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    Clinical Trial Results:
    A Phase III Study of Microsomal Triglyceride Transfer Protein (MTP) Inhibitor AEGR-733 in Patients with Homozygous Familial Hypercholesterolemia on Current Lipid-lowering Therapy

    Summary
    EudraCT number
    2008-007058-36
    Trial protocol
    IT  
    Global end of trial date
    13 Oct 2011

    Results information
    Results version number
    v1(current)
    This version publication date
    22 Apr 2018
    First version publication date
    22 Apr 2018
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    AEGR-733-005
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT00730236
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Aegerion Pharmaceuticals, Inc.
    Sponsor organisation address
    One Main Street, Suite 800, Cambridge, United States, 02142
    Public contact
    Agnieszka Jurecka, MD, PhD, Aegerion Pharmaceuticals, +1 857-242-5140, agnieszka.jurecka@aegerion.com
    Scientific contact
    Agnieszka Jurecka, MD, PhD, Aegerion Pharmaceuticals, +1 857-242-5140, agnieszka.jurecka@aegerion.com
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    No
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    13 Oct 2011
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    13 Oct 2011
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    The primary objective of this study was to evaluate the efficacy of lomitapide as defined by percent change from Baseline in LDL-C at the maximum tolerated dose after 26 weeks of treatment in combination with other lipid-lowering therapy in patients with HoFH.
    Protection of trial subjects
    The study was conducted in accordance with the ethical principles that have their origins in the Declaration of Helsinki, with Good Clinical Practice-International Conference on Harmonisation guidelines (GCP-ICH Consolidated Guideline) and with Directive 2001/20/EC. These practices included: IRB/IEC procedures, informed consent, protocol adherence, administrative documents, drug supply accountability, data collection, patient records (source documents), adverse event (AE) recording and reporting, inspection and audit preparation, and records retention. The Investigator was made aware that regulatory authorities and representatives of the Sponsor could inspect the documents and patient records at any time. All patient identities were kept confidential. Each patient was assigned a unique patient number, which in turn was used on the case report form (CRF) instead of the patient’s name.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    18 Dec 2007
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    Yes
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Italy: 6
    Country: Number of subjects enrolled
    United States: 7
    Country: Number of subjects enrolled
    Canada: 5
    Country: Number of subjects enrolled
    South Africa: 11
    Worldwide total number of subjects
    29
    EEA total number of subjects
    6
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    0
    Children (2-11 years)
    0
    Adolescents (12-17 years)
    0
    Adults (18-64 years)
    29
    From 65 to 84 years
    0
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    The study was performed from 18 Dec 2007 to 13 Oct 2011. A total of 11 medical clinics participated in the study.

    Pre-assignment
    Screening details
    6-week Run-in Phase. Following screening, patients entered a 6-week Run-in Phase to stabilize their regimen of current lipid-lowering therapy(ies) and to be placed on a low-fat diet containing <20% energy from fat.

    Period 1
    Period 1 title
    Efficacy Phase
    Is this the baseline period?
    Yes
    Allocation method
    Non-randomised - controlled
    Blinding used
    Not blinded

    Arms
    Arm title
    Lomitapide escalated
    Arm description
    Lomitapide escalated with an initial oral dose of 5 mg/day for 2 weeks and then escalated at 4 week intervals to 60 mg/day. In rare situations (1 patient)who met strict safety and efficacy criteria could have their dose escalated to 80 mg/day.
    Arm type
    Experimental

    Investigational medicinal product name
    Lomitapide
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Capsule
    Routes of administration
    Oral use
    Dosage and administration details
    During the 26-week Efficacy Phase (Weeks 0 to 26), lomitapide capsules were administered orally once daily to all patients who met study entry criteria. The dose was initiated at 5 mg/day for 2 weeks; the dose of lomitapide was then escalated to 10 mg/day for 4 weeks and subsequently to 20, 40, and 60 mg/day at 4-week intervals unless specific stopping rules applied. In rare situations, patients who met strict safety and efficacy criteria could have their dose escalated to 80 mg.

    Number of subjects in period 1
    Lomitapide escalated
    Started
    29
    Completed
    23
    Not completed
    6
         Consent withdrawn by subject
    3
         Adverse event, non-fatal
    2
         Non-compliance or lack of cooperation
    1
    Period 2
    Period 2 title
    Safety Phase
    Is this the baseline period?
    No
    Allocation method
    Non-randomised - controlled
    Blinding used
    Not blinded

    Arms
    Arm title
    Lomitapide escalated
    Arm description
    Lomitapide escalated with an initial oral dose of 5 mg/day for 2 weeks and then escalated at 4 week intervals to 60 mg/day. In rare situations (1 patient) who met strict safety and efficacy criteria could have their dose escalated to 80 mg/day.
    Arm type
    Experimental

    Investigational medicinal product name
    Lomitapide
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Capsule
    Routes of administration
    Oral use
    Dosage and administration details
    Following completion of the 26-week Efficacy Phase, patients entered the 52-week Safety Phase (Weeks 26 through 78) during which they received the maximum tolerated dose of lomitapide defined during the Efficacy Phase. Lomitapide capsules were administered orally once daily to all patients. During the Safety Phase, study drug dosage could be decreased if specific dose modification rules applied, but could not be increased above the highest dose administered during the Efficacy Phase.

