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Trial to Evaluate the Effect of Inclisiran Treatment on Low Density Lipoprotein Cholesterol (LDL-C) in Subjects With Heterozygous Familial Hypercholesterolemia (HeFH) (ORION-9)

Primary Purpose

Heterozygous Familial Hypercholesterolemia, Elevated Cholesterol

Status
Completed
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
Inclisiran
Placebo
Sponsored by
The Medicines Company
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Heterozygous Familial Hypercholesterolemia focused on measuring HeFH, LDL-C, Inclisiran

Eligibility Criteria

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

Inclusion Criteria:

Participants may be included if they meet all of the following inclusion criteria prior to randomization:

  1. Male or female participants ≥18 years of age.
  2. History of HeFH with a diagnosis of HeFH by genetic testing; and/or a documented history of untreated LDL-C of >190 mg/dL, and a family history of familial hypercholesterolemia, elevated cholesterol or early heart disease that may indicate familial hypercholesterolemia.
  3. Serum LDL-C ≥2.6 millimoles (mmol)/liter (L) (≥100 mg/dL) at screening.
  4. Fasting triglyceride <4.52 mmol/L (<400 mg/dL) at screening.
  5. Participants on statins should be receiving a maximally tolerated dose.
  6. Participants not receiving statins must have documented evidence of intolerance to all doses of at least 2 different statins.
  7. Participants on lipid-lowering therapies (such as a statin and/or ezetimibe) should be on a stable dose for ≥30 days before screening with no planned medication or dose change during study participation.

Exclusion Criteria:

Participants will be excluded from the study if any of the following exclusion criteria apply immediately prior to randomization:

  1. New York Heart Association (NYHA) class IV heart failure.
  2. Uncontrolled cardiac arrhythmia
  3. Uncontrolled severe hypertension
  4. Active liver disease
  5. Females who are pregnant or nursing, or who are of childbearing potential and unwilling to use at least 2 methods of highly effective contraception (failure rate less than 1% per year) (combined oral contraceptives, barrier methods, approved contraceptive implant, long-term injectable contraception, or intrauterine device) for the entire duration of the study. Exemptions from this criterion:

    1. Women >2 years postmenopausal (defined as 1 year or longer since last menstrual period) AND more than 55 years of age.
    2. Postmenopausal women (as defined above) and less than 55 years of age with a negative pregnancy test within 24 hours of randomization.
    3. Women who are surgically sterilized at least 3 months prior to enrollment.
  6. Males who are unwilling to use an acceptable method of birth control during the entire study period (condom with spermicide).
  7. Treatment with other investigational products or devices within 30 days or 5 half-lives of the screening visit, whichever is longer.
  8. Treatment (within 90 days of screening) with monoclonal antibodies directed towards PCSK9.

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

Sites / Locations

  • Site 90001-005
  • Site 90001-001
  • Site 90001-015
  • Site 90001-047
  • Site 90001-004
  • Site 90001-056
  • Site 90001-012
  • Site 90001-112
  • Site 90001-014
  • Site 90001-002
  • Site 90011-005
  • Site 90011-001
  • Site 90011-002
  • Site 90420-001
  • Site 90420-006
  • Site 90420-005
  • Site 90045-001
  • Site 90045-004
  • Site 90045-003
  • Site 90045-006
  • Site 90045-002
  • Site 90045-005
  • Site 90031-001
  • Site 90031-003
  • Site 90031-009
  • Site 90031-006
  • Site 90031-005
  • Site 90027-004
  • Site 90027-003
  • Site 90027-005
  • Site 90027-001
  • Site 90027-008
  • Site 90027-010
  • Site 90027-007
  • Site 90027-006
  • Site 90027-009
  • Site 90034-003
  • Site 90034-005
  • Site 90034-004
  • Site 90034-006
  • Site 90034-001
  • Site 90034-002
  • Site 90046-002
  • Site 90046-001
  • Site 90046-003

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

Inclisiran

Placebo

Arm Description

Inclisiran sodium 300 milligrams (mg) will be administered as a SC injection on Day 1, Day 90 then every 6 months.

Placebo will be administered as SC injections of saline solution on Day 1, Day 90 then every 6 months.

