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    Clinical Trial Results:
    A Double-blind, Randomized, Placebo-controlled, Multicenter Study to Evaluate Safety, Tolerability and Efficacy of AMG 145 on LDL-C in Subjects With Heterozygous Familial Hypercholesterolemia

    Summary
    EudraCT number
    2012-001365-32
    Trial protocol
    ES   NL   SE   GB   DE  
    Global end of trial date
    19 Dec 2013

    Results information
    Results version number
    v1(current)
    This version publication date
    20 Jun 2016
    First version publication date
    31 Jul 2015
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    20110117
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT01763918
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Amgen, Inc.
    Sponsor organisation address
    One Amgen Center Drive, Thousand Oaks, CA, United States, 91320
    Public contact
    IHQ Medical Info-Clinical Trials, Amgen (EUROPE) GmbH, MedInfoInternational@amgen.com
    Scientific contact
    IHQ Medical Info-Clinical Trials, Amgen (EUROPE) GmbH, MedInfoInternational@amgen.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
    19 Dec 2013
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    19 Dec 2013
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    The primary objective was to evaluate the effect of 12 weeks of evolocumab subcutaneous (SC) every other week (EOW)and once monthly (QM), compared with placebo, on percent change from baseline in low-density lipoprotein cholesterol (LDL-C) in subjects with heterozygous familial hypercholesterolemia (HeFH).
    Protection of trial subjects
    This study was conducted in accordance with International Conference on Harmonisation (ICH) Good Clinical Practice (GCP) regulations and guidelines, and Food and Drug Administration (FDA) regulations, and guidelines set forth in 21 CFR Parts 11, 50, 54, 56, and 312. All subjects provided written informed consent before undergoing any study-related procedures, including screening procedures. The study protocol, amendments, and the informed consent form (ICF) were reviewed by the Institutional Review Boards (IRBs) and Independent Ethics Committees (IECs). No subjects were recruited into the study and no investigational product (IP) was shipped until the IRB/IEC gave written approval of the protocol and ICF and Amgen received copies of these approvals.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    07 Feb 2013
    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
    Canada: 55
    Country: Number of subjects enrolled
    United States: 19
    Country: Number of subjects enrolled
    France: 14
    Country: Number of subjects enrolled
    Germany: 19
    Country: Number of subjects enrolled
    Netherlands: 50
    Country: Number of subjects enrolled
    Norway: 15
    Country: Number of subjects enrolled
    Spain: 36
    Country: Number of subjects enrolled
    Sweden: 15
    Country: Number of subjects enrolled
    Switzerland: 14
    Country: Number of subjects enrolled
    United Kingdom: 17
    Country: Number of subjects enrolled
    Australia: 14
    Country: Number of subjects enrolled
    Hong Kong: 10
    Country: Number of subjects enrolled
    New Zealand: 12
    Country: Number of subjects enrolled
    South Africa: 41
    Worldwide total number of subjects
    331
    EEA total number of subjects
    166
    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)
    282
    From 65 to 84 years
    49
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    Men and women 18 to 80 years old with a diagnosis of heterozygous familial hypercholesterolemia (HeFH) on stable doses of an approved statin with fasting low-density lipoprotein cholesterol (LDL-C) ≥ 100 mg/dL were eligible for this study. The first participant enrolled on 07 February 2013 and the last participant enrolled 03 September 2013.

    Pre-assignment
    Screening details
    Participants received subcutaneous placebo corresponding to the once monthly dose volume during a 6-week screening period. Those who completed the screening period and met final eligibility criteria were randomized 1:1:2:2 into 4 treatment groups. Randomization was stratified by LDL-C level (< 160 mg/dL vs ≥ 160 mg/dL) and ezetimibe use.

    Period 1
    Period 1 title
    Overall Study (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Randomised - controlled
    Blinding used
    Double blind
    Roles blinded
    Subject, Investigator

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Placebo Q2W
    Arm description
    Participants received placebo subcutaneous injection once every 2 weeks (Q2W) for up to 12 weeks.
    Arm type
    Placebo

    Investigational medicinal product name
    Placebo to Evolocumab
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for injection in pre-filled pen
    Routes of administration
    Subcutaneous use
    Dosage and administration details
    Administered by subcutaneous injection

    Arm title
    Placebo QM
    Arm description
    Participants received placebo subcutaneous injection once every month (QM) for up to 12 weeks.
    Arm type
    Placebo

    Investigational medicinal product name
    Placebo to Evolocumab
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for injection in pre-filled pen
    Routes of administration
    Subcutaneous use
    Dosage and administration details
    Administered by subcutaneous injection

    Arm title
    Evolocumab Q2W
    Arm description
    Participants received 140 mg evolocumab by subcutaneous injection once every 2 weeks for up to 12 weeks.
    Arm type
    Experimental

    Investigational medicinal product name
    Evolocumab
    Investigational medicinal product code
    AMG 145
    Other name
    Repatha
    Pharmaceutical forms
    Solution for injection in pre-filled pen
    Routes of administration
    Subcutaneous use
    Dosage and administration details
    Administered by subcutaneous injection

    Arm title
    Evolocumab QM
    Arm description
    Participants received 420 mg evolocumab by subcutaneous injection once a month for up to 12 weeks.
    Arm type
    Experimental

    Investigational medicinal product name
    Evolocumab
    Investigational medicinal product code
    AMG 145
    Other name
    Repatha
    Pharmaceutical forms
    Solution for injection in pre-filled pen
    Routes of administration
    Subcutaneous use
    Dosage and administration details
    Administered by subcutaneous injection

    Number of subjects in period 1
    Placebo Q2W Placebo QM Evolocumab Q2W Evolocumab QM
    Started
    55
    55
    111
    110
    Received Treatment
    54
    55
    110
    110
    Completed
    49
    54
    101
    108
    Not completed
    6
    1
    10
    2
         Consent withdrawn by subject
    2
    1
    1
    2
         Sponsor Decision
    4
    -
    9
    -

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Placebo Q2W
    Reporting group description
    Participants received placebo subcutaneous injection once every 2 weeks (Q2W) for up to 12 weeks.

    Reporting group title
    Placebo QM
    Reporting group description
    Participants received placebo subcutaneous injection once every month (QM) for up to 12 weeks.

    Reporting group title
    Evolocumab Q2W
    Reporting group description
    Participants received 140 mg evolocumab by subcutaneous injection once every 2 weeks for up to 12 weeks.

    Reporting group title
    Evolocumab QM
    Reporting group description
    Participants received 420 mg evolocumab by subcutaneous injection once a month for up to 12 weeks.