    Number of subjects in period 2
    Lomitapide escalated
    Started
    23
    Completed
    23

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Efficacy Phase
    Reporting group description
    -

    Reporting group values
    Efficacy Phase Total
    Number of subjects
    29 29
    Age categorical
    Units: Subjects
        In utero
    0 0
        Preterm newborn infants (gestational age < 37 wks)
    0 0
        Newborns (0-27 days)
    0 0
        Infants and toddlers (28 days-23 months)
    0 0
        Children (2-11 years)
    0 0
        Adolescents (12-17 years)
    0 0
        Adults (18-64 years)
    29 29
        From 65-84 years
    0 0
        85 years and over
    0 0
    Age continuous
    Units: years
        arithmetic mean (standard deviation)
    30.7 ± 10.64 -
    Gender categorical
    Units: Subjects
        Female
    13 13
        Male
    16 16
    Race
    Units: Subjects
        Caucasian
    25 25
        Asian
    2 2
        African American
    1 1
        Other
    1 1
    Weight
    Units: kg
        arithmetic mean (standard deviation)
    73.5 ± 18.10 -
    BMI
    Units: 1 kg / m2
        arithmetic mean (standard deviation)
    25.8 ± 5.43 -

    End points

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    End points reporting groups
    Reporting group title
    Lomitapide escalated
    Reporting group description
    Lomitapide escalated with an initial oral dose of 5 mg/day for 2 weeks and then escalated at 4 week intervals to 60 mg/day. In rare situations (1 patient)who met strict safety and efficacy criteria could have their dose escalated to 80 mg/day.
    Reporting group title
    Lomitapide escalated
    Reporting group description
    Lomitapide escalated with an initial oral dose of 5 mg/day for 2 weeks and then escalated at 4 week intervals to 60 mg/day. In rare situations (1 patient) who met strict safety and efficacy criteria could have their dose escalated to 80 mg/day.

    Primary: Percent Change From Baseline in Low-density Lipoprotein Cholesterol (LDL-C)

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    End point title
    Percent Change From Baseline in Low-density Lipoprotein Cholesterol (LDL-C) [1]
    End point description
    Percent change from Baseline in LDL-C
    End point type
    Primary
    End point timeframe
    Baseline and Week 26
    Notes
    [1] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: The hypothesis of no mean percent change (and mean change) from baseline will be tested using a paired t-test (or Wilcoxon Signed Rank test, if the data are not normally distributed) at each visit.
    End point values
    Lomitapide escalated
    Number of subjects analysed
    29
    Units: percent change
        arithmetic mean (standard deviation)
    -40.1 ± 31.25
    No statistical analyses for this end point

    Secondary: Percent Change From Baseline in Total Cholesterol (TC)

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    End point title
    Percent Change From Baseline in Total Cholesterol (TC)
    End point description
    Percent change from Baseline in TC
    End point type
    Secondary
    End point timeframe
    Baseline and Week 26
    End point values
    Lomitapide escalated
    Number of subjects analysed
    29
    Units: percent change
        arithmetic mean (standard deviation)
    -36.4 ± 28.2
    No statistical analyses for this end point

    Secondary: Percent Change From Baseline for Apolipoprotein B (Apo B)

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    End point title
    Percent Change From Baseline for Apolipoprotein B (Apo B)
    End point description
    Percent change from Baseline for Apo B
    End point type
    Secondary
    End point timeframe
    Baseline and Week 26
    End point values
    Lomitapide escalated
    Number of subjects analysed
    29
    Units: percent change
        arithmetic mean (standard deviation)
    -39.4 ± 30.01
    No statistical analyses for this end point

    Secondary: Percent Change From Baseline in Triglycerides

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    End point title
    Percent Change From Baseline in Triglycerides
    End point description
    Percent change from Baseline in triglycerides
    End point type
    Secondary
    End point timeframe
    Baseline and Week 26
    End point values
    Lomitapide escalated
    Number of subjects analysed
    29
    Units: percent change
        arithmetic mean (standard deviation)
    -29.0 ± 55.72
    No statistical analyses for this end point

