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A Study of ALN-PCSSC in Participants With Homozygous Familial Hypercholesterolemia (HoFH) (ORION-2)

Primary Purpose

Homozygous Familial Hypercholesterolemia

Status
Completed
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
ALN-PCSSC
Standard of Care
Sponsored by
The Medicines Company
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Homozygous Familial Hypercholesterolemia

Eligibility Criteria

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

Inclusion Criteria:

  • Males and females, ≥12 years of age with a diagnosis of homozygous familial hypercholesterolemia by genetic confirmation or a clinical diagnosis based on a history of an untreated low-density lipoprotein cholesterol (LDL-C) concentration >500 mg/deciliter (dL) [13 millimoles/liter (mmol/L)] together with either xanthoma before 10 years of age or evidence of heterozygous familial hypercholesterolemia in both parents.
  • Stable on a low-fat diet.
  • Stable on pre-existing, lipid-lowering therapies (such as statins, cholesterolabsorption inhibitors, bile-acid sequestrants, or combinations thereof) for at least 4 weeks with no planned medication or dose change for the duration of study participation.
  • Fasting central lab LDL-C concentration >130 mg/dL (3.4 mmol/L) and triglyceride concentration <400 mg/dL (4.5 mmol/L).
  • Body weight of 40 kilograms (kg) or greater at screening.

Exclusion Criteria:

  • LDL or plasma apheresis within 8 weeks prior to the screening visit, and no plan to receive it during the study because of the attendant difficulty in maintaining stable concentrations of LDL-C while receiving apheresis.
  • Use of mipomersen or lomitapide therapy within 5 months of screening.
  • Previous treatment with monoclonal antibodies directed towards PCSK9 within 8 weeks of screening.

The above information is not intended to contain all considerations relevant to a participant's potential participation in a clinical trial.

Sites / Locations

  • Research Site 201001
  • Research Site 231001
  • Research Site 227001

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

ALN-PCSSC

Arm Description

300 milligrams (mg) administered subcutaneous (SC) on Day 1. Participants with a mean serum proprotein convertase subtilisin/kexin type 9 (PCSK9) levels not suppressed by >70% at Day 60 or Day 90, as compared to baseline, will receive a second dose at Day 90 or Day 104, respectively, based on PCSK9 levels from the previous visit. Participants also received standard of care as background therapy.

Outcomes

Primary Outcome Measures

Percentage Change From Day 1 to Day 90 in LDL-C
Due to the small number of subjects, and the fact that the data are not normally distributed, the data are presented as descriptive statistics with no inferential and limited summary statistics presented.
Percentage Change From Day 1 to Day 180 (or Final Visit) in LDL-C

Secondary Outcome Measures

Absolute Change From Day 1 to Day 90 and to Day 180 (or Final Visit) in LDL-C
Percentage Change From Day 1 to Day 60 and to Day 90 in PCSK9
Absolute Change From Day 1 to Day 60 and to Day 90 in PCSK9
Percentage Change From Day 1 to Day 90 and to Day 180 (or Final Visit) in Total Cholesterol
Absolute Change From Day 1 to Day 90 and to Day 180 (or Final Visit) in Total Cholesterol
Percentage Change From Day 1 to Day 90 and to Day 180 (or Final Visit) in Triglycerides
Absolute Change From Day 1 to Day 90 and to Day 180 (or Final Visit) in Triglycerides
Percentage Change From Day 1 to Day 90 and to Day 180 (or Final Visit) in HDL-C
Absolute Change From Day 1 to Day 90 and to Day 180 (or Final Visit) in HDL-C
Percentage Change From Day 1 to Day 90 and to Day 180 (or Final Visit) in Non-HDL-C
Absolute Change From Day 1 to Day 90 and to Day 180 (or Final Visit) in Non-HDL-C
Percentage Change From Day 1 to Day 90 and to Day 180 (or Final Visit) in VLDL-C
Absolute Change From Day 1 to Day 90 and to Day 180 (or Final Visit) in VLDL-C
Percentage Change From Day 1 to Day 90 and to Day 180 (or Final Visit) in Apolipoprotein A1
Absolute Change From Day 1 to Day 90 and to Day 180 (or Final Visit) in Apolipoprotein A1
Percentage Change From Day 1 to Day 90 and to Day 180 (or Final Visit) in Apolipoprotein B
Absolute Change From Day 1 to Day 90 and to Day 180 (or Final Visit) in Apolipoprotein B
Percentage Change From Day 1 to Day 90 and to Day 180 (or Final Visit) in Lipoprotein-a
The reported percent change value is the per participant calculated Mean.
Absolute Change From Day 1 to Day 90 and to Day 180 (or Final Visit) in Lipoprotein-a

