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    Summary
    EudraCT Number:2013-002646-36
    Sponsor's Protocol Code Number:B1481022
    National Competent Authority:Spain - AEMPS
    Clinical Trial Type:EEA CTA
    Trial Status:Completed
    Date on which this record was first entered in the EudraCT database:2013-12-05
    Trial results View results
    Index
    A. PROTOCOL INFORMATION
    B. SPONSOR INFORMATION
    C. APPLICANT IDENTIFICATION
    D. IMP IDENTIFICATION
    D.8 INFORMATION ON PLACEBO
    E. GENERAL INFORMATION ON THE TRIAL
    F. POPULATION OF TRIAL SUBJECTS
    G. INVESTIGATOR NETWORKS TO BE INVOLVED IN THE TRIAL
    N. REVIEW BY THE COMPETENT AUTHORITY OR ETHICS COMMITTEE IN THE COUNTRY CONCERNED
    P. END OF TRIAL
    Expand All   Collapse All
    A. Protocol Information
    A.1Member State ConcernedSpain - AEMPS
    A.2EudraCT number2013-002646-36
    A.3Full title of the trial
    PHASE 3 MULTI-CENTER, DOUBLE-BLIND, RANDOMIZED, PLACEBO-CONTROLLED, PARALLEL GROUP EVALUATION OF THE EFFICACY, SAFETY, AND TOLERABILITY OF PF-04950615, IN REDUCING THE
    OCCURRENCE OF MAJOR CARDIOVASCULAR EVENTS IN HIGH RISK SUBJECTS
    ESTUDIO DE FASE III MULTICÉNTRICO, DOBLE CIEGO, ALEATORIZADO, CONTROLADO CON PLACEBO Y CON GRUPOS PARALELOS PARA EVALUAR LA EFICACIA, LA SEGURIDAD Y LA TOLERABILIDAD DE PF-04950615 EN LA REDUCCIÓN DEL NÚMERO DE ACONTECIMIENTOS CARDIOVASCULARES GRAVES EN PACIENTES DE ALTO RIESGO
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    A Phase 3 multi-centre study to test the efficacy, safety and tolerability of PF-04950615 administered subcutaneously in reducing the occurrence of major cardiovascular events due to clogging up of arteries by fatty substances in high risk subjects.
    Estudio de fase III multicéntrico para evaluar la eficacia, la seguridad y la tolerabilidad de PF-04950615 por vía subcutánea en la reducción del número de acontecimientos cardiovasculares graves debido a la obstrucción arterial por lípidos en pacientes de alto riesgo.
    A.4.1Sponsor's protocol code numberB1481022
    A.7Trial is part of a Paediatric Investigation Plan No
    A.8EMA Decision number of Paediatric Investigation Plan
    B. Sponsor Information
    B.Sponsor: 1
    B.1.1Name of SponsorPfizer Inc., 235 East 42nd Street, New York, ny 10017
    B.1.3.4CountryUnited States
    B.3.1 and B.3.2Status of the sponsorCommercial
    B.4 Source(s) of Monetary or Material Support for the clinical trial:
    B.4.1Name of organisation providing supportPfizer Inc.
