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Regeneron 1331 Kinetics Sub-Study HoFH

Primary Purpose

Hypercholesterolemia, Familial

Status
Completed
Phase
Not Applicable
Locations
International
Study Type
Interventional
Intervention
Kinetics test
Sponsored by
University of Pennsylvania
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional other trial for Hypercholesterolemia, Familial focused on measuring Lipid metabolism, Homozygous Familial Hypercholesterolemia, Evinacumab

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Eligibility criteria:

-Eligibility will be made based on the data collected at the screening visit of the R1500-CL-1331 protocol. Subjects must meet all inclusion/exclusion criteria for eligibility of that study to be eligible to participate in this sub-study. Below is the eligibility criteria for R1500-CL-1331.

Inclusion:

  • Men and women 18 years or older at the time of the screening visit
  • Diagnosis of HoFH by one of the following:

    1. Documented mutation or mutations in both LDLR alleles
    2. Documented presence of homozygous or compound heterozygous mutations in Apo B and/or PCSK9
    3. Documented skin fibroblast LDLR activity <20% of normal
  • Willing to consistently maintain his/her usual diet for the duration of the study
  • Willing and able to comply with clinic visits and study-related procedures
  • Provide signed informed consent

Exclusion:

  • Background medical LMT (if applicable) that has not been stable for at least 4 weeks (6 weeks for fibrates) prior to the screening visit (week -2) (unless participating in the run-in period to stabilize)
  • Having undergone lipid apheresis within 4 weeks prior to the screening visit (week -2) (unless participating in the run-in period to wash out)
  • Presence of any clinically significant uncontrolled endocrine disease known to influence serum lipids or lipoproteins. Note: Patients on thyroid replacement therapy can be included if the dosage of thyroxine has been stable for at least 12 weeks prior to screening visit (week -2)
  • Use of systemic corticosteroids, unless used as replacement therapy for pituitary/adrenal disease with a stable regiment for at least 6 weeks prior to the screening visit (week -2) Note: Topical, intra-articular, nasal, inhaled, and ophthalmic steroid therapies are not considered as "systemic" and are allowed
  • History of a myocardial infarction, unstable angina leading to hospitalization, coronary bypass graft surgery, percutaneous coronary intervention, uncontrolled cardiac arrhythmia, carotid surgery or stenting, stroke, transient ischemic attack, carotid revascularization, endovascular procedure or surgical intervention for peripheral vascular disease within 3 months prior to the screening visit (week -2)
  • Known history of HIV and a CD4 count less than 350c/mL Note: Patients with a history of HIV can be included, as long as they:

    1. have a CD4 count greater than 350c/mL;
    2. have an undetectable viral load for at least 12 months prior to screening;
    3. have no opportunistic infections or active tuberculosis for at least 12 months prior to screening;
    4. are not receiving prophylaxis for opportunistic infections; and have been on stable antiretroviral therapy for at least 12 months prior to screening
  • Use of another investigational drug or therapy within 30 days or at least 5 half-lives (whichever is longer) prior to screening visit (week -2). Includes patients who were involved in a prior clinical trial and are not sure of their treatment assignment.
  • Previous participation in any clinical trial of REGN1500
  • Conditions/situation such as:

    1. Any clinically significant abnormality identified at the time of screening that, in the judgement of the investigator or any subinvestigator, would preclude safe completion of the study or constrain endpoints assessment; eg. major systemic diseases, patients with short life expectancy
    2. Patient considered by the investigator or any subinvestigator as inappropriate for this study for any reason, eg: deemed unable to meet specific protocol requirements, such as scheduled visits. Deemed unable to tolerate injections as per the patient or the investigator. Investigator or any subinvestigator, pharmacist, study coordinator, other study staff or relative thereof directly involved in the conduct of the protocol, etc. Presence of any other conditions (eg, geographic or social), either actual or anticipated, that the investigator feels would restrict or limit the patient's participation for the duration of the study
  • Laboratory findings during screening period:

    1. Positive test for Hepatitis B surface antigen and/or Hepatitis C antibody
    2. Positive serum beta-human chorionic gonadotropin or urine pregnancy test in women of childbearing potential
    3. Triglycerides greater than 400 mg/dL ( >3.95 mmol/L) (1 repeat lab is allowed)
    4. Estimated glomerular filtration rate <30 mL/min/1.73m^2 according to 4-variable Modification of Diet in Renal Disease Study equation (calculated by central lab)
    5. Alanine amintransferase (ALT) or aspartate aminotransferase (AST) >3 x the upper limit of normal (ULN) (1 repeat lab is allowed)
    6. Creatine phosphokinase (CPK) >3 x ULN (1 repeat lab is allowed)
  • Known hypersensitivity to monoclonal antibody therapeutics
  • History of hypersensitivity reaction to doxycycline or similar compound
  • Pregnant or breast-feeding women
  • Sexually active men, or women of childbearing potential, who are unwilling to utilize adequate contraception for at least 6 months after the last dose of study drug.

