Ezetimibe (EZ)/Atorvastatin (Ator) (MK-0653C) vs. Ator in Chinese Hypercholesterolemic Participants (MK-0653C-439)
Primary Purpose
Hypercholesterolemia
Status
Completed
Phase
Phase 3
Locations
China
Study Type
Interventional
Intervention
EZ 10 mg/Ator 10 mg
EZ 10 mg/Ator 20 mg
Atorvastatin
Placebo for FDC EZ/Ator
Placebo for atorvastatin
Sponsored by
About this trial
This is an interventional treatment trial for Hypercholesterolemia
Eligibility Criteria
Inclusion Criteria:
- Has hypercholesterolemia diagnosed by investigator according to Chinese Guidelines on Prevention and Treatment of Dyslipidemia in Adults (2016 Edition).
- Has been stabilized on atorvastatin treatment at 10 mg or 20 mg (or other statins with LDL-C lowering efficacy equivalent to atorvastatin) for at least 4 weeks prior to Visit 1.
- If female, is not pregnant or breastfeeding, and is either not a woman of childbearing potential (WOCBP), or is a WOCBP who has used a contraceptive consistent with local regulations.
- If male, has used a contraceptive consistent with local regulations.
- Agrees to maintain a stable diet and stable exercise during the study.
Exclusion Criteria:
- Has uncontrolled hypertriglyceridemia which needs drug intervention or a fasting triglyceride (TG) value ≥500 mg/dL (4.52 mmol/L).
- Is currently treated with statin at dose of equivalent LDL-C lowering effect >20 mg atorvastatin.
- Has active liver disease
- Has New York Heart Association (NYHA) Class III or IV symptomatic congestive heart failure at Visit 1.
- Has had uncontrolled cardiac arrhythmias, myocardial infarction, percutaneous coronary intervention, coronary artery bypass graft, unstable angina, or stroke within 3 months (12 weeks) prior to Visit 1.
- Has homozygous familial hypercholesterolemia or has undergone LDL apheresis.
- Has endocrine or metabolic disease known to influence serum lipids or lipoproteins (i.e., secondary causes of hyperlipidemia, e.g., hyper or hypothyroidism, Cushing's syndrome).
- Has had a gastrointestinal tract bypass, or other significant intestinal malabsorption.
- Has a history of cancer within the past 5 years from Visit 1 (except for successfully treated dermatological basal cell or squamous cell carcinoma or in situ cervical cancer).
- Is known to be human immunodeficiency virus (HIV) positive.
- Has hypersensitivity or intolerance to ezetimibe, atorvastatin, the ezetimibe/atorvastatin combination tablet, or any component of these medications or has a condition or situation, which is described as a contraindication in labeling of EZETROL or Lipitor or may interfere with participation in the study.
- Has disorders of the hematologic, digestive, or central nervous systems including cerebrovascular disease and degenerative disease that would limit study evaluation or participation.
- Has a history of mental instability, drug/alcohol abuse within the past 5 years, or major psychiatric illness not adequately controlled and stable on pharmacotherapy.
- Has a history of myopathy or rhabdomyolysis with ezetimibe or any statin.
- Is a WOCBP who has had a positive urine pregnancy test within 24 hours before the first dose of study intervention. If the urine test is positive or cannot be confirmed as negative, a serum pregnancy test will be required.
- Is currently taking medications that are potent modulators of cytochrome P-450 3A4 (CYP3A4) including: cyclosporine, systemically administered azole antifungals (e.g., ketoconazole, fluconazole, and itraconazole), macrolide antibiotics (e.g., clarithromycin, and erythromycin), protease inhibitors (e.g., ritonavir, saquinavir, and lopinavir), grapefruit or juice of grapefruit (200 ml/day for >3 times per week)
- Is taking any cyclical hormones (e.g., cyclical oral contraceptives, cyclical hormone replacement), including the combination of ethinyl estradiol and norethisterone, or non-cyclical hormones, including non-cyclical hormone replacement therapy (HRT) or any estrogen antagonist/agonist within 8 weeks.