    Reporting group values
    Placebo Q2W Placebo QM Evolocumab Q2W Evolocumab QM Total
    Number of subjects
    55 55 111 110 331
    Age categorical
    Units: Subjects
    Age Continuous
    Units: years
        arithmetic mean (standard deviation)
    51.1 ( 14.1 ) 46.8 ( 12.1 ) 52.3 ( 12.6 ) 51.9 ( 12 ) -
    Gender, Male/Female
    Units: participants
        Female
    25 24 45 46 140
        Male
    30 31 66 64 191
    Race/Ethnicity, Customized
    Units: Subjects
        American Indian or Alaska Native
    0 0 0 0 0
        Asian
    1 3 4 8 16
        Black or African American
    1 0 1 1 3
        Native Hawaiian or Other Pacific Islander
    0 0 0 0 0
        White
    51 49 100 98 298
        Other
    2 3 6 3 14
    Race/Ethnicity, Customized
    Units: Subjects
        Hispanic or Latino
    1 0 0 1 2
        Not Hispanic or Latino
    54 55 111 109 329
    Stratification Factor: Low-Density Lipoprotein Cholesterol (LDL-C) Level
    Units: Subjects
        < 160 mg/dL
    35 35 70 70 210
        ≥ 160 mg/dL
    20 20 41 40 121
    Baseline Ezetimibe Use
    Units: Subjects
        No
    22 21 43 43 129
        Yes
    33 34 68 67 202
    LDL-C Concentration
    Data are provided for the full analysis set (all randomized participants who received at least 1 dose of investigational product)
    Units: mg/dL
        arithmetic mean (standard deviation)
    151.1 ( 36.5 ) 151.5 ( 42.5 ) 161.4 ( 51 ) 153.6 ( 43.3 ) -
    Non-High-Density Lipoprotein Cholesterol (non-HDL-C) Concentration
    Data are provided for the full analysis set
    Units: mg/dL
        arithmetic mean (standard deviation)
    175.4 ( 43.9 ) 175.4 ( 45.9 ) 187.4 ( 56.7 ) 178.5 ( 45.8 ) -
    Apolipoprotein B Concentration
    Data are provided for the full analysis set
    Units: mg/dL
        arithmetic mean (standard deviation)
    114.3 ( 29.8 ) 110.3 ( 21.7 ) 119 ( 30.7 ) 114.9 ( 25.5 ) -
    Total cholesterol/HDL-C Ratio
    Data are provided for the full analysis set
    Units: ratio
        arithmetic mean (standard deviation)
    4.695 ( 1.905 ) 4.844 ( 1.435 ) 5.159 ( 2.031 ) 4.842 ( 1.801 ) -
    Apolipoprotein B/Apolipoprotein A1 Ratio
    Data are provided for the full analysis set
    Units: ratio
        arithmetic mean (standard deviation)
    0.815 ( 0.264 ) 0.851 ( 0.249 ) 0.888 ( 0.322 ) 0.85 ( 0.331 ) -
    Lipoprotein(a) Concentration
    Data are provided for the full analysis set
    Units: nmol/L
        median (inter-quartile range (Q1-Q3))
    44 (24 to 105) 87 (36 to 219) 77.5 (29 to 205.5) 61 (17 to 194) -
    Triglyceride Concentration
    Data are provided for the full analysis set
    Units: mg/dL
        median (inter-quartile range (Q1-Q3))
    95.8 (74.5 to 143) 102 (79 to 151) 118.5 (86.5 to 160.5) 112.5 (84.5 to 156.5) -
    Very Low-Density Lipoprotein Cholesterol (VLDL-C) Concentration
    Data are provided for the full analysis set
    Units: mg/dL
        arithmetic mean (standard deviation)
    23.1 ( 10.7 ) 23.9 ( 10.5 ) 25.9 ( 11.8 ) 24.9 ( 11.7 ) -
    HDL-C Concentration
    Data are provided for the full analysis set
    Units: mg/dL
        arithmetic mean (standard deviation)
    53.2 ( 16.5 ) 49.1 ( 12.7 ) 50.4 ( 16.1 ) 51.9 ( 16 ) -

    End points

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    End points reporting groups
    Reporting group title
    Placebo Q2W
    Reporting group description
    Participants received placebo subcutaneous injection once every 2 weeks (Q2W) for up to 12 weeks.

    Reporting group title
    Placebo QM
    Reporting group description
    Participants received placebo subcutaneous injection once every month (QM) for up to 12 weeks.

    Reporting group title
    Evolocumab Q2W
    Reporting group description
    Participants received 140 mg evolocumab by subcutaneous injection once every 2 weeks for up to 12 weeks.

    Reporting group title
    Evolocumab QM
    Reporting group description
    Participants received 420 mg evolocumab by subcutaneous injection once a month for up to 12 weeks.

    Primary: Percent Change From Baseline in LDL-C at Week 12

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    End point title
    Percent Change From Baseline in LDL-C at Week 12
    End point description
    Calculated LDL-C was determined based on the Friedewald equation.
    End point type
    Primary
    End point timeframe
    Baseline and Week 12
    End point values
    Placebo Q2W Placebo QM Evolocumab Q2W Evolocumab QM
    Number of subjects analysed
    54
    55
    110
    110
    Units: percent change
        least squares mean (standard error)
    -2.02 ( 2.49 )
    5.53 ( 3.25 )
    -61.25 ( 1.77 )
    -55.74 ( 2.25 )
    Statistical analysis title
    Evolocumab Q2W vs Placebo Q2W
    Statistical analysis description
    Within each dose frequency, the null hypothesis was that there was no mean difference in the percent change from baseline at week 12 or in the mean percent change from baseline at weeks 10 and 12 in LDL-C between evolocumab and placebo, and the alternative hypothesis was that a mean difference did exist.
    Comparison groups
    Placebo Q2W v Evolocumab Q2W
    Number of subjects included in analysis
    164
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    < 0.001 [1]
    Method
    Repeated measures linear effects model
    Parameter type
    LS Mean Treatment Difference
    Point estimate
    -59.23
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -65.11
         upper limit
    -53.35
    Variability estimate
    Standard error of the mean
    Dispersion value
    2.98
    Notes
    [1] - The model includes treatment group, baseline LDL-C and ezetimibe use, scheduled visit, and the interaction of treatment with scheduled visit. Multiplicity adjusted p-value is significant if less than the familywise error rate of 0.05.
    Statistical analysis title
    Evolocumab QM vs Placebo QM
    Statistical analysis description
    Within each dose frequency, the null hypothesis was that there was no mean difference in the percent change from baseline at week 12 or in the mean percent change from baseline at weeks 10 and 12 in LDL-C between evolocumab and placebo, and the alternative hypothesis was that a mean difference did exist.
    Comparison groups
    Placebo QM v Evolocumab QM
    Number of subjects included in analysis
    165
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    < 0.001 [2]
    Method
    Repeated measures linear effects model
    Parameter type
    LS Mean Treatment Difference
    Point estimate
    -61.27
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -69
         upper limit
    -53.55
    Variability estimate
    Standard error of the mean
    Dispersion value
    3.91
    Notes
    [2] - The model includes treatment group, baseline LDL-C and ezetimibe use, scheduled visit, and the interaction of treatment with scheduled visit. Multiplicity adjusted p-value is significant if less than the familywise error rate of 0.05.

    Primary: Mean Percent Change From Baseline in LDL-C at Weeks 10 and 12

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    End point title
    Mean Percent Change From Baseline in LDL-C at Weeks 10 and 12
    End point description
    Calculated LDL-C was determined based on the Friedewald equation.
    End point type
    Primary
    End point timeframe
    Baseline and Weeks 10 and 12
    End point values
    Placebo Q2W Placebo QM Evolocumab Q2W Evolocumab QM
    Number of subjects analysed
    54
    55
    110
    110
    Units: percent change
        least squares mean (standard error)
    -1.08 ( 2.41 )
    2.3 ( 2.41 )
    -61.23 ( 1.71 )
    -63.25 ( 1.7 )
    Statistical analysis title
    Evolocumab Q2W vs Placebo Q2W
    Statistical analysis description
    Within each dose frequency, the null hypothesis was that there was no mean difference in the percent change from baseline at week 12 or in the mean percent change from baseline at weeks 10 and 12 in LDL-C between evolocumab and placebo, and the alternative hypothesis was that a mean difference did exist.
    Comparison groups
    Placebo Q2W v Evolocumab Q2W
    Number of subjects included in analysis
    164
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    < 0.001 [3]
    Method
    Repeated measures linear effects model
    Parameter type
    LS Mean Treatment Difference
    Point estimate
    -60.15
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -65.83
         upper limit
    -54.46
    Variability estimate
    Standard error of the mean
    Dispersion value
    2.88
    Notes
    [3] - The model includes treatment group, baseline LDL-C and ezetimibe use, scheduled visit, and the interaction of treatment with scheduled visit. Multiplicity adjusted p-value is significant if less than the familywise error rate of 0.05.
    Statistical analysis title
    Evolocumab QM vs Placebo QM
    Statistical analysis description
    Within each dose frequency, the null hypothesis was that there was no mean difference in the percent change from baseline at week 12 or in the mean percent change from baseline at weeks 10 and 12 in LDL-C between evolocumab and placebo, and the alternative hypothesis was that a mean difference did exist.
    Comparison groups
    Placebo QM v Evolocumab QM
    Number of subjects included in analysis
    165
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    < 0.001 [4]
    Method
    Repeated measures linear effects model
    Parameter type
    LS Mean Treatment Difference
    Point estimate
    -65.55
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -71.27
         upper limit
    -59.83
    Variability estimate
    Standard error of the mean
    Dispersion value
    2.9
    Notes
    [4] - The model includes treatment group, baseline LDL-C and ezetimibe use, scheduled visit, and the interaction of treatment with scheduled visit. Multiplicity adjusted p-value is significant if less than the familywise error rate of 0.05.