Sites / Locations

  • University of Pennsylvania
  • Department of Vascular Medicine Amsterdam UMC

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Volunteers with known HoFH and particpated in R1500-CL-1331 clinical trial

Arm Description

Outcomes

Primary Outcome Measures

Fractional catabolic rate (FCR) pools/day
First visit to be performed prior to first evinacumab administration; second visit to be performed approximately 4-6 weeks after evinacumab i.v. administration. About 8 weeks between the 2 visits.
Production rate (PR) of lipoproteins mg/kg/day
First visit to be performed prior to first evinacumab administration; second visit to be performed approximately 4-6 weeks after evinacumab i.v. administration. About 8 weeks between the 2 visits.

Secondary Outcome Measures

Full Information

First Posted
January 12, 2021
Last Updated
May 14, 2021
Sponsor
University of Pennsylvania
Collaborators
Regeneron Pharmaceuticals
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1. Study Identification

Unique Protocol Identification Number
NCT04722068
Brief Title
Regeneron 1331 Kinetics Sub-Study HoFH
Official Title
A Kinetic Study Investigating Lipoprotein Metabolism Before and After the Administration of REGN1500, an ANGPTL3 Inhibitor, in Patients With Homozygous Familial Hypercholesterolemia. A Sub-study for Subjects Enrolled in the R1500-CL-1331 Clinical Trial
Study Type
Interventional

2. Study Status

Record Verification Date
May 2021
Overall Recruitment Status
Completed
Study Start Date
October 7, 2016 (Actual)
Primary Completion Date
November 30, 2016 (Actual)
Study Completion Date
January 1, 2021 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
University of Pennsylvania
Collaborators
Regeneron Pharmaceuticals

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
To evaluate the lipoprotein kinetics of subjects enrolled in the R1500-CL-1331 clinical trial (NCT02265952) to assess the mechanism by which the evinacumab may affect lipid levels in HoFH subjects.
Detailed Description
Subjects enrolled in the R1500-CL-1331 clinical trial (NCT0226595) will participate in a study visit before and after administration of the ANGPTL3 inhibitor REGN1500, evinacumab) for the evaluation of its effect on lipoprotein kinetics.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Hypercholesterolemia, Familial
Keywords
Lipid metabolism, Homozygous Familial Hypercholesterolemia, Evinacumab