- Note: If participant has been treated with a stable regimen of non-cyclical HRT for > 8 weeks and agree to continue this regimen for the duration of the trial, concomitant therapy is acceptable.
- Is receiving treatment with systemic corticosteroids (intravenous, intramuscular and oral steroids).
- Is treated with psyllium, other fiber-based laxatives, phytosterol margarine, and herbal medicine and/or over the counter (OTC) therapies that are known to affect serum lipids.
- Note: If participant has been treated with a stable regimen for > 8 weeks and agrees to continue this regimen for the duration of the trial, concomitant therapy is acceptable.
- Is treated with an anti-obesity drug (e.g. mazindol) within 12 weeks prior to Visit 1.
- Is treated with warfarin or warfarin-like anticoagulants and has not been on a stable dose with a stable International Normalized Ratio (INR) for at least 6 weeks.
weeks.
- Has taken lipid-lowering agents (except probucol) including, Cholestin, bile acid sequestrants, ezetimibe, fibrates or niacin (>200 mg/day), proprotein convertases subtilisin/kexin type 9 (PCSK9) inhibitors within 6 weeks prior to Visit 1.
- Has taken probucol within 10 weeks prior to Visit 1.
- Has been treated with any other investigational drug within 30 days.
- Currently follows an excessive weight reduction diet.
- Currently engages in a vigorous exercise regimen (e.g., marathon training, body building training) or intends to start training during the study.
Sites / Locations
- The First Affiliated Hospital of Baotou Medical College ( Site 0025)
- Beijing Anzhen Hospital. Capital Medical University ( Site 0001)
- Aero Space center hospital ( Site 0003)
- Beijing Friendship Hospital ( Site 0005)
- Chongqing General Hospital ( Site 0037)
- Lanzhou University Second Hospital ( Site 0041)
- Guangdong General Hospital ( Site 0006)
- The First Affiliated Hospital.Sun Yat-sen University ( Site 0007)
- Sun Yat-sen Memorial Hospital of Sun Yat-sen University ( Site 0008)
- Daqing Oilfield General Hospital ( Site 0010)
- The first affiliated Hospital of Harbin Medical University ( Site 0009)
- The Third Xiangya Hospital of Central South University ( Site 0013)
- Hunan Provincial People's Hospital ( Site 0011)
- Zhongda Hospital Southeast University ( Site 0045)
- The Second Affiliated Hospital of Nanjing Medical University ( Site 0020)
- First Affiliated Hospital of Soochow University ( Site 0048)
- The Affiliated Hospital of Xuzhou Medical University ( Site 0017)
- Subei People's Hospital ( Site 0040)
- Second Affiliated Hospital of Nanchang University ( Site 0038)
- Ji Lin Province People Hospital ( Site 0016)
- China-Japan Union Hospital of Jilin University ( Site 0015)
- Central People s Hospital of Siping ( Site 0046)
- The People's Hospital of Liaoning Province-Cardiovascular ( Site 0022)
- Zhongshan Hospital Fudan University ( Site 0049)
- Shanghai Tongji Hospital ( Site 0031)
- Tianjin Union Medicine Centre ( Site 0032)
- People s Hospital of Lishui City ( Site 0036)
- Ningbo First Hospital ( Site 0042)
- Taizhou Hospital of Zhejiang Province ( Site 0035)
- The First Affiliated Hospital of Wenzhou Medical University ( Site 0034)
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Arm Type
Experimental
Active Comparator
Experimental
Active Comparator
Arm Label
EZ 10 mg/Ator 10 mg
Atorvastatin 20 mg
EZ 10 mg/Ator 20 mg
Atorvastatin 40 mg
Arm Description
Single oral dose of EZ10mg/Ator10mg FDC tablet once daily (QD) for 84 days
2 atorvastatin 10 mg tablets administered orally, QD for 84 days
Single oral dose of EZ10mg/Ator20mg FDC tablet QD for 84 days
2 atorvastatin 20 mg tablets administered orally, QD for 84 days
Outcomes
Primary Outcome Measures
Percent Change From Baseline in LDL-C at Week 12
Participants had LDL-C levels assessed at baseline and after 12 weeks of study drug administration. The change from baseline was calculated.