    Secondary: Mean Change From Baseline in LDL-C at Weeks 10 and 12

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    End point title
    Mean Change From Baseline in LDL-C at Weeks 10 and 12
    End point description
    Calculated LDL-C was determined based on the Friedewald equation.
    End point type
    Secondary
    End point timeframe
    Baseline and Weeks 10 and 12
    End point values
    Placebo Q2W Placebo QM Evolocumab Q2W Evolocumab QM
    Number of subjects analysed
    54
    55
    110
    110
    Units: mg/dL
        least squares mean (standard error)
    -6.5 ( 4.2 )
    -1.3 ( 4.1 )
    -101.7 ( 3 )
    -98.8 ( 2.9 )
    Statistical analysis title
    Evolocumab Q2W vs Placebo Q2W
    Comparison groups
    Placebo Q2W v Evolocumab Q2W
    Number of subjects included in analysis
    164
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    < 0.001 [5]
    Method
    Repeated measures linear effects model
    Parameter type
    LS Mean Treatment Difference
    Point estimate
    -95.2
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -105.1
         upper limit
    -85.2
    Variability estimate
    Standard error of the mean
    Dispersion value
    5
    Notes
    [5] - The model includes treatment group, baseline LDL-C and ezetimibe use, scheduled visit, and the interaction of treatment with scheduled visit. Multiplicity adjusted p-value is significant if less than the familywise error rate of 0.05.
    Statistical analysis title
    Evolocumab QM vs Placebo QM
    Comparison groups
    Placebo QM v Evolocumab QM
    Number of subjects included in analysis
    165
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    < 0.001 [6]
    Method
    Repeated measures linear effects model
    Parameter type
    LS Mean Treatment Difference
    Point estimate
    -97.4
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -107.1
         upper limit
    -87.7
    Variability estimate
    Standard error of the mean
    Dispersion value
    4.9
    Notes
    [6] - The model includes treatment group, baseline LDL-C and ezetimibe use, scheduled visit, and the interaction of treatment with scheduled visit. Multiplicity adjusted p-value is significant if less than the familywise error rate of 0.05.

    Secondary: Change From Baseline in LDL-C at Week 12

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    End point title
    Change From Baseline in LDL-C at Week 12
    End point description
    Calculated LDL-C was determined based on the Friedewald equation.
    End point type
    Secondary
    End point timeframe
    Baseline and Week 12
    End point values
    Placebo Q2W Placebo QM Evolocumab Q2W Evolocumab QM
    Number of subjects analysed
    54
    55
    110
    110
    Units: mg/dL
        least squares mean (standard error)
    -8.5 ( 4.2 )
    4.1 ( 5.2 )
    -101.3 ( 3 )
    -87.2 ( 3.6 )
    Statistical analysis title
    Evolocumab Q2W vs Placebo Q2W
    Comparison groups
    Placebo Q2W v Evolocumab Q2W
    Number of subjects included in analysis
    164
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    < 0.001 [7]
    Method
    Repeated measures linear effects model
    Parameter type
    LS Mean Treatment Difference
    Point estimate
    -92.9
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -102.9
         upper limit
    -82.8
    Variability estimate
    Standard error of the mean
    Dispersion value
    5.1
    Notes
    [7] - The model includes treatment group, baseline LDL-C and ezetimibe use, scheduled visit, and the interaction of treatment with scheduled visit. Multiplicity adjusted p-value is significant if less than the familywise error rate of 0.05.
    Statistical analysis title
    Evolocumab QM vs Placebo QM
    Comparison groups
    Placebo QM v Evolocumab QM
    Number of subjects included in analysis
    165
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    < 0.001 [8]
    Method
    Repeated measures linear effects model
    Parameter type
    LS Mean Treatment Difference
    Point estimate
    -91.3
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -103.8
         upper limit
    -78.9
    Variability estimate
    Standard error of the mean
    Dispersion value
    6.3
    Notes
    [8] - The model includes treatment group, baseline LDL-C and ezetimibe use, scheduled visit, and the interaction of treatment with scheduled visit. Multiplicity adjusted p-value is significant if less than the familywise error rate of 0.05.

    Secondary: Mean Percentage of Participants with LDL-C < 70 mg/dL (1.8 mmol/L) at Weeks 10 and 12

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    End point title
    Mean Percentage of Participants with LDL-C < 70 mg/dL (1.8 mmol/L) at Weeks 10 and 12
    End point description
    Mean low density lipoprotein-cholesterol response (low density lipoprotein-cholesterol < 70 mg/dL [1.8 mmol/L])
    End point type
    Secondary
    End point timeframe
    Weeks 10 and 12
    End point values
    Placebo Q2W Placebo QM Evolocumab Q2W Evolocumab QM
    Number of subjects analysed
    54
    55
    110
    110
    Units: percentage of participants
        number (confidence interval 95%)
    1.9 (0.3 to 9.9)
    1.9 (0.3 to 9.8)
    67 (57.7 to 75.1)
    80.4 (71.9 to 86.8)
    Statistical analysis title
    Evolocumab QM vs Placebo QM
    Comparison groups
    Placebo QM v Evolocumab QM
    Number of subjects included in analysis
    165
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    < 0.001 [9]
    Method
    Cochran-Mantel-Haenszel
    Parameter type
    Treatment Difference
    Point estimate
    78.5
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    66.9
         upper limit
    85.1
    Notes
    [9] - Cochran-Mantel Haenszel test stratified by baseline LDL-C and ezetimibe use. Multiplicity adjusted p-value is significant if less than the familywise error rate of 0.05.
    Statistical analysis title
    Evolocumab Q2W vs Placebo Q2W
    Comparison groups
    Placebo Q2W v Evolocumab Q2W
    Number of subjects included in analysis
    164
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    < 0.001 [10]
    Method
    Cochran-Mantel-Haenszel
    Parameter type
    Treatment Difference
    Point estimate
    65.1
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    52.8
         upper limit
    73.4
    Notes
    [10] - Cochran-Mantel Haenszel test stratified by baseline LDL-C and ezetimibe use. Multiplicity adjusted p-value is significant if less than the familywise error rate of 0.05.

    Secondary: Percentage of Participants with LDL-C < 70 mg/dL (1.8 mmol/L) at Week 12

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    End point title
    Percentage of Participants with LDL-C < 70 mg/dL (1.8 mmol/L) at Week 12
    End point description
    Low density lipoprotein-cholesterol response (low density lipoprotein-cholesterol < 70 mg/dL [1.8 mmol/L]).
    End point type
    Secondary
    End point timeframe
    Week 12
    End point values
    Placebo Q2W Placebo QM Evolocumab Q2W Evolocumab QM
    Number of subjects analysed
    54
    55
    110
    110
    Units: percentage of participants
        number (confidence interval 95%)
    2 (0.3 to 10.3)
    2.2 (0.4 to 11.3)
    68.3 (58.8 to 76.4)
    63.1 (53.5 to 71.8)
    Statistical analysis title
    Evolocumab QM vs Placebo QM
    Comparison groups
    Placebo QM v Evolocumab QM
    Number of subjects included in analysis
    165
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    < 0.001 [11]
    Method
    Cochran-Mantel-Haenszel
    Parameter type
    Treatment Difference
    Point estimate
    60.9
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    47.6
         upper limit
    69.8
    Notes
    [11] - Cochran-Mantel Haenszel test stratified by baseline LDL-C and ezetimibe use. Multiplicity adjusted p-value is significant if less than the familywise error rate of 0.05.
    Statistical analysis title
    Evolocumab Q2W vs Placebo Q2W
    Comparison groups
    Placebo Q2W v Evolocumab Q2W
    Number of subjects included in analysis
    164
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    < 0.001 [12]
    Method
    Cochran-Mantel-Haenszel
    Parameter type
    Treatment Difference
    Point estimate
    66.3
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    53.7
         upper limit
    74.6
    Notes
    [12] - Cochran-Mantel Haenszel test stratified by baseline LDL-C and ezetimibe use. Multiplicity adjusted p-value is significant if less than the familywise error rate of 0.05.

