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Safety, Tolerability, Pharmacokinetics, and Pharmacodynamics of IONIS ANGPTL3-LRx in Healthy Volunteers With Elevated Triglycerides and Participants With Familial Hypercholesterolemia

Primary Purpose

Hypertriglyceridemia, Familial Hypercholesterolemia

Status
Completed
Phase
Phase 1
Locations
Canada
Study Type
Interventional
Intervention
IONIS ANGPTL3-LRx
Placebo
Sponsored by
Ionis Pharmaceuticals, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional other trial for Hypertriglyceridemia focused on measuring ANGPTL-3

Eligibility Criteria

18 Years - 65 Years (Adult, Older Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria for All Cohorts:

  • Must have given written informed consent and be able to comply with all study requirements
  • Males or females 18 to 65 years, inclusive, at the time of informed consent
  • Body Mass Index (BMI) ≤ 35.0 kg/m2
  • Females must be non-pregnant and non-lactating, and either surgically sterile or postmenopausal.
  • Males must be surgically sterile, abstinent or using an acceptable contraceptive method

Inclusion criteria for Cohorts, A, D, and AA to DD only:

  • Fasting triglycerides (TG) ≥ 150 mg/dL at Screening
  • Fasting low density lipoprotein cholesterol (LDL-C) > 70 mg/dL at Screening

Inclusion criteria for Cohorts B and C only:

  • Fasting TG 90 - 150 mg/dL at Screening
  • Fasting LDL-C > 70 mg/dL at Screening

Inclusion Criteria for Cohort EE Only:

  • Homozygous FH diagnosis and fasting LDL-C ≥ 190 mg/dL (4.9 mmol/L)

Inclusion Criteria for Cohort FF Only:

  • Heterozygous FH diagnosis and fasting LDL-C ≥ 160 mg/dL (4.1 mmol/L)

Inclusion Criteria for Cohorts EE and FF Only:

  • Maximally tolerated stable LDL-C lowering agents (stable for at least 12 weeks)
  • On stable low-fat diet
  • Stable weight (± 4 kg) for ≥ 6 weeks prior to screening

Exclusion Criteria for All Cohorts:

  • Known history or positive test for Human Immunodeficiency Virus (HIV), Hepatitis C (HCV), or Hepatitis B (HBV)
  • Treatment with another Study Drug, biological agent, or device within one-month or 5-half-lives of screening
  • Regular use of alcohol within 6 months of screening
  • Use of concomitant drugs unless authorized by the Sponsor Medical Monitor
  • Known contraindication and/or allergy to heparin
  • Smoking > 10 cigarettes a day
  • Considered unsuitable for inclusion by the Principal Investigator

Exclusion Criteria for Cohorts EE and FF:

  • Myocardial infarction, percutaneous transluminal coronary intervention, or coronary artery bypass graft surgery within 12 weeks prior to screening, or cerebrovascular accident within 24 weeks prior to screening. Participants with adequately treated stable angina, per Investigator assessment, may be included
  • Congestive heart failure defined by NYHA Classes III or IV
  • Type 2 diabetes mellitus (T2DM) with HbA1c > 8.0%
  • Prior treatment with gene therapy
  • Currently receiving apheresis treatments or last apheresis treatment was within 8 weeks of screening

Sites / Locations

  • Clinical Site

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm 5

Arm 6

Arm 7

Arm 8

Arm 9

Arm 10

Arm 11

Arm Type

Placebo Comparator

Experimental

Experimental

Placebo Comparator

Experimental

Experimental

Placebo Comparator

Experimental

Experimental

Experimental

Experimental

Arm Label

Cohorts A, D: Placebo

Cohorts A, D: IONIS ANGPTL3-LRx 20 mg

Cohorts A, D: IONIS ANGPTL3-LRx 120 mg

Cohorts B, C: Placebo

Cohorts B, C: IONIS ANGPTL3-LRx 40 mg

Cohorts B, C: IONIS ANGPTL3-LRx 80 mg

Cohorts AA-DD: Placebo

Cohorts AA-DD: IONIS ANGPTL3-LRx 10 mg

Cohorts AA-DD: IONIS ANGPTL3-LRx 20 mg

Cohorts AA-DD: IONIS ANGPTL3-LRx 40 mg

Cohorts AA-DD: IONIS ANGPTL3-LRx 60 mg

Arm Description

Participants received a single-dose of IONIS ANGPTL3-LRx-matching placebo subcutaneously on Day 1.