Secondary Outcome Measures
Percentage of Participants With An Adverse Event (AE)
An AE is any untoward medical occurrence in a clinical study participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention. An AE can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease (new or exacerbated) temporally associated with the use of a study intervention.
Number of Participants Who Discontinued From Study Treatment
The number of participants who discontinued treatment over the 12-week treatment period was assessed.
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT03768427
Brief Title
Ezetimibe (EZ)/Atorvastatin (Ator) (MK-0653C) vs. Ator in Chinese Hypercholesterolemic Participants (MK-0653C-439)
Official Title
A Phase 3 Randomized, Active-comparator-controlled Clinical Study to Evaluate the Efficacy and Safety of Ezetimibe/Atorvastatin Combination Tablet (MK-0653C) as Second Line Lipid Lowering Treatment in Chinese Participants
Study Type
Interventional
2. Study Status
Record Verification Date
April 2023
Overall Recruitment Status
Completed
Study Start Date
May 27, 2019 (Actual)
Primary Completion Date
March 17, 2021 (Actual)
Study Completion Date
April 1, 2021 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Organon and Co
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No
5. Study Description
Brief Summary
This study will evaluate the EZ/Ator fixed-dose combination (FDC) tablet (MK-0653C) as second line Low-Density Lipoprotein - Cholesterol (LDL-C) treatment in Chinese participants. The primary hypothesis is that MK-0653C 10/10 mg is superior to atorvastatin 20 mg in percent change from baseline in LDL-C to 12 weeks after treatment.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Hypercholesterolemia
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
454 (Actual)
8. Arms, Groups, and Interventions
Arm Title
EZ 10 mg/Ator 10 mg
Arm Type
Experimental
Arm Description
Single oral dose of EZ10mg/Ator10mg FDC tablet once daily (QD) for 84 days
Arm Title
Atorvastatin 20 mg
Arm Type
Active Comparator
Arm Description
2 atorvastatin 10 mg tablets administered orally, QD for 84 days
Arm Title
EZ 10 mg/Ator 20 mg
Arm Type
Experimental
Arm Description
Single oral dose of EZ10mg/Ator20mg FDC tablet QD for 84 days
Arm Title
Atorvastatin 40 mg
Arm Type
Active Comparator
Arm Description
2 atorvastatin 20 mg tablets administered orally, QD for 84 days
Intervention Type
Combination Product
Intervention Name(s)
EZ 10 mg/Ator 10 mg
Intervention Description
FDC of EZ10 mg/Ator 10mg
Intervention Type
Combination Product
Intervention Name(s)
EZ 10 mg/Ator 20 mg
Intervention Description
FDC of EZ10 mg/Ator 20mg
Intervention Type
Drug
Intervention Name(s)
Atorvastatin
Other Intervention Name(s)
Lipitor^®
Intervention Description
Atorvastatin administered orally QD, either as two 10 mg tablets or as two 20 mg tablets
Intervention Type
Drug
Intervention Name(s)
Placebo for FDC EZ/Ator
Intervention Description
A single placebo tablet administered orally QD for 84 days
Intervention Type
Drug
Intervention Name(s)
Placebo for atorvastatin
Intervention Description
Two placebo tablets matching atorvastatin administered orally QD for 84 days
Primary Outcome Measure Information:
Title
Percent Change From Baseline in LDL-C at Week 12
Description
Participants had LDL-C levels assessed at baseline and after 12 weeks of study drug administration. The change from baseline was calculated.