    Secondary: Percent Change From Baseline in Non-HDL-C

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    End point title
    Percent Change From Baseline in Non-HDL-C
    End point description
    Percent change from Baseline in non-HDL-C
    End point type
    Secondary
    End point timeframe
    Baseline and Week 26
    End point values
    Lomitapide escalated
    Number of subjects analysed
    29
    Units: percent change
        arithmetic mean (standard deviation)
    -40.0 ± 29.66
    No statistical analyses for this end point

    Secondary: Percent change from Baseline in very-low density lipoprotein (VLDL-C)

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    End point title
    Percent change from Baseline in very-low density lipoprotein (VLDL-C)
    End point description
    Percent change from Baseline in VLDL-C
    End point type
    Secondary
    End point timeframe
    Baseline and Week 26
    End point values
    Lomitapide escalated
    Number of subjects analysed
    29
    Units: Percent change
        arithmetic mean (standard deviation)
    -28.6 ± 57.45
    No statistical analyses for this end point

    Secondary: Percent change in low-density lipoprotein-A (Lp(a))

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    End point title
    Percent change in low-density lipoprotein-A (Lp(a))
    End point description
    Percent change from Baseline in Lp(a)
    End point type
    Secondary
    End point timeframe
    Baseline and Week 26
    End point values
    Lomitapide escalated
    Number of subjects analysed
    29
    Units: Percent change
        arithmetic mean (standard deviation)
    -11.0 ± 34.04
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Week -2 to Week 78
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    11.0
    Reporting groups
    Reporting group title
    Safety Population
    Reporting group description
    -