    B.4.2CountryUnited States
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationPfizer Inc
    B.5.2Functional name of contact pointClinical Trials.gov Call Centre
    B.5.3 Address:
    B.5.3.1Street Address235 East 42nd Street
    B.5.3.2Town/ cityNew York
    B.5.3.3Post codeNY 10017
    B.5.3.4CountryUnited States
    B.5.4Telephone number+3491490 99 00
    B.5.5Fax number+1303739 1119
    B.5.6E-mailClinicalTrials.gov.CallCentre@pfizer.com
    D. IMP Identification
    D.IMP: 1
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation No
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.2Product code PF-04950615
    D.3.4Pharmaceutical form Solution for injection
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPSubcutaneous use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNNot Applicable
    D.3.9.1CAS number 1407435-02-6
    D.3.9.2Current sponsor codePF-04950615
    D.3.9.3Other descriptive nameRN316
    D.3.9.4EV Substance CodeSUB31542
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number100
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin No
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) Yes
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) Yes
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.8 Information on Placebo
    D.8 Placebo: 1
    D.8.1Is a Placebo used in this Trial?Yes
    D.8.3Pharmaceutical form of the placeboSolution for injection
    D.8.4Route of administration of the placeboSubcutaneous use
    E. General Information on the Trial
    E.1 Medical condition or disease under investigation
    E.1.1Medical condition(s) being investigated
    atherosclerosis
    Ateroesclerosis
    E.1.1.1Medical condition in easily understood language
    high cholesterol
    Colesterol alto
    E.1.1.2Therapeutic area Diseases [C] - Cardiovascular Diseases [C14]
    MedDRA Classification
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 16.1
    E.1.2Level LLT
    E.1.2Classification code 10003601
    E.1.2Term Atherosclerosis
    E.1.2System Organ Class 100000004866
    E.1.3Condition being studied is a rare disease No
    E.2 Objective of the trial
    E.2.1Main objective of the trial
    To demonstrate the superior efficacy of PF-04950615 compared with placebo in reducing the risk of major CV events, a composite endpoint which includes adjudicated and confirmed CV death, non-fatal MI, non-fatal stroke, and hospitalization for unstable angina with urgent revascularization in subjects at high or very high risk of major CV events who are on maximally tolerated background lipid lowering treatment but have an LDL-C ? 70 mg/dL (1.8 mmol/L) and < 100 mg/dL (2.6 mmol/L) or non-HDL-C ? 100 mg/dL (2.6 mmol/L) and < 130 mg/dL (3.4 mmol/L).
    El objetivo principal de este ensayo clínico es demostrar la eficacia superior de PF-04950615 respecto al placebo en la reducción del riesgo de acontecimientos CV graves, un criterio de valoración compuesto que incluye muerte CV, IM no mortal, accidente cerebrovascular no mortal y hospitalización por angina inestable que requiere revascularización urgente adjudicados y confirmados en pacientes con riesgo alto o muy alto de acontecimientos CV graves que están recibiendo tratamiento hipolipemiante de base a la dosis máxima tolerada, pero que tienen un C-LDL ? 70 mg/dl y < 100 mg/dl o un C-no-HDL ? 100 mg/dl y < 130 mg/dl
    E.2.2Secondary objectives of the trial
    To demonstrate in subjects with high or very high risk of major CV events on maximally tolerated background lipid lowering treatment with LDL-C?70 mg/dL and <100 mg/dL or non-HDL-C ?100 mg/dL and <130 mg/dL, the superior efficacy of PF-04950615
    compared with placebo in reducing the risk of adjudicated and confirmed key secondary endpoints of: (please refer to protocol section 2.1.2)
    To evaluate in subjects with high or very high risk of major CV events on maximally tolerated background lipid lowering treatment with LDL-C ?70 mg/dL and <100 mg/dL or non-HDL-C ?100 mg/dL and < 130 mg/dL, the efficacy of PF-04950615 compared with placebo in reducing the risk of other adjudicated and confirmed secondary endpoints (please refer to protocol section 2.1.2)
    Demostrar en pacientes con un riesgo alto o muy alto de acontecimientos CV graves que estén siendo tratados con hipolipemiantes de base a la dosis máxima tolerada y con un C-LDL >= 70 mg/dl y < 100 mg/dl o un C-no-HDL >=100 mg/dl y < 130 mg/dl, la eficacia superior de PF-04950615 respecto al placebo en la reducción del riesgo de criterios de valoración secundarios clave adjudicados y confirmados (ver sección 2.1.2 del protocolo)
    Evaluar en pacientes con un riesgo alto o muy alto de acontecimientos CV graves que estén siendo tratados con hipolipemiantes de base a la dosis máxima tolerada y con un C-LDL >= 70 mg/dl y < 100 mg/dl o un C-no-HDL >=100 mg/dl y < 130 mg/dl, la eficacia superior de PF-04950615 respecto al placebo en la reducción del riesgo de criterios de valoración secundarios adjudicados y confirmados (ver sección 2.1.2 del protocolo)
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    1. Evidence of a personally signed and dated informed consent document indicating that the subject (or a legal representative) has been informed of all pertinent aspects of the study.