Time Frame
Baseline (Day 1) and Week 12
Secondary Outcome Measure Information:
Title
Percentage of Participants With An Adverse Event (AE)
Description
An AE is any untoward medical occurrence in a clinical study participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention. An AE can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease (new or exacerbated) temporally associated with the use of a study intervention.
Time Frame
Up to approximately 17 weeks
Title
Number of Participants Who Discontinued From Study Treatment
Description
The number of participants who discontinued treatment over the 12-week treatment period was assessed.
Time Frame
Up to approximately 15 weeks
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Has hypercholesterolemia diagnosed by investigator according to Chinese Guidelines on Prevention and Treatment of Dyslipidemia in Adults (2016 Edition).
Has been stabilized on atorvastatin treatment at 10 mg or 20 mg (or other statins with LDL-C lowering efficacy equivalent to atorvastatin) for at least 4 weeks prior to Visit 1.
If female, is not pregnant or breastfeeding, and is either not a woman of childbearing potential (WOCBP), or is a WOCBP who has used a contraceptive consistent with local regulations.
If male, has used a contraceptive consistent with local regulations.
Agrees to maintain a stable diet and stable exercise during the study.
Exclusion Criteria:
Has uncontrolled hypertriglyceridemia which needs drug intervention or a fasting triglyceride (TG) value ≥500 mg/dL (4.52 mmol/L).
Is currently treated with statin at dose of equivalent LDL-C lowering effect >20 mg atorvastatin.
Has active liver disease
Has New York Heart Association (NYHA) Class III or IV symptomatic congestive heart failure at Visit 1.
Has had uncontrolled cardiac arrhythmias, myocardial infarction, percutaneous coronary intervention, coronary artery bypass graft, unstable angina, or stroke within 3 months (12 weeks) prior to Visit 1.
Has homozygous familial hypercholesterolemia or has undergone LDL apheresis.
Has endocrine or metabolic disease known to influence serum lipids or lipoproteins (i.e., secondary causes of hyperlipidemia, e.g., hyper or hypothyroidism, Cushing's syndrome).
Has had a gastrointestinal tract bypass, or other significant intestinal malabsorption.
Has a history of cancer within the past 5 years from Visit 1 (except for successfully treated dermatological basal cell or squamous cell carcinoma or in situ cervical cancer).
Is known to be human immunodeficiency virus (HIV) positive.
Has hypersensitivity or intolerance to ezetimibe, atorvastatin, the ezetimibe/atorvastatin combination tablet, or any component of these medications or has a condition or situation, which is described as a contraindication in labeling of EZETROL or Lipitor or may interfere with participation in the study.
Has disorders of the hematologic, digestive, or central nervous systems including cerebrovascular disease and degenerative disease that would limit study evaluation or participation.
Has a history of mental instability, drug/alcohol abuse within the past 5 years, or major psychiatric illness not adequately controlled and stable on pharmacotherapy.
Has a history of myopathy or rhabdomyolysis with ezetimibe or any statin.
Is a WOCBP who has had a positive urine pregnancy test within 24 hours before the first dose of study intervention. If the urine test is positive or cannot be confirmed as negative, a serum pregnancy test will be required.
Is currently taking medications that are potent modulators of cytochrome P-450 3A4 (CYP3A4) including: cyclosporine, systemically administered azole antifungals (e.g., ketoconazole, fluconazole, and itraconazole), macrolide antibiotics (e.g., clarithromycin, and erythromycin), protease inhibitors (e.g., ritonavir, saquinavir, and lopinavir), grapefruit or juice of grapefruit (200 ml/day for >3 times per week)
Is taking any cyclical hormones (e.g., cyclical oral contraceptives, cyclical hormone replacement), including the combination of ethinyl estradiol and norethisterone, or non-cyclical hormones, including non-cyclical hormone replacement therapy (HRT) or any estrogen antagonist/agonist within 8 weeks.