    Secondary: Mean Percent Change From Baseline in Non-High-Density Lipoprotein Cholesterol (non-HDL-C) at Weeks 10 and 12

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    End point title
    Mean Percent Change From Baseline in Non-High-Density Lipoprotein Cholesterol (non-HDL-C) at Weeks 10 and 12
    End point description
    End point type
    Secondary
    End point timeframe
    Baseline and Weeks 10 and 12
    End point values
    Placebo Q2W Placebo QM Evolocumab Q2W Evolocumab QM
    Number of subjects analysed
    54
    55
    110
    110
    Units: percent change
        least squares mean (standard error)
    0.21 ( 2.29 )
    2.72 ( 2.21 )
    -55.79 ( 1.63 )
    -57.28 ( 1.56 )
    Statistical analysis title
    Evolocumab Q2W vs Placebo Q2W
    Comparison groups
    Placebo Q2W v Evolocumab Q2W
    Number of subjects included in analysis
    164
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    < 0.001 [13]
    Method
    Repeated measures linear effects model
    Parameter type
    LS Mean Treatment Difference
    Point estimate
    -56
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -61.41
         upper limit
    -50.59
    Variability estimate
    Standard error of the mean
    Dispersion value
    2.74
    Notes
    [13] - The model includes treatment group, baseline LDL-C and ezetimibe use, scheduled visit, and the interaction of treatment with scheduled visit. Multiplicity adjusted p-value is significant if less than the familywise error rate of 0.05.
    Statistical analysis title
    Evolocumab QM vs Placebo QM
    Comparison groups
    Placebo QM v Evolocumab QM
    Number of subjects included in analysis
    165
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    < 0.001 [14]
    Method
    Repeated measures linear effects model
    Parameter type
    LS Mean Treatment Difference
    Point estimate
    -60.01
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -65.24
         upper limit
    -54.77
    Variability estimate
    Standard error of the mean
    Dispersion value
    2.65
    Notes
    [14] - The model includes treatment group, baseline LDL-C and ezetimibe use, scheduled visit, and the interaction of treatment with scheduled visit. Multiplicity adjusted p-value is significant if less than the familywise error rate of 0.05.

    Secondary: Percent Change From Baseline in non-HDL-C at Week 12

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    End point title
    Percent Change From Baseline in non-HDL-C at Week 12
    End point description
    End point type
    Secondary
    End point timeframe
    Baseline and Week 12
    End point values
    Placebo Q2W Placebo QM Evolocumab Q2W Evolocumab QM
    Number of subjects analysed
    54
    55
    110
    110
    Units: percent change
        least squares mean (standard error)
    -1.39 ( 2.4 )
    5.29 ( 2.94 )
    -56.19 ( 1.71 )
    -49.67 ( 2.04 )
    Statistical analysis title
    Evolocumab Q2W vs Placebo Q2W
    Comparison groups
    Placebo Q2W v Evolocumab Q2W
    Number of subjects included in analysis
    164
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    < 0.001 [15]
    Method
    Repeated measures linear effects model
    Parameter type
    LS Mean Treatment Difference
    Point estimate
    -54.79
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -60.47
         upper limit
    -49.12
    Variability estimate
    Standard error of the mean
    Dispersion value
    2.87
    Notes
    [15] - The model includes treatment group, baseline LDL-C and ezetimibe use, scheduled visit, and the interaction of treatment with scheduled visit. Multiplicity adjusted p-value is significant if less than the familywise error rate of 0.05.
    Statistical analysis title
    Evolocumab QM vs Placebo QM
    Comparison groups
    Placebo QM v Evolocumab QM
    Number of subjects included in analysis
    165
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    < 0.001 [16]
    Method
    Repeated measures linear effects model
    Parameter type
    LS Mean Treatment Difference
    Point estimate
    -54.95
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -61.95
         upper limit
    -47.96
    Variability estimate
    Standard error of the mean
    Dispersion value
    3.54
    Notes
    [16] - The model includes treatment group, baseline LDL-C and ezetimibe use, scheduled visit, and the interaction of treatment with scheduled visit. Multiplicity adjusted p-value is significant if less than the familywise error rate of 0.05.

    Secondary: Mean Percent Change From Baseline in Apolipoprotein B at Weeks 10 and 12

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    End point title
    Mean Percent Change From Baseline in Apolipoprotein B at Weeks 10 and 12
    End point description
    End point type
    Secondary
    End point timeframe
    Baseline and Weeks 10 and 12
    End point values
    Placebo Q2W Placebo QM Evolocumab Q2W Evolocumab QM
    Number of subjects analysed
    54
    55
    110
    110
    Units: percent change
        least squares mean (standard error)
    -0.19 ( 2.1 )
    2.21 ( 1.97 )
    -49.58 ( 1.48 )
    -52.76 ( 1.36 )
    Statistical analysis title
    Evolocumab Q2W vs Placebo Q2W
    Comparison groups
    Placebo Q2W v Evolocumab Q2W
    Number of subjects included in analysis
    164
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    < 0.001 [17]
    Method
    Repeated measures linear effects model
    Parameter type
    LS Mean Treatment Difference
    Point estimate
    -49.39
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -54.32
         upper limit
    -44.46
    Variability estimate
    Standard error of the mean
    Dispersion value
    2.5
    Notes
    [17] - The model includes treatment group, baseline LDL-C and ezetimibe use, scheduled visit, and the interaction of treatment with scheduled visit. Multiplicity adjusted p-value is significant if less than the familywise error rate of 0.05.
    Statistical analysis title
    Evolocumab QM vs Placebo QM
    Comparison groups
    Placebo QM v Evolocumab QM
    Number of subjects included in analysis
    165
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    < 0.001 [18]
    Method
    Repeated measures linear effects model
    Parameter type
    LS Mean Treatment Difference
    Point estimate
    -54.98
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -59.58
         upper limit
    -50.38
    Variability estimate
    Standard error of the mean
    Dispersion value
    2.33
    Notes
    [18] - The model includes treatment group, baseline LDL-C and ezetimibe use, scheduled visit, and the interaction of treatment with scheduled visit. Multiplicity adjusted p-value is significant if less than the familywise error rate of 0.05.

    Secondary: Percent Change From Baseline in Apolipoprotein B at Week 12

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    End point title
    Percent Change From Baseline in Apolipoprotein B at Week 12
    End point description
    End point type
    Secondary
    End point timeframe
    Baseline and Week 12
    End point values
    Placebo Q2W Placebo QM Evolocumab Q2W Evolocumab QM
    Number of subjects analysed
    54
    55
    110
    110
    Units: percent change
        least squares mean (standard error)
    -0.67 ( 2.32 )
    4.6 ( 2.7 )
    -49.75 ( 1.63 )
    -44.81 ( 1.8 )
    Statistical analysis title
    Evolocumab Q2W vs Placebo Q2W
    Comparison groups
    Placebo Q2W v Evolocumab Q2W
    Number of subjects included in analysis
    164
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    < 0.001 [19]
    Method
    Repeated measures linear effects model
    Parameter type
    LS Mean Treatment Difference
    Point estimate
    -49.09
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -54.55
         upper limit
    -43.63
    Variability estimate
    Standard error of the mean
    Dispersion value
    2.76
    Notes
    [19] - The model includes treatment group, baseline LDL-C and ezetimibe use, scheduled visit, and the interaction of treatment with scheduled visit. Multiplicity adjusted p-value is significant if less than the familywise error rate of 0.05.
    Statistical analysis title
    Evolocumab QM vs Placebo QM
    Comparison groups
    Placebo QM v Evolocumab QM
    Number of subjects included in analysis
    165
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    < 0.001 [20]
    Method
    Repeated measures linear effects model
    Parameter type
    LS Mean Treatment Difference
    Point estimate
    -49.41
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -55.73
         upper limit
    -43.1
    Variability estimate
    Standard error of the mean
    Dispersion value
    3.19
    Notes
    [20] - The model includes treatment group, baseline LDL-C and ezetimibe use, scheduled visit, and the interaction of treatment with scheduled visit. Multiplicity adjusted p-value is significant if less than the familywise error rate of 0.05.