Participants received a single-dose of IONIS ANGPTL3-LRx 20 milligrams (mg) subcutaneously on Day 1.

Participants received a single-dose of IONIS ANGPTL3-LRx 120 mg subcutaneously on Day 1.

Participants received a single-dose of IONIS ANGPTL3-LRx-matching placebo subcutaneously on Day 1.

Participants received a single-dose of IONIS ANGPTL3-LRx 40 mg subcutaneously on Day 1.

Participants received a single-dose of IONIS ANGPTL3-LRx 80 mg subcutaneously on Day 1.

Participants received IONIS ANGPTL3-LRx-matching placebo subcutaneously once per week for 6 weeks.

Participants received IONIS ANGPTL3-LRx 10 mg subcutaneously once per week for 6 weeks.

Participants received IONIS ANGPTL3-LRx 20 mg subcutaneously once per week for 6 weeks.

Participants received IONIS ANGPTL3-LRx 40 mg subcutaneously once per week for 6 weeks.

Participants received IONIS ANGPTL3-LRx 60 mg subcutaneously once per week for 6 weeks.

Outcomes

Primary Outcome Measures

Safety and tolerability of single and multiple doses of IONIS ANGPTL3-LRx (incidence, severity, and dose-relationship of adverse effects and changes in the laboratory parameters)
The safety and tolerability of IONIS ANGPTL3-LRx will be assessed by determining the incidence, severity, and dose-relationship of adverse effects and changes in the laboratory parameters by dose. Safety results in subjects dosed with IONIS ANGPTL3-LRx will be compared with those from subjects dosed with placebo.
Pharmacokinetics after single and multiple doses of IONIS ANGPTL3-LRx.
The plasma pharmacokinetics (concentration-time results) of IONIS ANGPTL3-LRx (unconjugated and conjugated ASO) will be assessed following single and multiple-dose SC administration. The amount of IONIS ANGPTL3-LRx excreted in urine at selected 24-hour intervals will also be determined.
Pharmacodynamics of IONIS ANGPTL3-LRx (Changes in serum ANGPTL3 levels)
Changes in serum angiopoietin-like 3 (ANGPTL3) levels compared to baseline.

Secondary Outcome Measures

Pharmacodynamic effects of IONIS ANGPTL3-LRx
Effects of IONIS ANGPTL3-LRx on changes in ANGPTL3 plasma protein compared to baseline.

Full Information

First Posted
November 22, 2015
Last Updated
November 17, 2020
Sponsor
Ionis Pharmaceuticals, Inc.
Collaborators
Akcea Therapeutics
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1. Study Identification

Unique Protocol Identification Number
NCT02709850
Brief Title
Safety, Tolerability, Pharmacokinetics, and Pharmacodynamics of IONIS ANGPTL3-LRx in Healthy Volunteers With Elevated Triglycerides and Participants With Familial Hypercholesterolemia
Official Title
A Placebo-Controlled, Dose-Escalation Study to Assess the Safety, Tolerability, Pharmacokinetics, and Pharmacodynamics of Single and Multiple Doses of ISIS 703802, Targeting ANGPTL3, Administered Subcutaneously to Healthy Volunteers With Elevated Triglycerides and Subjects With Familial Hypercholesterolemia
Study Type
Interventional

2. Study Status

Record Verification Date
November 2020
Overall Recruitment Status
Completed
Study Start Date
November 30, 2015 (Actual)
Primary Completion Date
April 12, 2017 (Actual)
Study Completion Date
June 26, 2017 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Ionis Pharmaceuticals, Inc.
Collaborators
Akcea Therapeutics

