcomes
Primary Outcome Measures
Percent Change in Triglyceride for All Subjects
This primary endpoint was tested in parallel together with the first of the secondary endpoints, each at 0.025 Type I error rate.
Secondary Outcome Measures
Percent Change in Triglycerides for Subjects With at Least 1 Qualifying Triglyceride >885 mg/dL
This first secondary endpoint in subjects with at least 1 qualifying triglyceride >885 mg/dL was tested in parallel together with the primary endpoint, each at 0.025 Type I error rate.
Percent Change in Non-High-Density Lipoprotein Cholesterol (mg/dL)
This secondary endpoint, together with the 3rd. and 4th secondary ones, was treated as the core secondary, and the p value from the hypothesis test on its treatment comparison was adjusted by using Hommel's procedure.
Percent Change in High-Density Lipoprotein Cholesterol (mg/dL)
This secondary endpoint, together with the 2nd. and 4th. secondary ones, was treated as the core secondary, and the p value from the hypothesis test on its treatment comparison was adjusted by using Hommel's procedure.
Percent Change in Triglyceride(mg/dL) in Subjects With Biochemically Defined Fredrickson Type V (Triglyceride/Very-Low-Density Lipoprotein Cholesterol ≥6)
This secondary endpoint in subjects with Biochemically Defined Fredrickson Type V (Triglyceride/Very-Low-Density Lipoprotein Cholesterol ≥6), together with the 2nd. and 3rd.secondary ones, was treated as the core secondary, and the p value from the hypothesis test on its treatment comparison was adjusted by using Hommel's procedure.
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT02009865
Brief Title
Epanova® for Lowering Very High Triglycerides II (EVOLVE II)
Acronym
EVOLVEII
Official Title
A 12-Week, Randomized, Double-Blind, Olive Oil-Controlled Phase 3 Study to Assess the Efficacy and Safety of EPANOVA™ in Subjects With Severe Hypertriglyceridemia (EVOLVE II)
Study Type
Interventional
2. Study Status
Record Verification Date
August 2019
Overall Recruitment Status
Completed
Study Start Date
December 16, 2013 (Actual)
Primary Completion Date
December 23, 2014 (Actual)
Study Completion Date
December 23, 2014 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
AstraZeneca
4. Oversight
Data Monitoring Committee
No
5. Study Description
Brief Summary
This is a double-blind, randomized, olive oil-controlled study to investigate the efficacy and safety of Epanova as an adjunct therapy to diet for reduction of TG levels in subjects with severe hypertriglyceridemia. The study consists of an approximately 8-week screening period that includes a diet and lifestyle stabilization and washout period and a 12-week treatment period.
Detailed Description
[During the screening period and treatment period, all visits are to be within ±3 days of the scheduled time.]
Screening Period:
Visit 1 will occur at Week -8 for subjects requiring washout and/or statin, cholesterol-absorption inhibitor (CAI), or statin-CAI stabilization. This includes subjects who:
Were previously on omega-3 drugs/supplements;
Require adjustment to or addition of permitted statins, CAI, or statin-CAI combination;
Have not been on a permitted stable dose of statin, CAI, or statin-CAI combination for at least 4 weeks prior to Visit 1; and/or
Need to washout of bile acid sequestrants, fibrates, niacin, and other supplements known to alter lipid metabolism.
For these subjects who require washout and/or statin, CAI, or statin-CAI stabilization, at Visit 1 (Week -8) screening procedures will be performed. Subjects will return at Visit 1a (Week -2) for their first qualifying lipid measurement.
For subjects not requiring washout, Visit 1 will occur at Week -2. All screening procedures will be performed at this visit including the first qualifying lipid measurement.
At Visit 2 (Week -1), all subjects will return for their second lipid qualifying measurement. If at Visit 2 the subject does not have an average TG ≥500 mg/dL (6 mmol/L) and <2500 mg/dL (28 mmol/L), the TG measurement may be repeated one additional time after Visit 2 (Visit 2a). The subject's qualifying measurement would be the average of Visit 1 or 1a + Visit 2 + Visit 2a (repeat measurement).
