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Evaluation of the Efficacy and Safety of Bempedoic Acid (ETC-1002) in Patients With Hyperlipidemia and Statin Intolerant (CLEAR Serenity)

Primary Purpose

Hypercholesterolemia, Atherosclerotic Cardiovascular Disease, Statin Adverse Reaction

Status
Completed
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
bempedoic acid
placebo
Sponsored by
Esperion Therapeutics, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Hypercholesterolemia focused on measuring hyperlipidemia, cholesterol, familial hypercholesterolemia, atherosclerotic cardiovascular disease, ASCVD, HeFH, LDL, statin intolerance

Eligibility Criteria

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

Inclusion Criteria:

  • Require lipid-modifying therapy for primary or secondary prevention of cardiovascular disease
  • Fasting LDL-C ≥130 mg/dL for primary prevention or LDL-C ≥100 mg/dL for secondary prevention (history of HeFH and/or ASCVD)
  • Be statin-intolerant (unable to tolerate 2 or more statins)

Exclusion Criteria:

  • Total fasting triglyceride ≥500 mg/dL
  • Renal dysfunction or nephrotic syndrome or history of nephritis
  • Body Mass Index (BMI) ≥50 kg/m2
  • Significant cardiovascular disease or cardiovascular event in the past 3 months

Sites / Locations

  • Site 1
  • Site 2
  • Site 1
  • Site 2

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

bempedoic acid

placebo

Arm Description

bempedoic acid 180 mg tablet taken orally, daily. Patients remain on ongoing lipid-modifying therapy (not study provided)

Matching placebo tablet taken orally, daily. Patients remain on ongoing lipid-modifying therapy (not study provided)

Outcomes

Primary Outcome Measures

Percent Change From Baseline (PCFB) in Low-density Lipoprotein Cholesterol (LDL-C) at Week 12
PCFB was calculated as the ([post-Baseline (BL) value minus the BL value] divided by the BL value ) x 100. BL was defined as the mean of the last two non-missing values on or prior to Day 1. If only one value was available, that single value was used as BL. PCFB in LDL-C was analyzed using analysis of covariance (ANCOVA), with treatment group and stratification factor (primary prevention; secondary prevention) as fixed effects and BL as a covariate. For participants with missing lipid data at Week 12 who were no longer taking study treatment, missing values were imputed using multiple imputation via a regression-based model including stratification and BL data from placebo participants only. In this imputation model, treatment group was not included. For participants with missing lipid data at Week 12 who were still taking study treatment, missing values were imputed using multiple imputation via a regression-based model including treatment, stratification and BL value.

Secondary Outcome Measures

Percent Change From Baseline in LDL-C at Week 24
PCFB was calculated as the ([post-BL value minus the BL value] divided by the BL value ) x 100. BL was defined as the mean of the last two non-missing values on or prior to Day 1. If only one value was available then that single value was used as BL. PCFB in LDL-C was analyzed using ANCOVA, with treatment group and stratification factor (primary prevention; secondary prevention) as fixed effects and BL as a covariate. For participants with missing lipid data at Week 12 who were no longer taking study treatment, missing values were imputed using multiple imputation via a regression-based model including stratification and BL data from placebo participants only. In this imputation model, treatment group was not included. For participants with missing lipid data at Week 12 who were still taking study treatment, missing values were imputed using multiple imputation via a regression-based model including treatment, stratification and BL value.
Percent Change From Baseline in the Lipid Profile at Week 12
PCFB was calculated as: ([post-BL value minus the BL value] divided by the BL value) x 100. BL was defined as the mean of the last two non-missing values on or prior to Day 1. If only one value was available, that single value was used as BL. apoB and TC BL were defined as the last non-missing value on/prior to Day 1. PCFB was analyzed using ANCOVA, with treatment and group stratification factor (primary prevention; secondary prevention) as fixed effects and BL as a covariate. For participants with missing data at Week 12 who were no longer taking study treatment (ST), missing values were imputed using multiple imputation via a regression-based model including stratification and BL data from placebo participants only. In this imputation model, treatment group was not included. For participants with missing lipid data at Week 12 who were still taking ST, missing values were imputed using multiple imputation via a regression-based model including treatment, stratification and BL value.
Percent Change From Baseline in High-Sensitivity C-Reactive Protein (hsCRP) at Week 12
Percent change from Baseline was calculated as the ([post-Baseline value minus the Baseline value] divided by the Baseline value) x 100. Baseline for hsCRP is defined as the last non-missing value on or prior to Day 1. Percent change from Baseline in hsCRP, non-parametric (Wilcoxon rank-sum test) analysis with Hodges-Lehmann estimates and confidence interval was performed.
Absolute Change From Baseline in LDL-C at Week 12 and Week 24
Change from Baseline is calculated as the ([post-Baseline value minus the Baseline value] divided by the Baseline value ) x 100. Baseline is defined as the mean of the last two non-missing values on or prior to Day 1.