Note: If participant has been treated with a stable regimen of non-cyclical HRT for > 8 weeks and agree to continue this regimen for the duration of the trial, concomitant therapy is acceptable.
Is receiving treatment with systemic corticosteroids (intravenous, intramuscular and oral steroids).
Is treated with psyllium, other fiber-based laxatives, phytosterol margarine, and herbal medicine and/or over the counter (OTC) therapies that are known to affect serum lipids.
Note: If participant has been treated with a stable regimen for > 8 weeks and agrees to continue this regimen for the duration of the trial, concomitant therapy is acceptable.
Is treated with an anti-obesity drug (e.g. mazindol) within 12 weeks prior to Visit 1.
Is treated with warfarin or warfarin-like anticoagulants and has not been on a stable dose with a stable International Normalized Ratio (INR) for at least 6 weeks.
weeks.
Has taken lipid-lowering agents (except probucol) including, Cholestin, bile acid sequestrants, ezetimibe, fibrates or niacin (>200 mg/day), proprotein convertases subtilisin/kexin type 9 (PCSK9) inhibitors within 6 weeks prior to Visit 1.
Has taken probucol within 10 weeks prior to Visit 1.
Has been treated with any other investigational drug within 30 days.
Currently follows an excessive weight reduction diet.
Currently engages in a vigorous exercise regimen (e.g., marathon training, body building training) or intends to start training during the study.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Medical Director
Organizational Affiliation
Merck Sharp & Dohme LLC
Official's Role
Study Director
Facility Information:
Facility Name
The First Affiliated Hospital of Baotou Medical College ( Site 0025)
City
Baotou
State/Province
Anhui
ZIP/Postal Code
014010
Country
China
Facility Name
Beijing Anzhen Hospital. Capital Medical University ( Site 0001)
City
Beijing
State/Province
Anhui
ZIP/Postal Code
100024
Country
China
Facility Name
Aero Space center hospital ( Site 0003)
City
Beijing
State/Province
Beijing
ZIP/Postal Code
100049
Country
China
Facility Name
Beijing Friendship Hospital ( Site 0005)
City
Beijing
State/Province
Beijing
ZIP/Postal Code
100050
Country
China
Facility Name
Chongqing General Hospital ( Site 0037)
City
Chongqing
State/Province
Chongqing
ZIP/Postal Code
400013
Country
China
Facility Name
Lanzhou University Second Hospital ( Site 0041)
City
Lanzhou
State/Province
Gansu
ZIP/Postal Code
730030
Country
China
Facility Name
Guangdong General Hospital ( Site 0006)
City
Guangzhou
State/Province
Guangdong
ZIP/Postal Code
510080
Country
China
Facility Name
The First Affiliated Hospital.Sun Yat-sen University ( Site 0007)
City
Guangzhou
State/Province
Guangdong
ZIP/Postal Code
510080
Country
China
Facility Name
Sun Yat-sen Memorial Hospital of Sun Yat-sen University ( Site 0008)
City
Guangzhou
State/Province
Guangdong
ZIP/Postal Code
510210
Country
China
Facility Name
Daqing Oilfield General Hospital ( Site 0010)
City
Daqing
State/Province
Heilongjiang
ZIP/Postal Code
163001
Country
China
Facility Name
The first affiliated Hospital of Harbin Medical University ( Site 0009)
City
Haerbin
State/Province
Heilongjiang
ZIP/Postal Code
150001
Country
China
Facility Name
The Third Xiangya Hospital of Central South University ( Site 0013)
City
Changsha
State/Province
Hunan
ZIP/Postal Code
410000
Country
China
Facility Name