7. Study Design

Primary Purpose
Other
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
4 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Volunteers with known HoFH and particpated in R1500-CL-1331 clinical trial
Arm Type
Experimental
Intervention Type
Other
Intervention Name(s)
Kinetics test
Intervention Description
Subjects will participate in two study visits to evaluate lipoprotein kinetics before and after administration of evinacumab.
Primary Outcome Measure Information:
Title
Fractional catabolic rate (FCR) pools/day
Description
First visit to be performed prior to first evinacumab administration; second visit to be performed approximately 4-6 weeks after evinacumab i.v. administration. About 8 weeks between the 2 visits.
Time Frame
completion of study, average of 8 weeks
Title
Production rate (PR) of lipoproteins mg/kg/day
Description
First visit to be performed prior to first evinacumab administration; second visit to be performed approximately 4-6 weeks after evinacumab i.v. administration. About 8 weeks between the 2 visits.
Time Frame
completion of study, average of 8 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Eligibility criteria: -Eligibility will be made based on the data collected at the screening visit of the R1500-CL-1331 protocol. Subjects must meet all inclusion/exclusion criteria for eligibility of that study to be eligible to participate in this sub-study. Below is the eligibility criteria for R1500-CL-1331. Inclusion: Men and women 18 years or older at the time of the screening visit Diagnosis of HoFH by one of the following: Documented mutation or mutations in both LDLR alleles Documented presence of homozygous or compound heterozygous mutations in Apo B and/or PCSK9 Documented skin fibroblast LDLR activity <20% of normal Willing to consistently maintain his/her usual diet for the duration of the study Willing and able to comply with clinic visits and study-related procedures Provide signed informed consent Exclusion: Background medical LMT (if applicable) that has not been stable for at least 4 weeks (6 weeks for fibrates) prior to the screening visit (week -2) (unless participating in the run-in period to stabilize) Having undergone lipid apheresis within 4 weeks prior to the screening visit (week -2) (unless participating in the run-in period to wash out) Presence of any clinically significant uncontrolled endocrine disease known to influence serum lipids or lipoproteins. Note: Patients on thyroid replacement therapy can be included if the dosage of thyroxine has been stable for at least 12 weeks prior to screening visit (week -2) Use of systemic corticosteroids, unless used as replacement therapy for pituitary/adrenal disease with a stable regiment for at least 6 weeks prior to the screening visit (week -2) Note: Topical, intra-articular, nasal, inhaled, and ophthalmic steroid therapies are not considered as "systemic" and are allowed History of a myocardial infarction, unstable angina leading to hospitalization, coronary bypass graft surgery, percutaneous coronary intervention, uncontrolled cardiac arrhythmia, carotid surgery or stenting, stroke, transient ischemic attack, carotid revascularization, endovascular procedure or surgical intervention for peripheral vascular disease within 3 months prior to the screening visit (week -2) Known history of HIV and a CD4 count less than 350c/mL Note: Patients with a history of HIV can be included, as long as they: have a CD4 count greater than 350c/mL; have an undetectable viral load for at least 12 months prior to screening; have no opportunistic infections or active tuberculosis for at least 12 months prior to screening; are not receiving prophylaxis for opportunistic infections; and have been on stable antiretroviral therapy for at least 12 months prior to screening Use of another investigational drug or therapy within 30 days or at least 5 half-lives (whichever is longer) prior to screening visit (week -2). Includes patients who were involved in a prior clinical trial and are not sure of their treatment assignment. Previous participation in any clinical trial of REGN1500 Conditions/situation such as: Any clinically significant abnormality identified at the time of screening that, in the judgement of the investigator or any subinvestigator, would preclude safe completion of the study or constrain endpoints assessment; eg. major systemic diseases, patients with short life expectancy Patient considered by the investigator or any subinvestigator as inappropriate for this study for any reason, eg: deemed unable to meet specific protocol requirements, such as scheduled visits. Deemed unable to tolerate injections as per the patient or the investigator. Investigator or any subinvestigator, pharmacist, study coordinator, other study staff or relative thereof directly involved in the conduct of the protocol, etc. Presence of any other conditions (eg, geographic or social), either actual or anticipated, that the investigator feels would restrict or limit the patient's participation for the duration of the study Laboratory findings during screening period: Positive test for Hepatitis B surface antigen and/or Hepatitis C antibody Positive serum beta-human chorionic gonadotropin or urine pregnancy test in women of childbearing potential Triglycerides greater than 400 mg/dL ( >3.95 mmol/L) (1 repeat lab is allowed) Estimated glomerular filtration rate <30 mL/min/1.73m^2 according to 4-variable Modification of Diet in Renal Disease Study equation (calculated by central lab) Alanine amintransferase (ALT) or aspartate aminotransferase (AST) >3 x the upper limit of normal (ULN) (1 repeat lab is allowed) Creatine phosphokinase (CPK) >3 x ULN (1 repeat lab is allowed) Known hypersensitivity to monoclonal antibody therapeutics History of hypersensitivity reaction to doxycycline or similar compound Pregnant or breast-feeding women Sexually active men, or women of childbearing potential, who are unwilling to utilize adequate contraception for at least 6 months after the last dose of study drug.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Marina Cuchel, MD, PhD
Organizational Affiliation
University of Pennsylvania
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of Pennsylvania
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19104
Country
United States
Facility Name
Department of Vascular Medicine Amsterdam UMC
City
Amsterdam
State/Province
AZ
ZIP/Postal Code
1105
Country
Netherlands

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
33691480
Citation
Reeskamp LF, Millar JS, Wu L, Jansen H, van Harskamp D, Schierbeek H, Gipe DA, Rader DJ, Dallinga-Thie GM, Hovingh GK, Cuchel M. ANGPTL3 Inhibition With Evinacumab Results in Faster Clearance of IDL and LDL apoB in Patients With Homozygous Familial Hypercholesterolemia-Brief Report. Arterioscler Thromb Vasc Biol. 2021 May 5;41(5):1753-1759. doi: 10.1161/ATVBAHA.120.315204. Epub 2021 Mar 11.
Results Reference
derived

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Regeneron 1331 Kinetics Sub-Study HoFH

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