Full Information

First Posted
December 7, 2016
Last Updated
March 20, 2020
Sponsor
Esperion Therapeutics, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT02988115
Brief Title
Evaluation of the Efficacy and Safety of Bempedoic Acid (ETC-1002) in Patients With Hyperlipidemia and Statin Intolerant
Acronym
CLEAR Serenity
Official Title
A Randomized, Double-Blind, Parallel Group, Multicenter Study to Evaluate the Efficacy and Safety of Bempedoic Acid (ETC-1002) 180 mg Compared to Placebo Added to Background Lipid-Modifying Therapy in Patients With Elevated LDL-C Who Are Statin Intolerant
Study Type
Interventional

2. Study Status

Record Verification Date
March 2020
Overall Recruitment Status
Completed
Study Start Date
November 16, 2016 (Actual)
Primary Completion Date
March 16, 2018 (Actual)
Study Completion Date
March 16, 2018 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Esperion Therapeutics, Inc.

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study is to determine if bempedoic acid (ETC-1002) is effective and safe versus placebo in patients with elevated LDL cholesterol and who are statin-intolerant.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Hypercholesterolemia, Atherosclerotic Cardiovascular Disease, Statin Adverse Reaction
Keywords
hyperlipidemia, cholesterol, familial hypercholesterolemia, atherosclerotic cardiovascular disease, ASCVD, HeFH, LDL, statin intolerance

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
345 (Actual)

8. Arms, Groups, and Interventions

Arm Title
bempedoic acid
Arm Type
Experimental
Arm Description
bempedoic acid 180 mg tablet taken orally, daily. Patients remain on ongoing lipid-modifying therapy (not study provided)
Arm Title
placebo
Arm Type
Placebo Comparator
Arm Description
Matching placebo tablet taken orally, daily. Patients remain on ongoing lipid-modifying therapy (not study provided)
Intervention Type
Drug
Intervention Name(s)
bempedoic acid
Other Intervention Name(s)
ETC-1002
Intervention Description
bempedoic acid 180 mg tablet
Intervention Type
Other
Intervention Name(s)
placebo
Other Intervention Name(s)
placebo control
Intervention Description
Matching placebo tablet
Primary Outcome Measure Information:
Title
Percent Change From Baseline (PCFB) in Low-density Lipoprotein Cholesterol (LDL-C) at Week 12
Description
PCFB was calculated as the ([post-Baseline (BL) value minus the BL value] divided by the BL value ) x 100. BL was defined as the mean of the last two non-missing values on or prior to Day 1. If only one value was available, that single value was used as BL. PCFB in LDL-C was analyzed using analysis of covariance (ANCOVA), with treatment group and stratification factor (primary prevention; secondary prevention) as fixed effects and BL as a covariate. For participants with missing lipid data at Week 12 who were no longer taking study treatment, missing values were imputed using multiple imputation via a regression-based model including stratification and BL data from placebo participants only. In this imputation model, treatment group was not included. For participants with missing lipid data at Week 12 who were still taking study treatment, missing values were imputed using multiple imputation via a regression-based model including treatment, stratification and BL value.
Time Frame
Baseline; Week 12
Secondary Outcome Measure Information:
Title
Percent Change From Baseline in LDL-C at Week 24
Description
PCFB was calculated as the ([post-BL value minus the BL value] divided by the BL value ) x 100. BL was defined as the mean of the last two non-missing values on or prior to Day 1. If only one value was available then that single value was used as BL. PCFB in LDL-C was analyzed using ANCOVA, with treatment group and stratification factor (primary prevention; secondary prevention) as fixed effects and BL as a covariate. For participants with missing lipid data at Week 12 who were no longer taking study treatment, missing values were imputed using multiple imputation via a regression-based model including stratification and BL data from placebo participants only. In this imputation model, treatment group was not included. For participants with missing lipid data at Week 12 who were still taking study treatment, missing values were imputed using multiple imputation via a regression-based model including treatment, stratification and BL value.
Time Frame
Baseline; Week 24
Title
Percent Change From Baseline in the Lipid Profile at Week 12
Description
PCFB was calculated as: ([post-BL value minus the BL value] divided by the BL value) x 100. BL was defined as the mean of the last two non-missing values on or prior to Day 1. If only one value was available, that single value was used as BL. apoB and TC BL were defined as the last non-missing value on/prior to Day 1. PCFB was analyzed using ANCOVA, with treatment and group stratification factor (primary prevention; secondary prevention) as fixed effects and BL as a covariate. For participants with missing data at Week 12 who were no longer taking study treatment (ST), missing values were imputed using multiple imputation via a regression-based model including stratification and BL data from placebo participants only. In this imputation model, treatment group was not included. For participants with missing lipid data at Week 12 who were still taking ST, missing values were imputed using multiple imputation via a regression-based model including treatment, stratification and BL value.
Time Frame
Baseline; Week 12
Title
Percent Change From Baseline in High-Sensitivity C-Reactive Protein (hsCRP) at Week 12
Description
Percent change from Baseline was calculated as the ([post-Baseline value minus the Baseline value] divided by the Baseline value) x 100. Baseline for hsCRP is defined as the last non-missing value on or prior to Day 1. Percent change from Baseline in hsCRP, non-parametric (Wilcoxon rank-sum test) analysis with Hodges-Lehmann estimates and confidence interval was performed.
Time Frame
Baseline; Week 12
Title
Absolute Change From Baseline in LDL-C at Week 12 and Week 24
Description
Change from Baseline is calculated as the ([post-Baseline value minus the Baseline value] divided by the Baseline value ) x 100. Baseline is defined as the mean of the last two non-missing values on or prior to Day 1.
Time Frame
Baseline; Week 12; Week 24

