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Study to Assess the Efficacy and Safety of LIB003 in HeFH Patients on Oral Lipid Therapy Needing Further LDL-C Reduction (LIBerate-FH)

Primary Purpose

Heterozygous Familial Hypercholesterolemia

Status
Active
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
lerodalcibep
Sponsored by
LIB Therapeutics LLC
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Heterozygous Familial Hypercholesterolemia focused on measuring lerodalcibep, PCSK9 inhibitor

Eligibility Criteria

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

Inclusion Criteria:

  • Provision of written and signed informed consent prior to any study-specific procedure;
  • Weight of ≥40 kg (88 lbs) and body mass index (BMI) ≥17 and ≤42 kg/m2;
  • Diagnosis of definite, probable or possible HeFH based either on clinical criteria (Simon Broome register criteria or Dutch Lipid Clinics [DLC] Network Criteria) or genotyping and at the defined eligibility visit (screening or post washout/stabilization)
  • LDL-C ≥70 mg/dL (if very-high risk for CVD) or ≥100 mg/dL (if high risk for CVD) and TG ≤400 mg/dL while on stable lipid lowering oral drug therapy (eg, maximally tolerated statin with or without ezetimibe); Patients unable to tolerate approved doses of a statin may take lower than approved doses and less frequently than daily as long as the dose and dosing frequency is consistent.
  • Patients with documentation of inability to tolerate any statin at any dose, or history of rhabdomyolysis, and unable to tolerate any other allowed oral lipid lowering agent, and thus on no lipid lowering therapy must have an LDL-C ≥190 mg/dL (4.9 mmol/L) at the Screening Visit unless they have a documented pathogenic FH variant;
  • Stable diet and other lipid lowering oral therapies besides statins and ezetimibe including bile-acid sequestrants, OM-3 compounds, fenofibrate, bezafibrate, nicotinic acid and bempedoic acid or combinations thereof for at least 4 weeks
  • Patients on a PCSK9 mAb at a dose of 75 mg, 140 mg, or 150 mg Q2W must undergo a washout period of ≥4 weeks after the last dose; for those on a dose of 300 mg or 420 mg Q4W (≤31 days) the washout period is ≥8 weeks following last dose;
  • Females of childbearing potential must be using a highly effective form of contraception if sexually active and have negative urine pregnancy test at the last Screening Visit

Exclusion Criteria:

  • Use of prohibited oral lipid lowering agents mipomersen or lomitapide within 6 months of screening, gemfibrozil within 6 weeks of the Screening Visit or LDL/plasma apheresis within 2 months prior to Day 1;
  • Documented history of HoFH defined clinically or genetically
  • History of any prior or active clinical condition or acute and/or unstable systemic disease compromising patient inclusion, at the discretion of the Investigator.
  • Females of childbearing potential who are sexually active, not using or unwilling to use a highly effective form of contraception, pregnant or breastfeeding, or who have a positive urine pregnancy test at the last Screening Visit;
  • Moderate to severe renal dysfunction, defined as an eGFR <30 mL/min/1.73m2
  • Active liver disease or hepatic dysfunction, history of liver transplant, and/or AST or ALT >2.5 × the ULN
  • Uncontrolled thyroid disease: hyperthyroidism or hypothyroidism as defined by TSH <LLN or >1.5 × ULN, respectively,
  • Uncontrolled Type 1 or Type 2 DM (fasting glucose≥200 mg/dL or HbA1c of ≥9%;
  • Planned cardiac surgery or revascularization;
  • New York Heart Association III-IV heart failure
  • Previous treatment with LIB003 or any adnectin product;
  • Any other finding which, in the opinion of the Investigator, would compromise the patient's safety or participation in the study

Sites / Locations

  • Metabolic & Atherosclerosis Research Center (MARC)
  • Department of Medicine, Hadassah University Hospital
  • Rabin Medical Center, Beilinson Hospital,
  • Lipid Clinic, Oslo University Hospital
  • Carbohydrate and Lipid Metabolism Research Unit
  • Division of Lipidology, Department of Medicine University of Cape Town
  • Ege University Medical School

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

LIB003 (lerodalcibep)