    2. Willing and able to comply with scheduled visits, treatment plan, laboratory tests, and other study procedures.
    3. Age: men or women aged ? 18 years for those with a confirmed prior CVD event; or men aged ? 55 years, or women, aged ? 65 years with a CVD risk equivalent.
    4. Willing and able to self-administer or be administered sub-cutaneous injections of investigational product.
    5. Must be treated with atorvastatin, rosuvastatin, or simvastatin, at the highest locally approved dose. If at a lower dose, there must be documentation that the subject is receiving a maximally tolerated dose of the aforementioned statins, or that the subject is at his or her LDL-C or non-HDL-C target; and no dose should be lower than atorvastatin 20 mg, rosuvastatin 20 mg, or simvastatin 40 mg, once a day.
    a. Subjects on simvastatin 80 mg must have been on this dose for > 1 year before
    screening.
    b. All subjects must be on a stable dose at least 6 weeks prior to screening. There should be no plans at the time of screening and randomization to modify the dose of statin for the duration of the trial.
    c. Source records and case report form (CRF) documentation of the above, must be shown.
    6. Qualifying CV risk factor: prior CVD event.
    A prior CVD event must be documented by source documentation that includes an anonymized hospital discharge summary describing the qualifying index CVD event diagnosis or surgical event and that includes documentation of the event?s date of occurrence.
    Qualifying prior CVD event:
    a. greater than thirty days but no more than five years post prior myocardial infarction as defined by the universal definition of MI excluding those with MI due to cocaine abuse or vasospasm) or ischemic stroke, as documented by hospital discharge summary and brain imaging scan
    b. greater than one year but no more than five years post previous cardiac revascularization including PCI or CABG, as documented by hospital discharge summary c. pre-existing arterial revascularization, documented as a carotid, or peripheral artery revascularization, as defined as surgery or stent placement and documented by hospital discharge summary (at least one month [30 days] but no more than five years prior to screening)
    7. Qualifying CV risk factor: CVD risk equivalent with two additional risk factors: Type I or Type II diabetes mellitus, as defined per local diabetes guidelines (eg, American Diabetes Association [ADA] in the U.S.A, European Association for the Study of Diabetes [EASD] in the European Union [E.U.]) heterozygous familial hypercholesterolemia (heFH), subjects with symptomatic peripheral vascular disease
    or chronic kidney disease (with a glomerular filtration rate of ?30 and ?60 mL/min/1.73m2, based on the screening visit measurement of creatinine, as calculated by Modification of Diet in Renal Disease [MDRD] formula, and not on dialysis) and ?55 years of age for men and ?65 years of age for women, with at least two of the following additional risk factors for CVD:
    a. Evidence of coronary artery stenoses of > 50% narrowing in at least two major coronary arteries as documented by coronary artery imaging;
    b. Current cigarette smoking, defined as smoking for 30 days or more (any number
    of cigarettes) at the time of screening;
    c. HDL-C < 40 mg/dL (< 1.0 mmol/L) as measured at the screening visit;
    d. hs-CRP > 2.0 mg/L documented within one year of the screening visit;
    e. A glomerular filtration rate (GFR) ?30 and ?60 mL/min/1.73m2 (based on the
    creatinine measured at the screening visit, and as calculated by the MDRD formula).