    Secondary: Mean Percent Change From Baseline in the Total Cholesterol/HDL-C Ratio at Weeks 10 and 12

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    End point title
    Mean Percent Change From Baseline in the Total Cholesterol/HDL-C Ratio at Weeks 10 and 12
    End point description
    End point type
    Secondary
    End point timeframe
    Baseline and Weeks 10 and 12
    End point values
    Placebo Q2W Placebo QM Evolocumab Q2W Evolocumab QM
    Number of subjects analysed
    54
    55
    110
    110
    Units: percent change
        least squares mean (standard error)
    0.86 ( 2.05 )
    4.14 ( 2.13 )
    -45.74 ( 1.45 )
    -45.02 ( 1.5 )
    Statistical analysis title
    Evolocumab Q2W vs Placebo Q2W
    Comparison groups
    Placebo Q2W v Evolocumab Q2W
    Number of subjects included in analysis
    164
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    < 0.001 [21]
    Method
    Repeated measures linear effects model
    Parameter type
    LS Mean Treatment Difference
    Point estimate
    -46.59
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -51.43
         upper limit
    -41.76
    Variability estimate
    Standard error of the mean
    Dispersion value
    2.45
    Notes
    [21] - The model includes treatment group, baseline LDL-C and ezetimibe use, scheduled visit, and the interaction of treatment with scheduled visit. Multiplicity adjusted p-value is significant if less than the familywise error rate of 0.05.
    Statistical analysis title
    Evolocumab QM vs Placebo QM
    Comparison groups
    Placebo QM v Evolocumab QM
    Number of subjects included in analysis
    165
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    < 0.001 [22]
    Method
    Repeated measures linear effects model
    Parameter type
    LS Mean Treatment Difference
    Point estimate
    -49.16
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -54.21
         upper limit
    -44.11
    Variability estimate
    Standard error of the mean
    Dispersion value
    2.56
    Notes
    [22] - The model includes treatment group, baseline LDL-C and ezetimibe use, scheduled visit, and the interaction of treatment with scheduled visit. Multiplicity adjusted p-value is significant if less than the familywise error rate of 0.05.

    Secondary: Percent Change From Baseline in the Total Cholesterol/HDL-C Ratio at Week 12

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    End point title
    Percent Change From Baseline in the Total Cholesterol/HDL-C Ratio at Week 12
    End point description
    End point type
    Secondary
    End point timeframe
    Baseline and Week 12
    End point values
    Placebo Q2W Placebo QM Evolocumab Q2W Evolocumab QM
    Number of subjects analysed
    54
    55
    110
    110
    Units: percent change
        least squares mean (standard error)
    0.12 ( 2.19 )
    7.11 ( 3.13 )
    -45.95 ( 1.56 )
    -38.32 ( 2.15 )
    Statistical analysis title
    Evolocumab Q2W vs Placebo Q2W
    Comparison groups
    Placebo Q2W v Evolocumab Q2W
    Number of subjects included in analysis
    164
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    < 0.001 [23]
    Method
    Repeated measures linear effects model
    Parameter type
    LS Mean Treatment Difference
    Point estimate
    -46.08
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -51.27
         upper limit
    -40.88
    Variability estimate
    Standard error of the mean
    Dispersion value
    2.63
    Notes
    [23] - The model includes treatment group, baseline LDL-C and ezetimibe use, scheduled visit, and the interaction of treatment with scheduled visit. Multiplicity adjusted p-value is significant if less than the familywise error rate of 0.05.
    Statistical analysis title
    Evolocumab QM vs Placebo QM
    Comparison groups
    Placebo QM v Evolocumab QM
    Number of subjects included in analysis
    165
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    < 0.001 [24]
    Method
    Repeated measures linear effects model
    Parameter type
    LS Mean Treatment Difference
    Point estimate
    -45.42
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -52.86
         upper limit
    -37.98
    Variability estimate
    Standard error of the mean
    Dispersion value
    3.77
    Notes
    [24] - The model includes treatment group, baseline LDL-C and ezetimibe use, scheduled visit, and the interaction of treatment with scheduled visit. Multiplicity adjusted p-value is significant if less than the familywise error rate of 0.05.

    Secondary: Mean Percent Change From Baseline in Apolipoprotein B/Apolipoprotein A1 Ratio at Weeks 10 and 12

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    End point title
    Mean Percent Change From Baseline in Apolipoprotein B/Apolipoprotein A1 Ratio at Weeks 10 and 12
    End point description
    End point type
    Secondary
    End point timeframe
    Baseline and Weeks 10 and 12
    End point values
    Placebo Q2W Placebo QM Evolocumab Q2W Evolocumab QM
    Number of subjects analysed
    54
    55
    110
    110
    Units: percent change
        least squares mean (standard error)
    0.78 ( 2.21 )
    1.65 ( 2.35 )
    -52.39 ( 1.56 )
    -53.91 ( 1.6 )
    Statistical analysis title
    Evolocumab Q2W vs Placebo Q2W
    Comparison groups
    Placebo Q2W v Evolocumab Q2W
    Number of subjects included in analysis
    164
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    < 0.001 [25]
    Method
    Repeated measures linear effects model
    Parameter type
    LS Mean Treatment Difference
    Point estimate
    -53.17
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -58.35
         upper limit
    -47.99
    Variability estimate
    Standard error of the mean
    Dispersion value
    2.62
    Notes
    [25] - The model includes treatment group, baseline LDL-C and ezetimibe use, scheduled visit, and the interaction of treatment with scheduled visit. Multiplicity adjusted p-value is significant if less than the familywise error rate of 0.05.
    Statistical analysis title
    Evolocumab QM vs Placebo QM
    Comparison groups
    Placebo QM v Evolocumab QM
    Number of subjects included in analysis
    165
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    < 0.001 [26]
    Method
    Repeated measures linear effects model
    Parameter type
    LS Mean Treatment Difference
    Point estimate
    -55.56
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -61.08
         upper limit
    -50.05
    Variability estimate
    Standard error of the mean
    Dispersion value
    2.79
    Notes
    [26] - The model includes treatment group, baseline LDL-C and ezetimibe use, scheduled visit, and the interaction of treatment with scheduled visit. Multiplicity adjusted p-value is significant if less than the familywise error rate of 0.05.