Placebo

Arm Description

300 mg (1.2 mL) SC Q4W

1.2 mL SC Q4W

Outcomes

Primary Outcome Measures

Change from baseline compared to placebo in LDL-C level
LS mean percent change in LDL-cholesterol compared to placebo

Secondary Outcome Measures

Incidence of Treatment-Emergent Adverse Events as assessed by Medical Dictionary for Regulatory Activities
Incidence of Treatment-Emergent Adverse Events (TEAE) as assessed by Medical Dictionary for Regulatory Activities as mild, moderate or severe compared to placebo
Change in serum free PCSK9 with LIB003 compared to placebo
Change in percent LS mean between LIB003 and placebo

Full Information

First Posted
March 10, 2021
Last Updated
November 3, 2022
Sponsor
LIB Therapeutics LLC
Collaborators
Medpace, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT04797104
Brief Title
Study to Assess the Efficacy and Safety of LIB003 in HeFH Patients on Oral Lipid Therapy Needing Further LDL-C Reduction
Acronym
LIBerate-FH
Official Title
Randomized, Double-Blind, Placebo-Controlled, Phase 3 Study to Evaluate the Long-Term Efficacy and Safety of LIB003 in Heterozygous FH Patients on Stable Lipid-Lowering Therapy Requiring Additional LDL-C Reduction
Study Type
Interventional

2. Study Status

Record Verification Date
November 2022
Overall Recruitment Status
Active, not recruiting
Study Start Date
April 22, 2021 (Actual)
Primary Completion Date
April 30, 2023 (Anticipated)
Study Completion Date
May 31, 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
LIB Therapeutics LLC
Collaborators
Medpace, Inc.

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
This study is to assess LDL-C reductions at Week 24 and the mean of Weeks 22 and 24 with monthly Q4W (≤31 days) dosing of LIB003 300 mg administered subcutaneously (SC) compared to placebo in patients 18 years or older with Heterozygous FH on stable diet and oral LDL-C lowering drug therapy.
Detailed Description
A randomized, double-blind, placebo-controlled, Phase 3 study of 24 weeks duration. Approximately 600 males and females aged ≥18 years with clinical or genetic heterozygous FH who fulfill the inclusion and exclusion criteria will be enrolled. Patients will be randomized in a 2:1 ratio to LIB003 (400 patients) or placebo (200 patients) administered SC Q4W (≤31 days). The study will consist of a Screening Period and a Treatment Period. The total study duration will be up to 35 weeks which includes up to an 11-week Screening Period (which may include up to a 8-week washout) and 24 weeks of study drug treatment.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Heterozygous Familial Hypercholesterolemia
Keywords
lerodalcibep, PCSK9 inhibitor