4. Oversight

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

5. Study Description

Brief Summary
The purpose is to assess the safety, tolerability, pharmacokinetics, and pharmacodynamics of IONIS ANGPTL3-LRx (ISIS 703802) given to healthy volunteer subjects with elevated triglycerides and subjects with familial hypercholesterolemia.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Hypertriglyceridemia, Familial Hypercholesterolemia
Keywords
ANGPTL-3

7. Study Design

Primary Purpose
Other
Study Phase
Phase 1
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
48 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Cohorts A, D: Placebo
Arm Type
Placebo Comparator
Arm Description
Participants received a single-dose of IONIS ANGPTL3-LRx-matching placebo subcutaneously on Day 1.
Arm Title
Cohorts A, D: IONIS ANGPTL3-LRx 20 mg
Arm Type
Experimental
Arm Description
Participants received a single-dose of IONIS ANGPTL3-LRx 20 milligrams (mg) subcutaneously on Day 1.
Arm Title
Cohorts A, D: IONIS ANGPTL3-LRx 120 mg
Arm Type
Experimental
Arm Description
Participants received a single-dose of IONIS ANGPTL3-LRx 120 mg subcutaneously on Day 1.
Arm Title
Cohorts B, C: Placebo
Arm Type
Placebo Comparator
Arm Description
Participants received a single-dose of IONIS ANGPTL3-LRx-matching placebo subcutaneously on Day 1.
Arm Title
Cohorts B, C: IONIS ANGPTL3-LRx 40 mg
Arm Type
Experimental
Arm Description
Participants received a single-dose of IONIS ANGPTL3-LRx 40 mg subcutaneously on Day 1.
Arm Title
Cohorts B, C: IONIS ANGPTL3-LRx 80 mg
Arm Type
Experimental
Arm Description
Participants received a single-dose of IONIS ANGPTL3-LRx 80 mg subcutaneously on Day 1.
Arm Title
Cohorts AA-DD: Placebo
Arm Type
Placebo Comparator
Arm Description
Participants received IONIS ANGPTL3-LRx-matching placebo subcutaneously once per week for 6 weeks.
Arm Title
Cohorts AA-DD: IONIS ANGPTL3-LRx 10 mg
Arm Type
Experimental
Arm Description
Participants received IONIS ANGPTL3-LRx 10 mg subcutaneously once per week for 6 weeks.
Arm Title
Cohorts AA-DD: IONIS ANGPTL3-LRx 20 mg
Arm Type
Experimental
Arm Description
Participants received IONIS ANGPTL3-LRx 20 mg subcutaneously once per week for 6 weeks.
Arm Title
Cohorts AA-DD: IONIS ANGPTL3-LRx 40 mg
Arm Type
Experimental
Arm Description
Participants received IONIS ANGPTL3-LRx 40 mg subcutaneously once per week for 6 weeks.
Arm Title
Cohorts AA-DD: IONIS ANGPTL3-LRx 60 mg
Arm Type
Experimental
Arm Description
Participants received IONIS ANGPTL3-LRx 60 mg subcutaneously once per week for 6 weeks.
Intervention Type
Drug
Intervention Name(s)
IONIS ANGPTL3-LRx
Other Intervention Name(s)
ISIS 703802
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
0.9%NaCl, water, riboflavin
Primary Outcome Measure Information:
Title
Safety and tolerability of single and multiple doses of IONIS ANGPTL3-LRx (incidence, severity, and dose-relationship of adverse effects and changes in the laboratory parameters)
Description
The safety and tolerability of IONIS ANGPTL3-LRx will be assessed by determining the incidence, severity, and dose-relationship of adverse effects and changes in the laboratory parameters by dose. Safety results in subjects dosed with IONIS ANGPTL3-LRx will be compared with those from subjects dosed with placebo.
Time Frame
Up to Day 127
Title
Pharmacokinetics after single and multiple doses of IONIS ANGPTL3-LRx.
Description
The plasma pharmacokinetics (concentration-time results) of IONIS ANGPTL3-LRx (unconjugated and conjugated ASO) will be assessed following single and multiple-dose SC administration. The amount of IONIS ANGPTL3-LRx excreted in urine at selected 24-hour intervals will also be determined.
Time Frame
Up to Day 127
Title
Pharmacodynamics of IONIS ANGPTL3-LRx (Changes in serum ANGPTL3 levels)
Description
Changes in serum angiopoietin-like 3 (ANGPTL3) levels compared to baseline.
Time Frame
Up to Day 127
Secondary Outcome Measure Information:
Title
Pharmacodynamic effects of IONIS ANGPTL3-LRx
Description
Effects of IONIS ANGPTL3-LRx on changes in ANGPTL3 plasma protein compared to baseline.
Time Frame
Up to Day 127