To be eligible for randomization, the subject must have a qualifying TG ≥500 mg/dL (6 mmol/L) and <2500 mg/dL (28 mmol/L). Of the total number of subjects, approximately 50% will have a qualifying TG >885 mg/dL (10 mmol/L) and <2500 mg/dL (28 mmol/L). Once approximately 50% of the total subjects has been reached for each TG group, enrollment of subjects with that specific TG criterion will stop. Subjects will be equally allocated to each treatment group.
[At the screening visit, all subjects will receive counseling regarding the National Cholesterol Education Program (NCEP) Therapeutic Lifestyle Changes (TLC) diet and will receive basic instructions on how to follow this diet. See Appendix C.]
Treatment Period:
At Visit 3 (Week 0), approximately 116 subjects will be randomized in a 1:1 ratio to receive daily olive oil 2 g or Epanova 2 g. Subjects will be stratified by lipid-altering drugs to ensure a balanced allocation of subjects who are users and non-users of the following permitted lipid-altering drugs in each treatment group: statin, CAI, or statin-CAI combination. During the treatment period, subjects will return to the site at Visit 4 (Week 6), Visit 5 (Week 10), and Visit 6 (Week 12) for efficacy and safety evaluations.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Hypertriglyceridemia
Keywords
Hypertriglyceridemia, Dyslipidemia, Eicosapentaenoic acid, EPA, Docosahexaenoic acid, DHA
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
379 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Epanova 2 g/day
Arm Type
Experimental
Arm Description
Arm 1
Arm Title
Olive Oil 2 g/day
Arm Type
Placebo Comparator
Arm Description
Arm 2
Intervention Type
Drug
Intervention Name(s)
Epanova
Other Intervention Name(s)
omega-3 free fatty acids
Intervention Description
Epanova will be provided in 1 g polyacrylate-coated soft gel capsules. Two capsules will be taken once per day, without regard to meals, for 12 weeks. At clinic visits, study drug will be administered at the clinic after fasting blood draws are complete.
Intervention Type
Drug
Intervention Name(s)
Olive Oil
Other Intervention Name(s)
placebo comparator
Intervention Description
Olive oil will be provided in 1 g polyacrylate-coated soft gel capsules. Two capsules will be taken once per day, without regard to meals, for 12 weeks. At clinic visits, study drug will be administered at the clinic after fasting blood draws are complete.
Primary Outcome Measure Information:
Title
Percent Change in Triglyceride for All Subjects
Description
This primary endpoint was tested in parallel together with the first of the secondary endpoints, each at 0.025 Type I error rate.
Time Frame
From Baseline to Week 12 Endpoint
Secondary Outcome Measure Information:
Title
Percent Change in Triglycerides for Subjects With at Least 1 Qualifying Triglyceride >885 mg/dL
Description
This first secondary endpoint in subjects with at least 1 qualifying triglyceride >885 mg/dL was tested in parallel together with the primary endpoint, each at 0.025 Type I error rate.
Time Frame
From Baseline to Week 12 Endpoint
Title
Percent Change in Non-High-Density Lipoprotein Cholesterol (mg/dL)
Description
This secondary endpoint, together with the 3rd. and 4th secondary ones, was treated as the core secondary, and the p value from the hypothesis test on its treatment comparison was adjusted by using Hommel's procedure.
Time Frame
From Baseline to Week 12 Endpoint
Title
Percent Change in High-Density Lipoprotein Cholesterol (mg/dL)
Description
This secondary endpoint, together with the 2nd. and 4th. secondary ones, was treated as the core secondary, and the p value from the hypothesis test on its treatment comparison was adjusted by using Hommel's procedure.