    Secondary: Percent Change From Baseline in Apolipoprotein B/Apolipoprotein A1 Ratio at Week 12

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    End point title
    Percent Change From Baseline in Apolipoprotein B/Apolipoprotein A1 Ratio at Week 12
    End point description
    End point type
    Secondary
    End point timeframe
    Baseline and Week 12
    End point values
    Placebo Q2W Placebo QM Evolocumab Q2W Evolocumab QM
    Number of subjects analysed
    54
    55
    110
    110
    Units: percent change
        least squares mean (standard error)
    1.54 ( 2.49 )
    4.23 ( 3.66 )
    -52.74 ( 1.75 )
    -45.31 ( 2.42 )
    Statistical analysis title
    Evolocumab Q2W vs Placebo Q2W
    Comparison groups
    Placebo Q2W v Evolocumab Q2W
    Number of subjects included in analysis
    164
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    < 0.001 [27]
    Method
    Repeated measures linear effects model
    Parameter type
    LS Mean Treatment Difference
    Point estimate
    -54.28
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -60.16
         upper limit
    -48.41
    Variability estimate
    Standard error of the mean
    Dispersion value
    2.97
    Notes
    [27] - The model includes treatment group, baseline LDL-C and ezetimibe use, scheduled visit, and the interaction of treatment with scheduled visit. Multiplicity adjusted p-value is significant if less than the familywise error rate of 0.05.
    Statistical analysis title
    Evolocumab QM vs Placebo QM
    Comparison groups
    Placebo QM v Evolocumab QM
    Number of subjects included in analysis
    165
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    < 0.001 [28]
    Method
    Repeated measures linear effects model
    Parameter type
    LS Mean Treatment Difference
    Point estimate
    -49.55
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -58.14
         upper limit
    -40.96
    Variability estimate
    Standard error of the mean
    Dispersion value
    4.35
    Notes
    [28] - The model includes treatment group, baseline LDL-C and ezetimibe use, scheduled visit, and the interaction of treatment with scheduled visit. Multiplicity adjusted p-value is significant if less than the familywise error rate of 0.05.

    Secondary: Mean Percent Change From Baseline in Lipoprotein (a) at Weeks 10 and 12

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    End point title
    Mean Percent Change From Baseline in Lipoprotein (a) at Weeks 10 and 12
    End point description
    End point type
    Secondary
    End point timeframe
    Baseline and Weeks 10 and 12
    End point values
    Placebo Q2W Placebo QM Evolocumab Q2W Evolocumab QM
    Number of subjects analysed
    54
    55
    110
    110
    Units: percent change
        least squares mean (standard error)
    7.34 ( 2.97 )
    5.35 ( 2.95 )
    -24.03 ( 2.09 )
    -25.65 ( 2.07 )
    Statistical analysis title
    Evolocumab QM vs Placebo QM
    Comparison groups
    Placebo QM v Evolocumab QM
    Number of subjects included in analysis
    165
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    < 0.001 [29]
    Method
    Repeated measures linear effects model
    Parameter type
    LS Mean Treatment Difference
    Point estimate
    -31
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -37.91
         upper limit
    -24.09
    Variability estimate
    Standard error of the mean
    Dispersion value
    3.5
    Notes
    [29] - The model includes treatment group, baseline LDL-C and ezetimibe use, scheduled visit, and the interaction of treatment with scheduled visit. Multiplicity adjusted p-value is significant if less than the familywise error rate of 0.05.
    Statistical analysis title
    Evolocumab Q2W vs Placebo Q2W
    Comparison groups
    Placebo Q2W v Evolocumab Q2W
    Number of subjects included in analysis
    164
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    < 0.001 [30]
    Method
    Repeated measures linear effects model
    Parameter type
    LS Mean Treatment Difference
    Point estimate
    -31.37
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -38.33
         upper limit
    -24.41
    Variability estimate
    Standard error of the mean
    Dispersion value
    3.52
    Notes
    [30] - The model includes treatment group, baseline LDL-C and ezetimibe use, scheduled visit, and the interaction of treatment with scheduled visit. Multiplicity adjusted p-value is significant if less than the familywise error rate of 0.05.

    Secondary: Percent Change From Baseline in Lipoprotein (a) at Week 12

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    End point title
    Percent Change From Baseline in Lipoprotein (a) at Week 12
    End point description
    End point type
    Secondary
    End point timeframe
    Baseline and Week 12
    End point values
    Placebo Q2W Placebo QM Evolocumab Q2W Evolocumab QM
    Number of subjects analysed
    54
    55
    110
    110
    Units: percent change
        least squares mean (standard error)
    8.68 ( 3.27 )
    6.69 ( 3.16 )
    -22.89 ( 2.31 )
    -21.55 ( 2.17 )
    Statistical analysis title
    Evolocumab Q2W vs Placebo Q2W
    Comparison groups
    Placebo Q2W v Evolocumab Q2W
    Number of subjects included in analysis
    164
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    < 0.001 [31]
    Method
    Repeated measures linear effects model
    Parameter type
    LS Mean Treatment Difference
    Point estimate
    -31.57
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -39.28
         upper limit
    -23.87
    Variability estimate
    Standard error of the mean
    Dispersion value
    3.9
    Notes
    [31] - The model includes treatment group, baseline LDL-C and ezetimibe use, scheduled visit, and the interaction of treatment with scheduled visit. Multiplicity adjusted p-value is significant if less than the familywise error rate of 0.05.
    Statistical analysis title
    Evolocumab QM vs Placebo QM
    Comparison groups
    Placebo QM v Evolocumab QM
    Number of subjects included in analysis
    165
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    < 0.001 [32]
    Method
    Repeated measures linear effects model
    Parameter type
    LS Mean Treatment Difference
    Point estimate
    -28.24
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -35.61
         upper limit
    -20.88
    Variability estimate
    Standard error of the mean
    Dispersion value
    3.73
    Notes
    [32] - The model includes treatment group, baseline LDL-C and ezetimibe use, scheduled visit, and the interaction of treatment with scheduled visit. Multiplicity adjusted p-value is significant if less than the familywise error rate of 0.05.

    Secondary: Mean Percent Change From Baseline in Triglycerides at Weeks 10 and 12

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    End point title
    Mean Percent Change From Baseline in Triglycerides at Weeks 10 and 12
    End point description
    End point type
    Secondary
    End point timeframe
    Baseline and Weeks 10 and 12
    End point values
    Placebo Q2W Placebo QM Evolocumab Q2W Evolocumab QM
    Number of subjects analysed
    54
    55
    110
    110
    Units: percent change
        least squares mean (standard error)
    9.09 ( 3.02 )
    7.49 ( 3.26 )
    -13.27 ( 2.14 )
    -9.25 ( 2.27 )
    Statistical analysis title
    Evolocumab Q2W vs Placebo Q2W
    Comparison groups
    Placebo Q2W v Evolocumab Q2W
    Number of subjects included in analysis
    164
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    < 0.001 [33]
    Method
    Repeated measures linear effects model
    Parameter type
    LS Mean Treatment Difference
    Point estimate
    -22.36
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -29.48
         upper limit
    -15.24
    Variability estimate
    Standard error of the mean
    Dispersion value
    3.6
    Notes
    [33] - The model includes treatment group, baseline LDL-C and ezetimibe use, scheduled visit, and the interaction of treatment with scheduled visit. Multiplicity adjusted p-value is significant if less than the familywise error rate of 0.05.
    Statistical analysis title
    Evolocumab QM vs Placebo QM
    Comparison groups
    Placebo QM v Evolocumab QM
    Number of subjects included in analysis
    165
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    < 0.001 [34]
    Method
    Repeated measures linear effects model
    Parameter type
    LS Mean Treatment Difference
    Point estimate
    -16.74
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -24.43
         upper limit
    -9.05
    Variability estimate
    Standard error of the mean
    Dispersion value
    3.89
    Notes
    [34] - The model includes treatment group, baseline LDL-C and ezetimibe use, scheduled visit, and the interaction of treatment with scheduled visit. Multiplicity adjusted p-value is significant if less than the familywise error rate of 0.05.