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria for All Cohorts: Must have given written informed consent and be able to comply with all study requirements Males or females 18 to 65 years, inclusive, at the time of informed consent Body Mass Index (BMI) ≤ 35.0 kg/m2 Females must be non-pregnant and non-lactating, and either surgically sterile or postmenopausal. Males must be surgically sterile, abstinent or using an acceptable contraceptive method Inclusion criteria for Cohorts, A, D, and AA to DD only: Fasting triglycerides (TG) ≥ 150 mg/dL at Screening Fasting low density lipoprotein cholesterol (LDL-C) > 70 mg/dL at Screening Inclusion criteria for Cohorts B and C only: Fasting TG 90 - 150 mg/dL at Screening Fasting LDL-C > 70 mg/dL at Screening Inclusion Criteria for Cohort EE Only: Homozygous FH diagnosis and fasting LDL-C ≥ 190 mg/dL (4.9 mmol/L) Inclusion Criteria for Cohort FF Only: Heterozygous FH diagnosis and fasting LDL-C ≥ 160 mg/dL (4.1 mmol/L) Inclusion Criteria for Cohorts EE and FF Only: Maximally tolerated stable LDL-C lowering agents (stable for at least 12 weeks) On stable low-fat diet Stable weight (± 4 kg) for ≥ 6 weeks prior to screening Exclusion Criteria for All Cohorts: Known history or positive test for Human Immunodeficiency Virus (HIV), Hepatitis C (HCV), or Hepatitis B (HBV) Treatment with another Study Drug, biological agent, or device within one-month or 5-half-lives of screening Regular use of alcohol within 6 months of screening Use of concomitant drugs unless authorized by the Sponsor Medical Monitor Known contraindication and/or allergy to heparin Smoking > 10 cigarettes a day Considered unsuitable for inclusion by the Principal Investigator Exclusion Criteria for Cohorts EE and FF: Myocardial infarction, percutaneous transluminal coronary intervention, or coronary artery bypass graft surgery within 12 weeks prior to screening, or cerebrovascular accident within 24 weeks prior to screening. Participants with adequately treated stable angina, per Investigator assessment, may be included Congestive heart failure defined by NYHA Classes III or IV Type 2 diabetes mellitus (T2DM) with HbA1c > 8.0% Prior treatment with gene therapy Currently receiving apheresis treatments or last apheresis treatment was within 8 weeks of screening
Facility Information:
Facility Name
Clinical Site
City
Toronto
State/Province
Ontario
ZIP/Postal Code
M9L 3A2
Country
Canada

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
28538111
Citation
Graham MJ, Lee RG, Brandt TA, Tai LJ, Fu W, Peralta R, Yu R, Hurh E, Paz E, McEvoy BW, Baker BF, Pham NC, Digenio A, Hughes SG, Geary RS, Witztum JL, Crooke RM, Tsimikas S. Cardiovascular and Metabolic Effects of ANGPTL3 Antisense Oligonucleotides. N Engl J Med. 2017 Jul 20;377(3):222-232. doi: 10.1056/NEJMoa1701329. Epub 2017 May 24.
Results Reference
derived

Learn more about this trial

Safety, Tolerability, Pharmacokinetics, and Pharmacodynamics of IONIS ANGPTL3-LRx in Healthy Volunteers With Elevated Triglycerides and Participants With Familial Hypercholesterolemia

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