    8. Subject must have an LDL-C ?70 mg/dL (1.8 mmol/L) and < 100 mg/dL (2.6
    mmol/L) or non-HDL-C ?100 mg/dL (2.6 mmol/L) and < 130 mg/dL (3.4 mmol/L)
    at Visit 3.
    9. Male and female subjects of childbearing potential must agree to use a highly
    effective method of contraception throughout the study and for at least 63 days after the last dose of assigned treatment. A subject is of childbearing potential if, in the opinion of the investigator, he/she is biologically capable of having children and is sexually active.
    10. Female subjects who are not of childbearing potential should meet at least one of the following criteria:
    a. Have undergone a documented hysterectomy and/or bilateral oophorectomy; b. Have medically confirmed ovarian failure, or
    c. Achieved post-menopausal status, defined as: cessation of regular menses for at least 12 consecutive months with no alternative pathological or physiological cause; and have a serum follicle stimulating hormone (FSH) level within the laboratory?s reference range for postmenopausal females.
    1.Prueba de un documento de consentimiento informado, firmado y fechado personalmente, que indique que se ha informado al paciente (o a su representante legal) de todos los aspectos pertinentes del estudio.
    2.Desea y es capaz de cumplir con las visitas programadas, el plan de tratamiento, los análisis de laboratorio y otros procedimientos del estudio.
    3.Edad: hombres o mujeres de >=18 años de edad para aquellos que hayan sufrido un acontecimiento de ECV previo confirmado ; u hombres de >=55 años de edad, o mujeres de >=65 años de edad con un riesgo de ECV equivalente
    4.Desea y es capaz de autoadministrarse o de que le administren inyecciones subcutáneas del producto en investigación.
    5.Debe ser tratado con atorvastatina, rosuvastatina o simvastatina, a la dosis máxima aprobada localmente. Si está siendo tratado a una dosis inferior, debe existir documentación de que el paciente está recibiendo una dosis máxima tolerada de las estatinas antes mencionadas, o de que el paciente ha alcanzado su objetivo de C-LDL o C-no-HDL; ninguna dosis debe ser inferior a 20mg de atorvastatina, 20mg de rosuvastatina o 40mg de simvastatina, una vez al día; a)Los pacientes tratados con 80 mg de simvastatina deben haber permanecido en esta dosis durante >1 año antes de la selección. b)Todos los pacientes deben haber estado recibiendo una dosis estable al menos 6 semanas antes de la selección. No deben existir planes en el momento de la selección y la aleatorización de modificar la dosis de estatina mientras dure el ensayo.c) Debe mostrarse la documentación de los registros originales y el cuaderno de recogida de datos (CRD) de lo mencionado anteriormente.
    6.Factor de riesgo CV requerido: acontecimiento de ECV previo. Un acontecimiento de ECV previo, incluido un resumen anónimo del alta hospitalaria que describa el diagnóstico de acontecimiento de ECV índice requerido o el acontecimiento quirúrgico, y que incluya también documentación de la fecha en la que se produjo el acontecimiento. Acontecimiento de ECV previo requerido: a) >30 días pero no >15años después de un infarto de miocardio previo, tal como define la definición universal de IM (excepto aquellos con IM provocado por el abuso de cocaína o un vasoespasmo) o accidente cerebrovascular isquémico, documentado por el resumen del alta hospitalaria y un escáner cerebral; b) >1año pero no más >5años después de una revascularización cardiaca previa, incluidos la ICP y el IDAC, documentada por el resumen del alta hospitalaria; c)Revascularización arterial preexistente, documentada como revascularización carotídea o de arteria periférica, definida como cirugía o colocación de stent y documentada por el resumen del alta hospitalaria (al menos un mes [30 días] pero no más de cinco años antes de la selección).