Time Frame
From Baseline to Week 12 Endpoint
Title
Percent Change in Triglyceride(mg/dL) in Subjects With Biochemically Defined Fredrickson Type V (Triglyceride/Very-Low-Density Lipoprotein Cholesterol ≥6)
Description
This secondary endpoint in subjects with Biochemically Defined Fredrickson Type V (Triglyceride/Very-Low-Density Lipoprotein Cholesterol ≥6), together with the 2nd. and 3rd.secondary ones, was treated as the core secondary, and the p value from the hypothesis test on its treatment comparison was adjusted by using Hommel's procedure.
Time Frame
From Baseline to Week 12 Endpoint
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
130 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Understanding of the study procedures, willingness to adhere to the study schedule, and agreement to participate in the study by giving written informed consent prior to screening;
Willing to use an appropriate and effective method of contraception;
Qualifying (average of Visit 1 or 1a + Visit 2 + Visit 2a [repeat measurement]) serum TG ≥500 mg/dL (6 mMol/L) and <2500 mg/dL (28 mMol/L);
Body mass index ≥20 kg/m2;
Untreated dyslipidemia or dyslipidemia treated with a statin, CAI, or statin-CAI combination that has been stable for 6 weeks prior to randomization; and
Willingness to maintain current physical activity level and follow the TLC diet throughout the study.
Exclusion Criteria:
Allergy or intolerance to omega-3 fatty acids, omega-3-acid ethyl esters, or fish;
Known lipoprotein lipase impairment;
Known non-responder to omega-3 or fenofibrate therapy;
Use of any prescription medications containing EPA and/or DHA (eg, Lovaza® or Vascepa®) within 8 weeks prior to randomization. Up to 1 g capsule/day of an omega-3 dietary supplement will be permitted;
Unable to discontinue use of bile acid sequestrants, fibrates or niacin (other than niacin-containing vitamins <200 mg), or any supplement used to alter lipid metabolism including but not limited to dietary fiber supplements, red rice yeast supplements, garlic supplements, soy isoflavone supplements, sterol/stanol products, or policosanols at screening;
Use of tamoxifen, estrogens, or progestins that has not been stable for >4 weeks at screening or is unstable prior to randomization;
Use of oral or injected corticosteroids or anabolic steroids prior to randomization;
History of hospitalization for pancreatitis in the last 5 years;
Uncontrolled diabetes (hemoglobin A1c [HbA1c] >10%);
Uncontrolled hypothyroidism or thyroid-stimulating hormone (TSH) >5 mIU/L;
History of cancer (other than basal cell carcinoma) in the past 2 years;
Cardiovascular event (ie, myocardial infarction, acute coronary syndrome, new onset angina, stroke, transient heart attack, unstable congestive heart failure requiring a change in treatment), revascularization procedure or vascular surgery within 6 months of randomization;
Use of simvastatin 80 mg or Vytorin 10/80 mg;
Recent history (within 6 months of randomization) of significant nephrotic syndrome, pulmonary, hepatic, biliary, gastrointestinal, or immunologic disease;
Poorly controlled hypertension (systolic blood pressure ≥180 mmHg and/or diastolic blood pressure ≥110 mmHg);
Alanine aminotransferase (ALT) or aspartate aminotransferase (AST) >3 × the upper limit of normal (ULN); if ALT/AST is >3 × ULN, the levels have been stable for 3 months and are <5 × ULN;
Exposure to any investigational product within 4 weeks of randomization; or
Any condition or therapy which, in the opinion of the Investigator, might pose a risk to the subject or make participation in the study not in the subject's best interest.