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Require lipid-modifying therapy for primary or secondary prevention of cardiovascular disease Fasting LDL-C ≥130 mg/dL for primary prevention or LDL-C ≥100 mg/dL for secondary prevention (history of HeFH and/or ASCVD) Be statin-intolerant (unable to tolerate 2 or more statins) Exclusion Criteria: Total fasting triglyceride ≥500 mg/dL Renal dysfunction or nephrotic syndrome or history of nephritis Body Mass Index (BMI) ≥50 kg/m2 Significant cardiovascular disease or cardiovascular event in the past 3 months
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Ron Haberman, MD
Organizational Affiliation
Esperion Therapeutics, Inc.
Official's Role
Study Director
Facility Information:
City
Gilbert
State/Province
Arizona
Country
United States
City
Anaheim
State/Province
California
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United States
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Long Beach
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California
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United States
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Sacramento
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California
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United States
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Santa Ana
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California
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United States
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Torrance
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California
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United States
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Ventura
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California
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United States
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Hamden
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Connecticut
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Daytona Beach
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Florida
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United States
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Fort Lauderdale
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Florida
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United States
Facility Name
Site 1
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Miami
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Florida
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United States
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Site 2
City
Miami
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Florida
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United States
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Orlando
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Florida
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United States
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West Palm Beach
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Florida
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Atlanta
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Georgia
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Savannah
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Georgia
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Meridian
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Idaho
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Evanston
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Illinois
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Evansville
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Indiana
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Iowa City
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Iowa
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United States
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Waterloo
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Iowa
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United States
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Monroe
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Louisiana
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United States
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Slidell
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Louisiana
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United States
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Tupelo
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Mississippi
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United States
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Lincoln
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Nebraska
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United States
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Somerset
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New Jersey
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Binghamton
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New York
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Endwell
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New York
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New Windsor
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New York
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Greensboro
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North Carolina
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Morganton
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Mount Airy
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Columbus
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Ohio
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Marion
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Ohio
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Maumee
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Ohio
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Oklahoma City
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Oklahoma
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Beaver
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Pennsylvania
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United States
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Langhorne
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Pennsylvania
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United States
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Cumberland
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Rhode Island
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Anderson
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South Carolina
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Summerville
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South Carolina
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Jackson
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Tennessee
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Knoxville
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Tennessee
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Memphis
State/Province
Tennessee
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Amarillo
State/Province
Texas
Country
United States
Facility Name
Site 1
City
Dallas
State/Province
Texas
Country
United States
Facility Name
Site 2
City
Dallas
State/Province
Texas
Country
United States
City
Houston
State/Province
Texas
Country
United States
City
San Antonio
State/Province
Texas
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United States
City
Clinton
State/Province
Utah
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United States
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Hampton
State/Province
Virginia
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United States
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Kenosha
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Wisconsin
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United States
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Brossard
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Canada
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Chicoutimi
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Canada
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Gatineau
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Canada
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London
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Canada
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Longueuil
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Canada
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Mirabel
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Canada
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Montréal
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Canada
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Newmarket
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Canada
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Oakville
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Canada
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Peterborough
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Canada
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Pointe-Claire
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Canada
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Saint-Jérôme
Country
Canada
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Sarnia
Country
Canada
City
Toronto
Country
Canada
City
Victoriaville
Country
Canada