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Model Description
Randomized double blind placebo controlled
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Masking Description
double blind to treatment (LIB003 or placebo) and lipid data
Allocation
Randomized
Enrollment
450 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
LIB003 (lerodalcibep)
Arm Type
Experimental
Arm Description
300 mg (1.2 mL) SC Q4W
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
1.2 mL SC Q4W
Intervention Type
Drug
Intervention Name(s)
lerodalcibep
Other Intervention Name(s)
LIB003
Intervention Description
300 mg Q4W
Primary Outcome Measure Information:
Title
Change from baseline compared to placebo in LDL-C level
Description
LS mean percent change in LDL-cholesterol compared to placebo
Time Frame
24 weeks
Secondary Outcome Measure Information:
Title
Incidence of Treatment-Emergent Adverse Events as assessed by Medical Dictionary for Regulatory Activities
Description
Incidence of Treatment-Emergent Adverse Events (TEAE) as assessed by Medical Dictionary for Regulatory Activities as mild, moderate or severe compared to placebo
Time Frame
24 weeks
Title
Change in serum free PCSK9 with LIB003 compared to placebo
Description
Change in percent LS mean between LIB003 and placebo
Time Frame
24 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Provision of written and signed informed consent prior to any study-specific procedure; Weight of ≥40 kg (88 lbs) and body mass index (BMI) ≥17 and ≤42 kg/m2; Diagnosis of definite, probable or possible HeFH based either on clinical criteria (Simon Broome register criteria or Dutch Lipid Clinics [DLC] Network Criteria) or genotyping and at the defined eligibility visit (screening or post washout/stabilization) LDL-C ≥70 mg/dL (if very-high risk for CVD) or ≥100 mg/dL (if high risk for CVD) and TG ≤400 mg/dL while on stable lipid lowering oral drug therapy (eg, maximally tolerated statin with or without ezetimibe); Patients unable to tolerate approved doses of a statin may take lower than approved doses and less frequently than daily as long as the dose and dosing frequency is consistent. Patients with documentation of inability to tolerate any statin at any dose, or history of rhabdomyolysis, and unable to tolerate any other allowed oral lipid lowering agent, and thus on no lipid lowering therapy must have an LDL-C ≥190 mg/dL (4.9 mmol/L) at the Screening Visit unless they have a documented pathogenic FH variant; Stable diet and other lipid lowering oral therapies besides statins and ezetimibe including bile-acid sequestrants, OM-3 compounds, fenofibrate, bezafibrate, nicotinic acid and bempedoic acid or combinations thereof for at least 4 weeks Patients on a PCSK9 mAb at a dose of 75 mg, 140 mg, or 150 mg Q2W must undergo a washout period of ≥4 weeks after the last dose; for those on a dose of 300 mg or 420 mg Q4W (≤31 days) the washout period is ≥8 weeks following last dose; Females of childbearing potential must be using a highly effective form of contraception if sexually active and have negative urine pregnancy test at the last Screening Visit Exclusion Criteria: Use of prohibited oral lipid lowering agents mipomersen or lomitapide within 6 months of screening, gemfibrozil within 6 weeks of the Screening Visit or LDL/plasma apheresis within 2 months prior to Day 1; Documented history of HoFH defined clinically or genetically History of any prior or active clinical condition or acute and/or unstable systemic disease compromising patient inclusion, at the discretion of the Investigator. Females of childbearing potential who are sexually active, not using or unwilling to use a highly effective form of contraception, pregnant or breastfeeding, or who have a positive urine pregnancy test at the last Screening Visit; Moderate to severe renal dysfunction, defined as an eGFR <30 mL/min/1.73m2 Active liver disease or hepatic dysfunction, history of liver transplant, and/or AST or ALT >2.5 × the ULN Uncontrolled thyroid disease: hyperthyroidism or hypothyroidism as defined by TSH <LLN or >1.5 × ULN, respectively, Uncontrolled Type 1 or Type 2 DM (fasting glucose≥200 mg/dL or HbA1c of ≥9%; Planned cardiac surgery or revascularization; New York Heart Association III-IV heart failure Previous treatment with LIB003 or any adnectin product; Any other finding which, in the opinion of the Investigator, would compromise the patient's safety or participation in the study
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
David Kallend, MB BCh
Organizational Affiliation
LIB Therapeutics
Official's Role
Study Director
Facility Information:
Facility Name
Metabolic & Atherosclerosis Research Center (MARC)
City
Cincinnati
State/Province
Ohio
ZIP/Postal Code
45227
Country
United States
Facility Name
Department of Medicine, Hadassah University Hospital
City
Jerusalem
ZIP/Postal Code
12000
Country
Israel
Facility Name
Rabin Medical Center, Beilinson Hospital,
City
Petah Tikva
ZIP/Postal Code
49100
Country
Israel
Facility Name
Lipid Clinic, Oslo University Hospital
City
Oslo
ZIP/Postal Code
0586
Country
Norway
Facility Name
Carbohydrate and Lipid Metabolism Research Unit
City
Johannesburg
State/Province
Gauteng
ZIP/Postal Code
2193
Country
South Africa
Facility Name
Division of Lipidology, Department of Medicine University of Cape Town
City
Cape Town
State/Province
Western Province
ZIP/Postal Code
7925
Country
South Africa
Facility Name
Ege University Medical School
City
İzmir
State/Province
Bornova
ZIP/Postal Code
35040
Country
Turkey

12. IPD Sharing Statement

Plan to Share IPD
No

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Study to Assess the Efficacy and Safety of LIB003 in HeFH Patients on Oral Lipid Therapy Needing Further LDL-C Reduction

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