    Secondary: Percent Change From Baseline in Triglycerides at Week 12

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    End point title
    Percent Change From Baseline in Triglycerides at Week 12
    End point description
    End point type
    Secondary
    End point timeframe
    Baseline and Week 12
    End point values
    Placebo Q2W Placebo QM Evolocumab Q2W Evolocumab QM
    Number of subjects analysed
    54
    55
    110
    110
    Units: percent change
        least squares mean (standard error)
    3.5 ( 3.51 )
    6.43 ( 4.15 )
    -16.09 ( 2.49 )
    -5.13 ( 2.84 )
    Statistical analysis title
    Evolocumab Q2W vs Placebo Q2W
    Comparison groups
    Placebo Q2W v Evolocumab Q2W
    Number of subjects included in analysis
    164
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    < 0.001 [35]
    Method
    Repeated measures linear effects model
    Parameter type
    LS Mean Treatment Difference
    Point estimate
    -19.59
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -27.92
         upper limit
    -11.26
    Variability estimate
    Standard error of the mean
    Dispersion value
    4.22
    Notes
    [35] - The model includes treatment group, baseline LDL-C and ezetimibe use, scheduled visit, and the interaction of treatment with scheduled visit. Multiplicity adjusted p-value is significant if less than the familywise error rate of 0.05.
    Statistical analysis title
    Evolocumab QM vs Placebo QM
    Comparison groups
    Placebo QM v Evolocumab QM
    Number of subjects included in analysis
    165
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    < 0.001 [36]
    Method
    Repeated measures linear effects model
    Parameter type
    LS Mean Treatment Difference
    Point estimate
    -11.56
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -21.38
         upper limit
    -1.74
    Variability estimate
    Standard error of the mean
    Dispersion value
    4.97
    Notes
    [36] - The model includes treatment group, baseline LDL-C and ezetimibe use, scheduled visit, and the interaction of treatment with scheduled visit. Multiplicity adjusted p-value is significant if less than the familywise error rate of 0.05.

    Secondary: Mean Percent Change From Baseline in HDL-C at Weeks 10 and 12

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    End point title
    Mean Percent Change From Baseline in HDL-C at Weeks 10 and 12
    End point description
    End point type
    Secondary
    End point timeframe
    Baseline and Weeks 10 and 12
    End point values
    Placebo Q2W Placebo QM Evolocumab Q2W Evolocumab QM
    Number of subjects analysed
    54
    55
    110
    110
    Units: percent change
        least squares mean (standard error)
    -0.45 ( 1.7 )
    -2.86 ( 1.84 )
    7.93 ( 1.2 )
    6.62 ( 1.29 )
    Statistical analysis title
    Evolocumab Q2W vs Placebo Q2W
    Comparison groups
    Placebo Q2W v Evolocumab Q2W
    Number of subjects included in analysis
    164
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    < 0.001 [37]
    Method
    Repeated measures linear effects model
    Parameter type
    LS Mean Treatment Difference
    Point estimate
    8.38
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    4.36
         upper limit
    12.4
    Variability estimate
    Standard error of the mean
    Dispersion value
    2.04
    Notes
    [37] - The model includes treatment group, baseline LDL-C and ezetimibe use, scheduled visit, and the interaction of treatment with scheduled visit. Multiplicity adjusted p-value is significant if less than the familywise error rate of 0.05.
    Statistical analysis title
    Evolocumab QM vs Placebo QM
    Comparison groups
    Placebo QM v Evolocumab QM
    Number of subjects included in analysis
    165
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    < 0.001 [38]
    Method
    Repeated measures linear effects model
    Parameter type
    LS Mean Treatment Difference
    Point estimate
    9.48
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    5.1
         upper limit
    13.85
    Variability estimate
    Standard error of the mean
    Dispersion value
    2.21
    Notes
    [38] - The model includes treatment group, baseline LDL-C and ezetimibe use, scheduled visit, and the interaction of treatment with scheduled visit. Multiplicity adjusted p-value is significant if less than the familywise error rate of 0.05.

    Secondary: Percent Change From Baseline in HDL-C at Week 12

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    End point title
    Percent Change From Baseline in HDL-C at Week 12
    End point description
    End point type
    Secondary
    End point timeframe
    Baseline and Week 12
    End point values
    Placebo Q2W Placebo QM Evolocumab Q2W Evolocumab QM
    Number of subjects analysed
    54
    55
    110
    110
    Units: percent change
        least squares mean (standard error)
    -1.15 ( 1.91 )
    -3.73 ( 2.35 )
    8.05 ( 1.35 )
    5.35 ( 1.62 )
    Statistical analysis title
    Evolocumab Q2W vs Placebo Q2W
    Comparison groups
    Placebo Q2W v Evolocumab Q2W
    Number of subjects included in analysis
    164
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    < 0.001 [39]
    Method
    Repeated measures linear effects model
    Parameter type
    LS Mean Treatment Difference
    Point estimate
    9.2
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    4.66
         upper limit
    13.74
    Variability estimate
    Standard error of the mean
    Dispersion value
    2.3
    Notes
    [39] - The model includes treatment group, baseline LDL-C and ezetimibe use, scheduled visit, and the interaction of treatment with scheduled visit. Multiplicity adjusted p-value is significant if less than the familywise error rate of 0.05.
    Statistical analysis title
    Evolocumab QM vs Placebo QM
    Comparison groups
    Placebo QM v Evolocumab QM
    Number of subjects included in analysis
    165
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    < 0.001 [40]
    Method
    Repeated measures linear effects model
    Parameter type
    LS Mean Treatment Difference
    Point estimate
    9.07
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    3.48
         upper limit
    1466
    Variability estimate
    Standard error of the mean
    Dispersion value
    2.83
    Notes
    [40] - The model includes treatment group, baseline LDL-C and ezetimibe use, scheduled visit, and the interaction of treatment with scheduled visit. Multiplicity adjusted p-value is significant if less than the familywise error rate of 0.05.

    Secondary: Mean Percent Change From Baseline in Very Low-Density Lipoprotein Cholesterol (VLDL-C) at Weeks 10 and 12

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    End point title
    Mean Percent Change From Baseline in Very Low-Density Lipoprotein Cholesterol (VLDL-C) at Weeks 10 and 12
    End point description
    End point type
    Secondary
    End point timeframe
    Baseline and Weeks 10 and 12
    End point values
    Placebo Q2W Placebo QM Evolocumab Q2W Evolocumab QM
    Number of subjects analysed
    54
    55
    110
    110
    Units: percent change
        least squares mean (standard error)
    8.66 ( 2.9 )
    6.34 ( 3.27 )
    -13.97 ( 2.06 )
    -9.2 ( 2.27 )
    Statistical analysis title
    Evolocumab Q2W vs Placebo Q2W
    Comparison groups
    Placebo Q2W v Evolocumab Q2W
    Number of subjects included in analysis
    164
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    < 0.001 [41]
    Method
    Repeated measures linear effects model
    Parameter type
    LS Mean Treatment Difference
    Point estimate
    -22.63
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -29.46
         upper limit
    -15.81
    Variability estimate
    Standard error of the mean
    Dispersion value
    3.46
    Notes
    [41] - The model includes treatment group, baseline LDL-C and ezetimibe use, scheduled visit, and the interaction of treatment with scheduled visit. Multiplicity adjusted p-value is significant if less than the familywise error rate of 0.05.
    Statistical analysis title
    Evolocumab QM vs Placebo QM
    Comparison groups
    Placebo QM v Evolocumab QM
    Number of subjects included in analysis
    165
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    < 0.001 [42]
    Method
    Repeated measures linear effects model
    Parameter type
    LS Mean Treatment Difference
    Point estimate
    -15.54
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -23.25
         upper limit
    -7.84
    Variability estimate
    Standard error of the mean
    Dispersion value
    3.9
    Notes
    [42] - The model includes treatment group, baseline LDL-C and ezetimibe use, scheduled visit, and the interaction of treatment with scheduled visit. Multiplicity adjusted p-value is significant if less than the familywise error rate of 0.05.