Outcomes

Primary Outcome Measures

Percent Change in LDL-C From Baseline To Day 510
Time-adjusted Percent Change in LDL-C From Baseline After Day 90 and up to Day 540
Assessments performed at Baseline, Day 90, Day 540, time-adjusted percent change at Day 90 reported

Secondary Outcome Measures

Absolute Change in LDL-C From Baseline to Day 510
Time-adjusted Absolute Change in LDL-C From Baseline After Day 90 and up to Day 540
Assessments performed at Baseline, Day 90, Day 540, absolute change at Day 90 reported
Percentage Change in Proprotein Convertase Subtilisin/Kexin Type 9 (PCSK9) From Baseline to Day 510
Percentage Change in Total Cholesterol From Baseline to Day 510
Percent Change in Apolipoprotein B (Apo-B) From Baseline To Day 510
Percent Change in Non-high-density Lipoprotein (HDL)-C From Baseline To Day 510

Full Information

First Posted
January 2, 2018
Last Updated
October 6, 2020
Sponsor
The Medicines Company
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1. Study Identification

Unique Protocol Identification Number
NCT03397121
Brief Title
Trial to Evaluate the Effect of Inclisiran Treatment on Low Density Lipoprotein Cholesterol (LDL-C) in Subjects With Heterozygous Familial Hypercholesterolemia (HeFH)
Acronym
ORION-9
Official Title
Placebo-Controlled, Double-Blind, Randomized Trial to Evaluate the Effect of 300 mg of Inclisiran Sodium Given as Subcutaneous Injections in Subjects With Heterozygous Familial Hypercholesterolemia (HeFH) and Elevated Low-Density Lipoprotein Cholesterol (LDL-C).
Study Type
Interventional

2. Study Status

Record Verification Date
October 2020
Overall Recruitment Status
Completed
Study Start Date
November 28, 2017 (Actual)
Primary Completion Date
August 27, 2019 (Actual)
Study Completion Date
September 17, 2019 (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
This is a Phase III, placebo-controlled, double-blind, randomized study in participants with HeFH and elevated LDL-C to evaluate the efficacy, safety, and tolerability of subcutaneous (SC) injection(s) of inclisiran. The study will be multicenter and international.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Heterozygous Familial Hypercholesterolemia, Elevated Cholesterol
Keywords
HeFH, LDL-C, Inclisiran

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare Provider
Allocation
Randomized
Enrollment
482 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Inclisiran
Arm Type
Experimental
Arm Description
Inclisiran sodium 300 milligrams (mg) will be administered as a SC injection on Day 1, Day 90 then every 6 months.
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Placebo will be administered as SC injections of saline solution on Day 1, Day 90 then every 6 months.
Intervention Type
Drug
Intervention Name(s)
Inclisiran
Intervention Description
Inclisiran is a small interfering ribonucleic acid (RNA) that inhibits PCSK9 synthesis.
Intervention Type
Drug
Intervention Name(s)
Placebo
Other Intervention Name(s)
Saline Solution
Intervention Description
Placebo will be supplied as sterile normal saline (0.9% sodium chloride in water for injection).
Primary Outcome Measure Information:
Title
Percent Change in LDL-C From Baseline To Day 510
Time Frame
Baseline, Day 510
Title
Time-adjusted Percent Change in LDL-C From Baseline After Day 90 and up to Day 540
Description
Assessments performed at Baseline, Day 90, Day 540, time-adjusted percent change at Day 90 reported
Time Frame
Baseline, Day 90
Secondary Outcome Measure Information:
Title
Absolute Change in LDL-C From Baseline to Day 510
Time Frame
Baseline, Day 510
Title
Time-adjusted Absolute Change in LDL-C From Baseline After Day 90 and up to Day 540
Description
Assessments performed at Baseline, Day 90, Day 540, absolute change at Day 90 reported
Time Frame
Baseline, Day 90
Title
Percentage Change in Proprotein Convertase Subtilisin/Kexin Type 9 (PCSK9) From Baseline to Day 510
Time Frame
Baseline, Day 510
Title
Percentage Change in Total Cholesterol From Baseline to Day 510
Time Frame
Baseline, Day 510
Title
Percent Change in Apolipoprotein B (Apo-B) From Baseline To Day 510
Time Frame
Baseline, Day 510
Title
Percent Change in Non-high-density Lipoprotein (HDL)-C From Baseline To Day 510
Time Frame
Baseline, Day 510