    Serious adverse events
    Safety Population
    Total subjects affected by serious adverse events
         subjects affected / exposed
    3 / 29 (10.34%)
         number of deaths (all causes)
    0
         number of deaths resulting from adverse events
    Cardiac disorders
    Acute coronary syndrome
         subjects affected / exposed
    1 / 29 (3.45%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Angina pectoris
         subjects affected / exposed
    1 / 29 (3.45%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Coronary artery arteriosclerosis
         subjects affected / exposed
    1 / 29 (3.45%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Reproductive system and breast disorders
    Menorrhagia
         subjects affected / exposed
    1 / 29 (3.45%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Infections and infestations
    Lower respiratory tract infection
         subjects affected / exposed
    1 / 29 (3.45%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    Safety Population
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    27 / 29 (93.10%)
    Vascular disorders
    Hot flush
         subjects affected / exposed
    2 / 29 (6.90%)
         occurrences all number
    2
    Hypertension
         subjects affected / exposed
    2 / 29 (6.90%)
         occurrences all number
    2
    General disorders and administration site conditions
    Chest pain
         subjects affected / exposed
    7 / 29 (24.14%)
         occurrences all number
    8
    Fatigue
         subjects affected / exposed
    5 / 29 (17.24%)
         occurrences all number
    5
    Pyrexia
         subjects affected / exposed
    3 / 29 (10.34%)
         occurrences all number
    3
    Respiratory, thoracic and mediastinal disorders
    Cough
         subjects affected / exposed
    2 / 29 (6.90%)
         occurrences all number
    2
    Epistaxis
         subjects affected / exposed
    2 / 29 (6.90%)
         occurrences all number
    3
    Nasal congestion
         subjects affected / exposed
    3 / 29 (10.34%)
         occurrences all number
    3
    Pharyngolarygeal Pain
         subjects affected / exposed
    4 / 29 (13.79%)
         occurrences all number
    5
    Psychiatric disorders
    Anxiety
         subjects affected / exposed
    2 / 29 (6.90%)
         occurrences all number
    3
    Depression
         subjects affected / exposed
    2 / 29 (6.90%)
         occurrences all number
    2
    Investigations
    Alanine aminotransferase increased
         subjects affected / exposed
    5 / 29 (17.24%)
         occurrences all number
    7
    Aspartate aminotransferase increased
         subjects affected / exposed
    2 / 29 (6.90%)
         occurrences all number
    2
    Transaminases increased
         subjects affected / exposed
    2 / 29 (6.90%)
         occurrences all number
    3
    Weight decreased
         subjects affected / exposed
    7 / 29 (24.14%)
         occurrences all number
    7
    Injury, poisoning and procedural complications
    Laceration
         subjects affected / exposed
    2 / 29 (6.90%)
         occurrences all number
    2
    Limb injury
         subjects affected / exposed
    2 / 29 (6.90%)
         occurrences all number
    2
    Thermal burn
         subjects affected / exposed
    2 / 29 (6.90%)
         occurrences all number
    2
    Cardiac disorders
    Angina pectoris
         subjects affected / exposed
    3 / 29 (10.34%)
         occurrences all number
    3
    Palpitations
         subjects affected / exposed
    3 / 29 (10.34%)
         occurrences all number
    3
    Nervous system disorders
    Dizziness
         subjects affected / exposed
    3 / 29 (10.34%)
         occurrences all number
    6
    Headache
         subjects affected / exposed
    3 / 29 (10.34%)
         occurrences all number
    3
    Paraesthesia
         subjects affected / exposed
    2 / 29 (6.90%)
         occurrences all number
    3
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    2 / 29 (6.90%)
         occurrences all number
    3
    Lymphadenopathy
         subjects affected / exposed
    2 / 29 (6.90%)
         occurrences all number
    3
    Eye disorders
    Conjunctivitis
         subjects affected / exposed
    1 / 29 (3.45%)
         occurrences all number
    1
    Gastrointestinal disorders
    Abdominal discomfort
         subjects affected / exposed
    6 / 29 (20.69%)
         occurrences all number
    6
    Abdominal distension
         subjects affected / exposed
    6 / 29 (20.69%)
         occurrences all number
    14
    Abdominal pain
         subjects affected / exposed
    8 / 29 (27.59%)
         occurrences all number
    13
    Abdominal pain upper
         subjects affected / exposed
    5 / 29 (17.24%)
         occurrences all number
    7
    Constipation
         subjects affected / exposed
    6 / 29 (20.69%)
         occurrences all number
    15
    Defaecation urgency
         subjects affected / exposed
    3 / 29 (10.34%)
         occurrences all number
    3
    Diarrhoea
         subjects affected / exposed
    23 / 29 (79.31%)
         occurrences all number
    86
    Dyspepsia
         subjects affected / exposed
    11 / 29 (37.93%)
         occurrences all number
    14
    Eructation
         subjects affected / exposed
    2 / 29 (6.90%)
         occurrences all number
    3
    Flatulence
         subjects affected / exposed
    6 / 29 (20.69%)
         occurrences all number
    10
    Gastritis
         subjects affected / exposed
    2 / 29 (6.90%)
         occurrences all number
    2
    Gastrooesophageal reflux disease
         subjects affected / exposed
    3 / 29 (10.34%)
         occurrences all number
    5
    Gingivitis
         subjects affected / exposed
    2 / 29 (6.90%)
         occurrences all number
    2
    Nausea
         subjects affected / exposed
    19 / 29 (65.52%)
         occurrences all number
    53
    Rectal tenesmus
         subjects affected / exposed
    3 / 29 (10.34%)
         occurrences all number
    4
    Vomiting
         subjects affected / exposed
    10 / 29 (34.48%)
         occurrences all number
    33
    Stomach Discomfort
         subjects affected / exposed
    2 / 29 (6.90%)
         occurrences all number
    2
    Hepatobiliary disorders
    Hepatic steatosis
         subjects affected / exposed
    2 / 29 (6.90%)
         occurrences all number
    5
    Musculoskeletal and connective tissue disorders
    Arthralgia
         subjects affected / exposed
    2 / 29 (6.90%)
         occurrences all number
    3
    Back pain
         subjects affected / exposed
    4 / 29 (13.79%)
         occurrences all number
    4
    Musculoskeletal pain
         subjects affected / exposed
    2 / 29 (6.90%)
         occurrences all number
    3
    Myalgia
         subjects affected / exposed
    2 / 29 (6.90%)
         occurrences all number
    2
    Pain in extremity
         subjects affected / exposed
    2 / 29 (6.90%)
         occurrences all number
    3
    Infections and infestations
    Bronchitis
         subjects affected / exposed
    2 / 29 (6.90%)
         occurrences all number
    3
    Gastroenteritis
         subjects affected / exposed
    4 / 29 (13.79%)
         occurrences all number
    4
    Influenza
         subjects affected / exposed
    6 / 29 (20.69%)
         occurrences all number
    6
    Nasopharyngitis
         subjects affected / exposed
    5 / 29 (17.24%)
         occurrences all number
    13
    Upper respiratory tract infection
         subjects affected / exposed
    2 / 29 (6.90%)
         occurrences all number
    2
    Metabolism and nutrition disorders
    Anorexia
         subjects affected / exposed
    2 / 29 (6.90%)
         occurrences all number
    2

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? No

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    None reported
    For support, Contact us.
    The status and protocol content of GB trials is no longer updated since 1 January 2021. For the UK, as of 31 January 2021, EU Law applies only to the territory of Northern Ireland (NI) to the extent foreseen in the Protocol on Ireland/NI. Legal notice
    As of 31 January 2023, all EU/EEA initial clinical trial applications must be submitted through CTIS . Updated EudraCT trials information and information on PIP/Art 46 trials conducted exclusively in third countries continues to be submitted through EudraCT and published on this website.

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