    Secondary: Percent Change From Baseline in VLDL-C at Week 12

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    End point title
    Percent Change From Baseline in VLDL-C at Week 12
    End point description
    End point type
    Secondary
    End point timeframe
    Baseline and Week 12
    End point values
    Placebo Q2W Placebo QM Evolocumab Q2W Evolocumab QM
    Number of subjects analysed
    54
    55
    110
    110
    Units: percent change
        least squares mean (standard error)
    3.73 ( 3.5 )
    4.1 ( 4.17 )
    -17.25 ( 2.48 )
    -5.06 ( 2.84 )
    Statistical analysis title
    Evolocumab Q2W vs Placebo Q2W
    Comparison groups
    Placebo Q2W v Evolocumab Q2W
    Number of subjects included in analysis
    164
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    < 0.001 [43]
    Method
    Repeated measures linear effects model
    Parameter type
    LS Mean Treatment Difference
    Point estimate
    -20.97
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -29.29
         upper limit
    -12.66
    Variability estimate
    Standard error of the mean
    Dispersion value
    4.21
    Notes
    [43] - The model includes treatment group, baseline LDL-C and ezetimibe use, scheduled visit, and the interaction of treatment with scheduled visit. Multiplicity adjusted p-value is significant if less than the familywise error rate of 0.05.
    Statistical analysis title
    Evolocumab QM vs Placebo QM
    Comparison groups
    Placebo QM v Evolocumab QM
    Number of subjects included in analysis
    165
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    < 0.001 [44]
    Method
    Repeated measures linear effects model
    Parameter type
    LS Mean Treatment Difference
    Point estimate
    -9.17
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -19.01
         upper limit
    0.68
    Variability estimate
    Standard error of the mean
    Dispersion value
    4.98
    Notes
    [44] - The model includes treatment group, baseline LDL-C and ezetimibe use, scheduled visit, and the interaction of treatment with scheduled visit. Multiplicity adjusted p-value is significant if less than the familywise error rate of 0.05.

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    From the first dose of study drug until 28 days after the last dose (12 weeks).
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    17.0
    Reporting groups
    Reporting group title
    Placebo Q2W
    Reporting group description
    Participants received placebo subcutaneous injection once every 2 weeks (Q2W) and placebo tablets once a day for up to 12 weeks.

    Reporting group title
    Placebo QM
    Reporting group description
    Participants received placebo subcutaneous injection once every month (QM) and placebo tablets once a day for up to 12 weeks.

    Reporting group title
    Evolocumab Q2W
    Reporting group description
    Participants received 140 mg evolocumab by subcutaneous injection once every 2 weeks and placebo tablets once a day for up to 12 weeks.

    Reporting group title
    Evolocumab QM
    Reporting group description
    Participants received 420 mg evolocumab by subcutaneous injection once a month and placebo tablets once a day for up to 12 weeks.

    Serious adverse events
    Placebo Q2W Placebo QM Evolocumab Q2W Evolocumab QM
    Total subjects affected by serious adverse events
         subjects affected / exposed
    2 / 54 (3.70%)
    3 / 55 (5.45%)
    3 / 110 (2.73%)
    4 / 110 (3.64%)
         number of deaths (all causes)
    0
    0
    0
    0
         number of deaths resulting from adverse events
    Investigations
    Blood creatine phosphokinase increased
         subjects affected / exposed
    0 / 54 (0.00%)
    1 / 55 (1.82%)
    0 / 110 (0.00%)
    0 / 110 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Colonoscopy abnormal
         subjects affected / exposed
    0 / 54 (0.00%)
    0 / 55 (0.00%)
    0 / 110 (0.00%)
    1 / 110 (0.91%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Endoscopy gastrointestinal abnormal
         subjects affected / exposed
    0 / 54 (0.00%)
    0 / 55 (0.00%)
    0 / 110 (0.00%)
    1 / 110 (0.91%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Cardiac disorders
    Acute myocardial infarction
         subjects affected / exposed
    0 / 54 (0.00%)
    0 / 55 (0.00%)
    1 / 110 (0.91%)
    0 / 110 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Angina pectoris
         subjects affected / exposed
    0 / 54 (0.00%)
    0 / 55 (0.00%)
    1 / 110 (0.91%)
    1 / 110 (0.91%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Coronary artery disease
         subjects affected / exposed
    1 / 54 (1.85%)
    0 / 55 (0.00%)
    0 / 110 (0.00%)
    0 / 110 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Nervous system disorders
    Epilepsy
         subjects affected / exposed
    0 / 54 (0.00%)
    0 / 55 (0.00%)
    0 / 110 (0.00%)
    1 / 110 (0.91%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Gastrointestinal disorders
    Inguinal hernia
         subjects affected / exposed
    1 / 54 (1.85%)
    0 / 55 (0.00%)
    0 / 110 (0.00%)
    0 / 110 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Pancreatitis acute
         subjects affected / exposed
    0 / 54 (0.00%)
    0 / 55 (0.00%)
    0 / 110 (0.00%)
    1 / 110 (0.91%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Chronic obstructive pulmonary disease
         subjects affected / exposed
    0 / 54 (0.00%)
    1 / 55 (1.82%)
    0 / 110 (0.00%)
    0 / 110 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Skin and subcutaneous tissue disorders
    Erythema
         subjects affected / exposed
    0 / 54 (0.00%)
    0 / 55 (0.00%)
    1 / 110 (0.91%)
    0 / 110 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Psychiatric disorders
    Depression
         subjects affected / exposed
    0 / 54 (0.00%)
    1 / 55 (1.82%)
    0 / 110 (0.00%)
    0 / 110 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    Placebo Q2W Placebo QM Evolocumab Q2W Evolocumab QM
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    5 / 54 (9.26%)
    10 / 55 (18.18%)
    17 / 110 (15.45%)
    24 / 110 (21.82%)
    Nervous system disorders
    Dizziness
         subjects affected / exposed
    1 / 54 (1.85%)
    3 / 55 (5.45%)
    0 / 110 (0.00%)
    4 / 110 (3.64%)
         occurrences all number
    1
    3
    0
    4
    Headache
         subjects affected / exposed
    1 / 54 (1.85%)
    3 / 55 (5.45%)
    4 / 110 (3.64%)
    5 / 110 (4.55%)
         occurrences all number
    2
    4
    10
    6
    Musculoskeletal and connective tissue disorders
    Arthralgia
         subjects affected / exposed
    1 / 54 (1.85%)
    1 / 55 (1.82%)
    7 / 110 (6.36%)
    1 / 110 (0.91%)
         occurrences all number
    1
    1
    8
    1
    Back pain
         subjects affected / exposed
    0 / 54 (0.00%)
    1 / 55 (1.82%)
    2 / 110 (1.82%)
    6 / 110 (5.45%)
         occurrences all number
    0
    1
    2
    6
    Infections and infestations
    Nasopharyngitis
         subjects affected / exposed
    2 / 54 (3.70%)
    3 / 55 (5.45%)
    8 / 110 (7.27%)
    11 / 110 (10.00%)
         occurrences all number
    2
    3
    8
    14

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    01 Aug 2012
    - added testing for prior or existing HCV infection in high risk individuals and evaluation of viral load in those who show evidence thereof - clarified that subjects with known sensitivity to the “active substances or the excipients” were excluded - added urine pregnancy testing at day 1, week 4, and week 8 for women of childbearing potential - implemented minor error corrections
    10 Oct 2012
    - added the RUTHERFORD-2 study acronym and short title - added new evolocumab formulation and autoinjectors to allow administration of investigational product in a home-use setting - revised schedule of assessment and description of procedures in Section 7 to replace weeks 4 and 6 visits with home-use IP administration - added reporting requirements for product/device complaints - updated program status in evolocumab background section - added subjects with a history of HCV infection to the HCV antibody testing and viral load monitoring, if positive - updated sections on collection and reporting of adverse events and serious adverse events, including adding device related adverse events, and the serious adverse event contingency form - moved change from baseline in VLDL-C at week 12 from tertiary to secondary endpoints - added transient ischemic attacks and non-coronary revascularization as exploratory endpoints - made other minor clarifications and error corrections
    10 Dec 2012
    - added the LDL-C endpoint of mean percent change from baseline at weeks 10 and 12 as a co-primary endpoint - added the means of weeks 10 and 12 as co-secondary endpoints to all secondary endpoints - added alert threshold for elevated triglycerides - added publication references for primary result publications of phase 2 studies MENDEL and LAPLACE - introduced simplified terminology of QM dosing - made other minor clarifications and error corrections

    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.
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