Facility Information:
Facility Name
Research Site
City
Los Angeles
State/Province
California
ZIP/Postal Code
90057
Country
United States
Facility Name
Research Site
City
Saint Petersburg
State/Province
Florida
ZIP/Postal Code
33709
Country
United States
Facility Name
Research Site
City
Addison
State/Province
Illinois
ZIP/Postal Code
60101
Country
United States
Facility Name
Research Site
City
Louisville
State/Province
Kentucky
ZIP/Postal Code
40213
Country
United States
Facility Name
Research Site
City
Cincinnati
State/Province
Ohio
ZIP/Postal Code
45227
Country
United States
Facility Name
Research Site
City
Cincinnati
State/Province
Ohio
ZIP/Postal Code
45246
Country
United States
Facility Name
Research Site
City
Columbus
State/Province
Ohio
ZIP/Postal Code
43213
Country
United States
Facility Name
Research Site
City
Kettering
State/Province
Ohio
ZIP/Postal Code
45429
Country
United States
Facility Name
Research Site
City
Lyndhurst
State/Province
Ohio
ZIP/Postal Code
44124
Country
United States
Facility Name
Research Site
City
Oklahoma City
State/Province
Oklahoma
ZIP/Postal Code
73103
Country
United States
Facility Name
Research Site
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19104
Country
United States
Facility Name
Research Site
City
Orangeburg
State/Province
South Carolina
ZIP/Postal Code
29118
Country
United States
Facility Name
Research Site
City
Bristol
State/Province
Tennessee
ZIP/Postal Code
37620
Country
United States
Facility Name
Research Site
City
Houston
State/Province
Texas
ZIP/Postal Code
77074
Country
United States
Facility Name
Research Site
City
Katy
State/Province
Texas
ZIP/Postal Code
77450
Country
United States
Facility Name
Research Site
City
Chicoutimi
State/Province
Quebec
ZIP/Postal Code
G7H 7K9
Country
Canada
Facility Name
Research Site
City
Hradec Kralova
ZIP/Postal Code
50005
Country
Czechia
Facility Name
Research Site
City
Trutnov
ZIP/Postal Code
541 21
Country
Czechia
Facility Name
Research Site
City
Zlín
ZIP/Postal Code
76275
Country
Czechia
Facility Name
Research Site
City
Esbjerg
ZIP/Postal Code
6700
Country
Denmark
Facility Name
Research Site
City
Gentofte
ZIP/Postal Code
2820
Country
Denmark
Facility Name
Research Site
City
Herlev
ZIP/Postal Code
2730
Country
Denmark
Facility Name
Research Site
City
Viborg
ZIP/Postal Code
8800
Country
Denmark
Facility Name
Research Site
City
Baja
ZIP/Postal Code
6500
Country
Hungary
Facility Name
Research Site
City
Balatonfured
ZIP/Postal Code
8230
Country
Hungary
Facility Name
Research Site
City
Budapest
ZIP/Postal Code
1062
Country
Hungary
Facility Name
Research Site
City
Debrecen
ZIP/Postal Code
4031
Country
Hungary
Facility Name
Research Site
City
Debrecen
ZIP/Postal Code
4032
Country
Hungary
Facility Name
Research Site
City
Szikszó
ZIP/Postal Code
3800
Country
Hungary
Facility Name
Research Site
City
Székesfehérvár
ZIP/Postal Code
8000
Country
Hungary
Facility Name
Research Site
City
Sátoraljaújhely
ZIP/Postal Code
3980
Country
Hungary
Facility Name
Research Site
City
Alkmaar
ZIP/Postal Code
1815JD
Country
Netherlands
Facility Name
Research Site
City
Amsterdam
ZIP/Postal Code
1105 AZ
Country
Netherlands
Facility Name
Research Site
City
Barnaul
ZIP/Postal Code
656055
Country
Russian Federation
Facility Name
Research Site
City
Ekaterinburg
ZIP/Postal Code
620219
Country
Russian Federation
Facility Name
Research Site
City
Kemerovo
ZIP/Postal Code
650002
Country
Russian Federation
Facility Name
Research Site
City
Moscow
ZIP/Postal Code
121551
Country
Russian Federation
Facility Name
Research Site
City
Moscow
ZIP/Postal Code
121552
Country
Russian Federation
Facility Name
Research Site
City
Saint Petersburg
ZIP/Postal Code
196601
Country
Russian Federation
Facility Name
Research Site
City
Tomsk
ZIP/Postal Code
634012
Country
Russian Federation
12. IPD Sharing Statement
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Epanova® for Lowering Very High Triglycerides II (EVOLVE II)
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