Full Information

First Posted
November 10, 2016
Last Updated
May 14, 2020
Sponsor
The Medicines Company
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1. Study Identification

Unique Protocol Identification Number
NCT02963311
Brief Title
A Study of ALN-PCSSC in Participants With Homozygous Familial Hypercholesterolemia (HoFH)
Acronym
ORION-2
Official Title
An Open-Label, Single-Arm, Multicenter Pilot Study to Evaluate Safety, Tolerability, and Efficacy of ALN-PCSSC in Subjects With Homozygous Familial Hypercholesterolemia (HoFH)
Study Type
Interventional

2. Study Status

Record Verification Date
May 2020
Overall Recruitment Status
Completed
Study Start Date
December 13, 2016 (Actual)
Primary Completion Date
October 8, 2018 (Actual)
Study Completion Date
October 8, 2018 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
The Medicines Company

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study is to assess the safety, tolerability, and efficacy of ALN-PCSSC in participants with homozygous familial hypercholesterolemia.

6. Conditions and Keywords

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

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
9 (Actual)

8. Arms, Groups, and Interventions

Arm Title
ALN-PCSSC
Arm Type
Experimental
Arm Description
300 milligrams (mg) administered subcutaneous (SC) on Day 1. Participants with a mean serum proprotein convertase subtilisin/kexin type 9 (PCSK9) levels not suppressed by >70% at Day 60 or Day 90, as compared to baseline, will receive a second dose at Day 90 or Day 104, respectively, based on PCSK9 levels from the previous visit. Participants also received standard of care as background therapy.
Intervention Type
Drug
Intervention Name(s)
ALN-PCSSC
Other Intervention Name(s)
PCSK9 synthesis inhibitor
Intervention Description
ALN-PCSSC is a small interfering ribonucleic acid (siRNA) that inhibits PCSK9 synthesis and is given as SC injections.
Intervention Type
Drug
Intervention Name(s)
Standard of Care
Intervention Description
Included maximally-tolerated statin therapy and/or other low density lipoprotein-cholesterol (LDL-C)-lowering therapies.
Primary Outcome Measure Information:
Title
Percentage Change From Day 1 to Day 90 in LDL-C
Description
Due to the small number of subjects, and the fact that the data are not normally distributed, the data are presented as descriptive statistics with no inferential and limited summary statistics presented.
Time Frame
Day 1, Day 90
Title
Percentage Change From Day 1 to Day 180 (or Final Visit) in LDL-C
Time Frame
Day 1, Day 180 (or Final Visit)
Secondary Outcome Measure Information:
Title
Absolute Change From Day 1 to Day 90 and to Day 180 (or Final Visit) in LDL-C
Time Frame
Day 1, Day 90, Day 180 (or Final Visit)
Title
Percentage Change From Day 1 to Day 60 and to Day 90 in PCSK9
Time Frame
Day 1, Day 60, Day 90
Title
Absolute Change From Day 1 to Day 60 and to Day 90 in PCSK9
Time Frame
Day 1, Day 60, Day 90
Title
Percentage Change From Day 1 to Day 90 and to Day 180 (or Final Visit) in Total Cholesterol
Time Frame
Day 1, Day 90, Day 180 (or Final Visit)
Title
Absolute Change From Day 1 to Day 90 and to Day 180 (or Final Visit) in Total Cholesterol
Time Frame
Day 1, Day 90, Day 180 (or Final Visit)
Title
Percentage Change From Day 1 to Day 90 and to Day 180 (or Final Visit) in Triglycerides
Time Frame
Day 1, Day 90, Day 180 (or Final Visit)
Title
Absolute Change From Day 1 to Day 90 and to Day 180 (or Final Visit) in Triglycerides
Time Frame
Day 1, Day 90, Day 180 (or Final Visit)
Title
Percentage Change From Day 1 to Day 90 and to Day 180 (or Final Visit) in HDL-C
Time Frame
Day 1, Day 90, Day 180 (or Final Visit)
Title
Absolute Change From Day 1 to Day 90 and to Day 180 (or Final Visit) in HDL-C
Time Frame
Day 1, Day 90, Day 180 (or Final Visit)
Title
Percentage Change From Day 1 to Day 90 and to Day 180 (or Final Visit) in Non-HDL-C
Time Frame
Day 1, Day 90, Day 180 (or Final Visit)
Title
Absolute Change From Day 1 to Day 90 and to Day 180 (or Final Visit) in Non-HDL-C
Time Frame
Day 1, Day 90, Day 180 (or Final Visit)
Title
Percentage Change From Day 1 to Day 90 and to Day 180 (or Final Visit) in VLDL-C
Time Frame
Day 1, Day 90, Day 180 (or Final Visit)
Title
Absolute Change From Day 1 to Day 90 and to Day 180 (or Final Visit) in VLDL-C
Time Frame
Day 1, Day 90, Day 180 (or Final Visit)
Title
Percentage Change From Day 1 to Day 90 and to Day 180 (or Final Visit) in Apolipoprotein A1
Time Frame
Day 1, Day 90, Day 180 (or Final Visit)
Title
Absolute Change From Day 1 to Day 90 and to Day 180 (or Final Visit) in Apolipoprotein A1
Time Frame
Day 1, Day 90, Day 180 (or Final Visit)
Title
Percentage Change From Day 1 to Day 90 and to Day 180 (or Final Visit) in Apolipoprotein B
Time Frame
Day 1, Day 90, Day 180 (or Final Visit)
Title
Absolute Change From Day 1 to Day 90 and to Day 180 (or Final Visit) in Apolipoprotein B
Time Frame
Day 1, Day 90, Day 180 (or Final Visit)
Title
Percentage Change From Day 1 to Day 90 and to Day 180 (or Final Visit) in Lipoprotein-a
Description
The reported percent change value is the per participant calculated Mean.
Time Frame
Day 1, Day 90, Day 180 (or Final Visit)
Title
Absolute Change From Day 1 to Day 90 and to Day 180 (or Final Visit) in Lipoprotein-a
Time Frame
Day 1, Day 90, Day 180 (or Final Visit)