Hunan Provincial People's Hospital ( Site 0011)
City
Changsha
State/Province
Hunan
ZIP/Postal Code
410005
Country
China
Facility Name
Zhongda Hospital Southeast University ( Site 0045)
City
Nanjing
State/Province
Jiangsu
ZIP/Postal Code
210009
Country
China
Facility Name
The Second Affiliated Hospital of Nanjing Medical University ( Site 0020)
City
Nanjing
State/Province
Jiangsu
ZIP/Postal Code
210011
Country
China
Facility Name
First Affiliated Hospital of Soochow University ( Site 0048)
City
Suzhou
State/Province
Jiangsu
ZIP/Postal Code
215006
Country
China
Facility Name
The Affiliated Hospital of Xuzhou Medical University ( Site 0017)
City
Xuzhou
State/Province
Jiangsu
ZIP/Postal Code
221000
Country
China
Facility Name
Subei People's Hospital ( Site 0040)
City
Yangzhou
State/Province
Jiangsu
ZIP/Postal Code
225001
Country
China
Facility Name
Second Affiliated Hospital of Nanchang University ( Site 0038)
City
Nanchang
State/Province
Jiangxi
ZIP/Postal Code
330006
Country
China
Facility Name
Ji Lin Province People Hospital ( Site 0016)
City
Changchun
State/Province
Jilin
ZIP/Postal Code
130021
Country
China
Facility Name
China-Japan Union Hospital of Jilin University ( Site 0015)
City
Changchun
State/Province
Jilin
ZIP/Postal Code
130033
Country
China
Facility Name
Central People s Hospital of Siping ( Site 0046)
City
Siping
State/Province
Jilin
ZIP/Postal Code
136000
Country
China
Facility Name
The People's Hospital of Liaoning Province-Cardiovascular ( Site 0022)
City
Shenyang
State/Province
Liaoning
ZIP/Postal Code
110016
Country
China
Facility Name
Zhongshan Hospital Fudan University ( Site 0049)
City
Shanghai
State/Province
Shanghai
ZIP/Postal Code
200032
Country
China
Facility Name
Shanghai Tongji Hospital ( Site 0031)
City
Shanghai
State/Province
Shanghai
ZIP/Postal Code
200065
Country
China
Facility Name
Tianjin Union Medicine Centre ( Site 0032)
City
Tianjin
State/Province
Tianjin
ZIP/Postal Code
300121
Country
China
Facility Name
People s Hospital of Lishui City ( Site 0036)
City
Lishui
State/Province
Zhejiang
ZIP/Postal Code
323000
Country
China
Facility Name
Ningbo First Hospital ( Site 0042)
City
Ningbo
State/Province
Zhejiang
ZIP/Postal Code
315010
Country
China
Facility Name
Taizhou Hospital of Zhejiang Province ( Site 0035)
City
Taizhou
State/Province
Zhejiang
ZIP/Postal Code
317000
Country
China
Facility Name
The First Affiliated Hospital of Wenzhou Medical University ( Site 0034)
City
Wenzhou
State/Province
Zhejiang
ZIP/Postal Code
325000
Country
China
12. IPD Sharing Statement
Plan to Share IPD
Yes
IPD Sharing Plan Description
http://engagezone.msd.com/doc/ProcedureAccessClinicalTrialData.pdf
IPD Sharing URL
http://engagezone.msd.com/ds_documentation.php
Citations:
PubMed Identifier
36182594
Citation
Qian J, Li Z, Zhang X, Chen J, Ding C, Yang P, Liu Y, Shi M, Ren X, Ge J; Phase III Study Investigators. Efficacy and Tolerability of Ezetimibe/Atorvastatin Fixed-dose Combination Versus Atorvastatin Monotherapy in Hypercholesterolemia: A Phase III, Randomized, Active-controlled Study in Chinese Patients. Clin Ther. 2022 Oct;44(10):1282-1296. doi: 10.1016/j.clinthera.2022.08.013. Epub 2022 Sep 29.
Results Reference
derived
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Ezetimibe (EZ)/Atorvastatin (Ator) (MK-0653C) vs. Ator in Chinese Hypercholesterolemic Participants (MK-0653C-439)
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