    7.Factor de riesgo CV requerido: riesgo de ECV equivalente con dos factores de riesgo adicionales: Diabetes mellitus de tipo I o II, tal como definen las directrices de diabetes locales (p. ej., Asociación Americana para la Diabetes en los EE. UU., en la Unión Europea, hipercolesterolemia familiar heterocigótica (HFhe; tal como se define en el apéndice 2), pacientes con vasculopatía periférica sintomática (como se define en el apéndice 3) o enfermedad renal crónica (con una tasa de filtración glomerular ??30 y ??60 ml/min/1,73m2, basada en la medición de creatinina de la visita de selección, calculada mediante la fórmula de modificación de la dieta en la enfermedad renal y no en la diálisis) y ??55 años de edad para hombres y ??65 años de edad para mujeres, con al menos dos de los siguientes factores de riesgo adicionales para ECV: a) Evidencia de estenosis de arterias coronarias con un estrechamiento >50 % en al menos dos arterias coronarias principales, documentada mediante imágenes de las arterias coronarias; b) Tabaquismo actual, definido como fumar durante 30 días o más (cualquier número de cigarrillos) en el momento de la selección; c) C-HDL <40 mg/dl, medido en la visita de selección;d)PCRas >2,0mg/l documentada en el año anterior a la visita de selección;e)Una tasa de filtración glomerular ??0 y <=60ml/min/1,73m2 (basada en la creatinina medida en la visita de selección, y calculada mediante la fórmula MDER).
    8.El paciente debe tener un C-LDL >= 70 mg/dl y < 100 mg/dl (2,6 mmol/l) o un C-no-HDL >=100 mg/dl y < 130 mg/dl en la visita 3.
    9.Los pacientes de sexo masculino y femenino en edad fértil deben acceder a utilizar un método anticonceptivo altamente eficaz durante todo el estudio y durante, al menos, 63 días después de la última dosis del tratamiento asignado. Se considera que un paciente tiene capacidad reproductiva si, a juicio del investigador, está capacitado biológicamente para tener hijos y es sexualmente activo. (más criterios de inclusión en la sección 4.1. del protocolo)
    E.4Principal exclusion criteria
    1. Subjects who are investigational site staff members directly involved in the conduct of the trial and their family members, site staff members otherwise supervised by the Investigator, or subjects who are Pfizer employees directly involved in the conduct of the trial.
    2. A planned coronary (PCI or CABG) or other arterial revascularization.
    3. Participation in other studies involving molecule investigational drug(s) (Phases 1-4) within 1 month, any participation in a cholesteryl ester transfer protein inhibitor trial for any length of time, or biological agents within 6 months or 5 half lives, whichever is longer before the current study begins and/or during study participation. If the blind has been broken and the investigator knows (with documentation) that the subject received placebo, he/she can be included.
    4. Other severe, acute, or chronic medical or psychiatric condition or laboratory abnormality that may increase the risk associated with study participation or investigational product administration or may interfere with the interpretation of study results and, in the judgment of the investigator, would make the subject inappropriate for entry into this study.
    5. Pregnant females; breastfeeding females; males and females of childbearing potential who are unwilling or unable to use a highly effective method of contraception as outlined in this protocol for the duration of the study and for 63 days after last dose of investigational product.
    6. Latex sensitive individuals (due to potential for exposure to natural dry rubber in the prefilled syringe cap of investigational product, during administration).
    7.Potential subjects with an LDL-C < 70 mg/dL (< 1.8 mmol/L) or ? 100 mg/dL (2.6 mmol/L or non-HDL-C < 100 mg/dL (2.6 mmol/L) or ? 130 mg/dL (3.4 mmol/L) at Visit 1 or Visit 3.
    8. Undergoing lipid apheresis or planned start of lipid apheresis.
    9. Congestive heart failure of New York Heart Association (NYHA) Class IV, or left ventricular ejection fraction (LVEF) of <25%, measured by imaging.
    10. Potential subjects with end stage renal disease on dialysis.
    11. Potential subjects with chronic renal insufficiency and a creatinine clearance of < 30 ml/min/1.73m2 by MDRD formula.