10. Eligibility

Sex
All
Minimum Age & Unit of Time
12 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Males and females, ≥12 years of age with a diagnosis of homozygous familial hypercholesterolemia by genetic confirmation or a clinical diagnosis based on a history of an untreated low-density lipoprotein cholesterol (LDL-C) concentration >500 mg/deciliter (dL) [13 millimoles/liter (mmol/L)] together with either xanthoma before 10 years of age or evidence of heterozygous familial hypercholesterolemia in both parents. Stable on a low-fat diet. Stable on pre-existing, lipid-lowering therapies (such as statins, cholesterolabsorption inhibitors, bile-acid sequestrants, or combinations thereof) for at least 4 weeks with no planned medication or dose change for the duration of study participation. Fasting central lab LDL-C concentration >130 mg/dL (3.4 mmol/L) and triglyceride concentration <400 mg/dL (4.5 mmol/L). Body weight of 40 kilograms (kg) or greater at screening. Exclusion Criteria: LDL or plasma apheresis within 8 weeks prior to the screening visit, and no plan to receive it during the study because of the attendant difficulty in maintaining stable concentrations of LDL-C while receiving apheresis. Use of mipomersen or lomitapide therapy within 5 months of screening. Previous treatment with monoclonal antibodies directed towards PCSK9 within 8 weeks of screening. The above information is not intended to contain all considerations relevant to a participant's potential participation in a clinical trial.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Kees Hovingh, MD, PhD
Organizational Affiliation
Department of Vascular Medicine, Academic Medical Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
Research Site 201001
City
Los Angeles
State/Province
California
ZIP/Postal Code
90001
Country
United States
Facility Name
Research Site 231001
City
Amsterdam
Country
Netherlands
Facility Name
Research Site 227001
City
Parktown
State/Province
Johannesburg
ZIP/Postal Code
2193
Country
South Africa

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

A Study of ALN-PCSSC in Participants With Homozygous Familial Hypercholesterolemia (HoFH)

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