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Participants may be included if they meet all of the following inclusion criteria prior to randomization: Male or female participants ≥18 years of age. History of HeFH with a diagnosis of HeFH by genetic testing; and/or a documented history of untreated LDL-C of >190 mg/dL, and a family history of familial hypercholesterolemia, elevated cholesterol or early heart disease that may indicate familial hypercholesterolemia. Serum LDL-C ≥2.6 millimoles (mmol)/liter (L) (≥100 mg/dL) at screening. Fasting triglyceride <4.52 mmol/L (<400 mg/dL) at screening. Participants on statins should be receiving a maximally tolerated dose. Participants not receiving statins must have documented evidence of intolerance to all doses of at least 2 different statins. Participants on lipid-lowering therapies (such as a statin and/or ezetimibe) should be on a stable dose for ≥30 days before screening with no planned medication or dose change during study participation. Exclusion Criteria: Participants will be excluded from the study if any of the following exclusion criteria apply immediately prior to randomization: New York Heart Association (NYHA) class IV heart failure. Uncontrolled cardiac arrhythmia Uncontrolled severe hypertension Active liver disease Females who are pregnant or nursing, or who are of childbearing potential and unwilling to use at least 2 methods of highly effective contraception (failure rate less than 1% per year) (combined oral contraceptives, barrier methods, approved contraceptive implant, long-term injectable contraception, or intrauterine device) for the entire duration of the study. Exemptions from this criterion: Women >2 years postmenopausal (defined as 1 year or longer since last menstrual period) AND more than 55 years of age. Postmenopausal women (as defined above) and less than 55 years of age with a negative pregnancy test within 24 hours of randomization. Women who are surgically sterilized at least 3 months prior to enrollment. Males who are unwilling to use an acceptable method of birth control during the entire study period (condom with spermicide). Treatment with other investigational products or devices within 30 days or 5 half-lives of the screening visit, whichever is longer. Treatment (within 90 days of screening) with monoclonal antibodies directed towards PCSK9. 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
Frederick J. Raal, MD
Organizational Affiliation
University of Witwatersrand, South Africa
Official's Role
Principal Investigator
Facility Information:
Facility Name
Site 90001-005
City
Mission Viejo
State/Province
California
ZIP/Postal Code
92691
Country
United States
Facility Name
Site 90001-001
City
Newport Beach
State/Province
California
ZIP/Postal Code
92663
Country
United States
Facility Name
Site 90001-015
City
Stanford
State/Province
California
ZIP/Postal Code
94305
Country
United States
Facility Name
Site 90001-047
City
Boca Raton
State/Province
Florida
ZIP/Postal Code
33434
Country
United States
Facility Name
Site 90001-004
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02114
Country
United States
Facility Name
Site 90001-056
City
Saint Paul
State/Province
Minnesota
ZIP/Postal Code
55102
Country
United States
Facility Name
Site 90001-012
City
Butte
State/Province
Montana
ZIP/Postal Code
59701
Country
United States
Facility Name
Site 90001-112
City
Las Vegas
State/Province
Nevada
ZIP/Postal Code
89119
Country
United States
Facility Name
Site 90001-014
City
Summit
State/Province
New Jersey
ZIP/Postal Code
07901
Country
United States
Facility Name
Site 90001-002
City
Cincinnati
State/Province
Ohio
ZIP/Postal Code
45227