12. IPD Sharing Statement

Citations:
PubMed Identifier
27892461
Citation
Pinkosky SL, Newton RS, Day EA, Ford RJ, Lhotak S, Austin RC, Birch CM, Smith BK, Filippov S, Groot PHE, Steinberg GR, Lalwani ND. Liver-specific ATP-citrate lyase inhibition by bempedoic acid decreases LDL-C and attenuates atherosclerosis. Nat Commun. 2016 Nov 28;7:13457. doi: 10.1038/ncomms13457.
Results Reference
background
PubMed Identifier
21067804
Citation
Cholesterol Treatment Trialists' (CTT) Collaboration; Baigent C, Blackwell L, Emberson J, Holland LE, Reith C, Bhala N, Peto R, Barnes EH, Keech A, Simes J, Collins R. Efficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170,000 participants in 26 randomised trials. Lancet. 2010 Nov 13;376(9753):1670-81. doi: 10.1016/S0140-6736(10)61350-5. Epub 2010 Nov 8.
Results Reference
background
PubMed Identifier
20444930
Citation
Eckel RH. Approach to the patient who is intolerant of statin therapy. J Clin Endocrinol Metab. 2010 May;95(5):2015-22. doi: 10.1210/jc.2009-2689.
Results Reference
background
PubMed Identifier
15635109
Citation
Ridker PM, Cannon CP, Morrow D, Rifai N, Rose LM, McCabe CH, Pfeffer MA, Braunwald E; Pravastatin or Atorvastatin Evaluation and Infection Therapy-Thrombolysis in Myocardial Infarction 22 (PROVE IT-TIMI 22) Investigators. C-reactive protein levels and outcomes after statin therapy. N Engl J Med. 2005 Jan 6;352(1):20-8. doi: 10.1056/NEJMoa042378.
Results Reference
background
PubMed Identifier
25994746
Citation
Robinson JG, Stone NJ. The 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular disease risk: a new paradigm supported by more evidence. Eur Heart J. 2015 Aug 14;36(31):2110-2118. doi: 10.1093/eurheartj/ehv182. Epub 2015 May 20.
Results Reference
background
PubMed Identifier
35916348
Citation
Ballantyne CM, Bays HE, Louie MJ, Smart J, Zhang Y, Ray KK. Factors Associated With Enhanced Low-Density Lipoprotein Cholesterol Lowering With Bempedoic Acid. J Am Heart Assoc. 2022 Aug 2;11(15):e024531. doi: 10.1161/JAHA.121.024531. Epub 2022 Aug 2.
Results Reference
derived
PubMed Identifier
32609313
Citation
Banach M, Duell PB, Gotto AM Jr, Laufs U, Leiter LA, Mancini GBJ, Ray KK, Flaim J, Ye Z, Catapano AL. Association of Bempedoic Acid Administration With Atherogenic Lipid Levels in Phase 3 Randomized Clinical Trials of Patients With Hypercholesterolemia. JAMA Cardiol. 2020 Oct 1;5(10):1124-1135. doi: 10.1001/jamacardio.2020.2314.
Results Reference
derived
PubMed Identifier
30922146
Citation
Laufs U, Banach M, Mancini GBJ, Gaudet D, Bloedon LT, Sterling LR, Kelly S, Stroes ESG. Efficacy and Safety of Bempedoic Acid in Patients With Hypercholesterolemia and Statin Intolerance. J Am Heart Assoc. 2019 Apr 2;8(7):e011662. doi: 10.1161/JAHA.118.011662.
Results Reference
derived
Links:
URL
http://www.who.int/mediacentre/factsheets/fs317/en/
Description
World Health Organization Fact Sheet No. 317

Learn more about this trial

Evaluation of the Efficacy and Safety of Bempedoic Acid (ETC-1002) in Patients With Hyperlipidemia and Statin Intolerant

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