    12. Poorly controlled hypertension (defined as the average of two systolic blood pressure (BP) measurements greater than 160 mm Hg or diastolic BP measurements greater than 100 mm Hg, even with treatment). Subjects who have hypertension and are controlled on stable dosages of anti-hypertensive medications can be included. Subjects may be permitted into the study if in the Principal Investigator?s opinion the assessment(s) are not clinically significant. BP measurement may be repeated up to three times within the hour or at the completion of the office visit, to confirm a reading.
    11. A prior history of hemorrhagic stroke.
    12. Plans to donate blood during the study.
    13. Current history of alcoholism or drug addiction according to diagnostic and statistical manual of mental disorders(DSM) IV criteria within 12 months prior to screening. Use of any recreational drugs within 12 months prior to screening.
    14. Medical history of positive testing for human immunodeficiency virus.
    15. Subjects with prior exposure to PF-04950615 (RN316) or other investigational PCSK9 inhibitor.
    16. Subjects who are receiving routine intramuscular(IM) injections or for whom IM therapy is anticipated during the course of the study. Elevations of Creatinine Kinase(CK) is known to occur with IM injections, hence the elimination of the use of IM injections with concomitant medications will minimize the diagnostic uncertainty of CK elevations.
    17. History of allergic or anaphylactic reaction to any therapeutic or diagnostic monoclonal antibody (immunoglobulin G protein) or molecules made of components of monoclonal antibodies (eg, Enbrel® which contains the fragment crystallizable (Fc) portion of an antibody or Lucentis® which is a monoclonal antibody fragment).
    18. Positive hepatitis B surface antigen hepatitis B core antibody, or hepatitis C antibody tests indicative of present or prior infection. NOTE: If a subject tests negative for HBsAg, but positive for HBcAb, the subject would be considered eligible if the subject tests positive for antibody to HB surface antigen (HBsAb or anti HBsAg) reflex testing.
    19. Creatinine kinase >3.0x upper limit of normal (ULN). A measurement >3.0xULN may be repeated once during screening, and if <3.0 xULN the subject is eligible.
    20. Alanine amino transferase (ALT) or aspartate amino transferase (AST)>2xULN.
    21. Direct bilirubin>1.5xULN.
    22. Subjects with cancer who are actively receiving chemotherapy. Potential subjects with a prior history of malignancy should have thorough documentation of the malignancy type and the extent of disease. Potential subjects considered at high risk of recurrence or the development of metastatic disease within the time frame of the conduct of the CT should be excluded.
    1.Pacientes que sean miembros del personal del centro de investigación directamente implicados en la realización del ensayo, así como sus familiares, miembros del personal del centro supervisados de alguna otra manera por el investigador o empleados de Pfizer directamente implicados en la realización del ensayo.
    2.Una revascularización coronaria (ICP o IDAC) u otra revascularización arterial planificada3.Participación en otros estudios que impliquen fármacos moleculares en investigación (fases I IV) en el mes anterior, cualquier participación en un ensayo de inhibidores de la proteína de transferencia del éster de colesterilo (CETP) de cualquier duración, o agentes biológicos en los 6 meses previos o 5 semividas, lo que sea más largo antes de que empiece el estudio actual o durante la participación en el estudio (el investigador debe consultar los documentos proporcionados por el paciente referentes al otro estudio para determinar la semivida del producto en investigación). Si se ha producido un desenmascaramiento y el investigador sabe (con documentación) que el paciente recibía placebo, este puede ser incluido.
    4.Otros trastornos médicos o psiquiátricos graves, agudos o crónicos, o anomalías analíticas que puedan aumentar el riesgo asociado con la participación en el estudio o con la administración del producto en investigación, o que puedan interferir en la interpretación de los resultados del estudio y, a juicio del investigador, hagan que el paciente no sea apto para incorporarse a este estudio.