Country
United States
Facility Name
Site 90011-005
City
Chicoutimi
State/Province
Quebec
ZIP/Postal Code
G7H 7K9
Country
Canada
Facility Name
Site 90011-001
City
Montréal
State/Province
Quebec
ZIP/Postal Code
H2W 1R7
Country
Canada
Facility Name
Site 90011-002
City
Quebec City
State/Province
Quebec
ZIP/Postal Code
G1V 4W2
Country
Canada
Facility Name
Site 90420-001
City
Prague
ZIP/Postal Code
140 21
Country
Czechia
Facility Name
Site 90420-006
City
Prague
ZIP/Postal Code
180 00
Country
Czechia
Facility Name
Site 90420-005
City
Trutnov
ZIP/Postal Code
541 01
Country
Czechia
Facility Name
Site 90045-001
City
Aalborg
ZIP/Postal Code
DK-9000
Country
Denmark
Facility Name
Site 90045-004
City
Esbjerg
ZIP/Postal Code
DK-6700
Country
Denmark
Facility Name
Site 90045-003
City
Herning
ZIP/Postal Code
7400
Country
Denmark
Facility Name
Site 90045-006
City
Hvidovre
ZIP/Postal Code
2650
Country
Denmark
Facility Name
Site 90045-002
City
Roskilde
ZIP/Postal Code
DK-4000
Country
Denmark
Facility Name
Site 90045-005
City
Viborg
ZIP/Postal Code
DK-8800
Country
Denmark
Facility Name
Site 90031-001
City
Amersfoort
ZIP/Postal Code
3813 TZ
Country
Netherlands
Facility Name
Site 90031-003
City
Amsterdam
ZIP/Postal Code
1105 AZ
Country
Netherlands
Facility Name
Site 90031-009
City
Hoorn
ZIP/Postal Code
1624 NP
Country
Netherlands
Facility Name
Site 90031-006
City
Tilburg
ZIP/Postal Code
5042 AD
Country
Netherlands
Facility Name
Site 90031-005
City
Utrecht
ZIP/Postal Code
3584 CX
Country
Netherlands
Facility Name
Site 90027-004
City
Cape Town
State/Province
Western Cape
ZIP/Postal Code
7130
Country
South Africa
Facility Name
Site 90027-003
City
Bloemfontein
ZIP/Postal Code
9301
Country
South Africa
Facility Name
Site 90027-005
City
Cape Town
ZIP/Postal Code
7130
Country
South Africa
Facility Name
Site 90027-001
City
Cape Town
ZIP/Postal Code
7500
Country
South Africa
Facility Name
Site 90027-008
City
Cape Town
ZIP/Postal Code
7530
Country
South Africa
Facility Name
Site 90027-010
City
Johannesburg
ZIP/Postal Code
2193
Country
South Africa
Facility Name
Site 90027-007
City
Pretoria
ZIP/Postal Code
0157
Country
South Africa
Facility Name
Site 90027-006
City
Pretoria
ZIP/Postal Code
0184
Country
South Africa
Facility Name
Site 90027-009
City
Witbank
ZIP/Postal Code
1035
Country
South Africa
Facility Name
Site 90034-003
City
A Coruña
ZIP/Postal Code
15006
Country
Spain
Facility Name
Site 90034-005
City
Barcelona
Country
Spain
Facility Name
Site 90034-004
City
Córdoba
ZIP/Postal Code
14004
Country
Spain
Facility Name
Site 90034-006
City
L'Hospitalet De Llobregat
ZIP/Postal Code
8907
Country
Spain
Facility Name
Site 90034-001
City
Reus
ZIP/Postal Code
43204
Country
Spain
Facility Name
Site 90034-002
City
Zaragoza
ZIP/Postal Code
50009
Country
Spain
Facility Name
Site 90046-002
City
Göteborg
ZIP/Postal Code
SE-41345
Country
Sweden
Facility Name
Site 90046-001
City
Stockholm
ZIP/Postal Code
SE-11157
Country
Sweden
Facility Name
Site 90046-003
City
Stockholm
ZIP/Postal Code
SE-14186
Country
Sweden

12. IPD Sharing Statement

Citations:
PubMed Identifier
32197277
Citation
Raal FJ, Kallend D, Ray KK, Turner T, Koenig W, Wright RS, Wijngaard PLJ, Curcio D, Jaros MJ, Leiter LA, Kastelein JJP; ORION-9 Investigators. Inclisiran for the Treatment of Heterozygous Familial Hypercholesterolemia. N Engl J Med. 2020 Apr 16;382(16):1520-1530. doi: 10.1056/NEJMoa1913805. Epub 2020 Mar 18.
Results Reference
derived

Learn more about this trial

Trial to Evaluate the Effect of Inclisiran Treatment on Low Density Lipoprotein Cholesterol (LDL-C) in Subjects With Heterozygous Familial Hypercholesterolemia (HeFH)

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