    5.Mujeres embarazadas; mujeres en período de lactancia; mujeres y hombres en edad fértil que no desean o no pueden usar un método anticonceptivo altamente eficaz tal como se describe en este protocolo durante todo el estudio y en los 63 días posteriores a la última dosis del producto en investigación (véase la sección 4.4.2).
    6.Personas sensibles al látex (debido a la posible exposición al caucho natural seco del capuchón de las jeringas precargadas del producto en investigación, durante la administración).
    7.Pacientes potenciales con un C-LDL < 70 mg/dl o >= 100 mg/dl o un C-no-HDL < 100 mg/dl o >= 130 mg/dl en la visita 1 o la visita 3.
    8.Estar sometiéndose a una aféresis de lípidos o tener planeado iniciar una aféresis de lípidos.
    9.Insuficiencia cardiaca congestiva de la clase IV de la Asociación del Corazón de Nueva York (NYHA), o una fracción de eyección del ventrículo izquierdo (FEVI) de < 25 %, medida con pruebas de imagen.
    10.Pacientes potenciales con una enfermedad renal terminal en diálisis.
    11.Pacientes potenciales con insuficiencia renal crónica y un aclaramiento de creatinina < 30 ml/min/1,73 m2 mediante la fórmula MDER.
    12.Hipertensión mal controlada (definida como la media de dos mediciones de la tensión arterial (TA) sistólica superior a 160 mmHg o mediciones de TA diastólica superior a 100 mmHg, incluso con tratamiento). Los pacientes con hipertensión y controlados con dosificaciones estables de medicaciones antihipertensivas pueden ser incluidos. Se puede permitir la inclusión en el estudio de pacientes si, a juicio del investigador principal, las evaluaciones no son clínicamente significativas. La medición de la TA se puede repetir hasta tres veces en una hora o al finalizar la visita en la consulta, para confirmar la lectura.
    11. Antecedentes de accidente cerebrovascular hemorrágico.
    12.Tener previsto donar sangre durante el estudio.
    13.Historia actual de alcoholismo o drogadicción según los criterios de la cuarta edición del Manual diagnóstico y estadístico de los trastornos mentales (DSM) dentro de los 12 meses previos a la selección. Uso de cualquier droga recreativa en los 12 meses previos a la selección.
    14.Antecedentes médicos de pruebas positivas para el virus de la inmunodeficiencia humana (VIH).
    15.Pacientes que han estado expuestos previamente a PF-04950615 (RN316) u otros inhibidores de la PCSK9 en investigación.
    16.Pacientes que están recibiendo inyecciones intramusculares (i.m.) rutinarias o para los que está previsto una terapia i.m. durante la duración del estudio. Se sabe que las inyecciones i.m. provocan elevaciones de la creatinina [sic: creatina] quinasa (CK), por lo que la eliminación del uso de inyecciones i.m. con medicaciones concomitantes minimizará la incerteza diagnóstica de las elevaciones de la CK.
    17.Antecedentes de reacciones alérgicas o anafilácticas a algún anticuerpo monoclonal terapéutico o diagnóstico (proteína inmunoglobulina G [IgG]) o a moléculas formadas por componentes de anticuerpos monoclonales (p. ej., Enbrel®, que contiene la porción fragmento cristalizable (Fc) de un anticuerpo, o Lucentis®, que es un fragmento de anticuerpo monoclonal). (más criterios de exclusión en la sección 4.2. del protocolo)
    E.5 End points
    E.5.1Primary end point(s)
    the time from randomisation to confirmed CV death, non-fatal MI, non-fatal stroke, and hospitalization for unstable angina needing urgent revascularization
    El tiempo desde la aleatorización hasta la confirmación de un acontecimiento cardiovascular grave, un criterio de valoración compuesto que incluye la muerte CV, el IM no mortal, el accidente cerebrovascular no mortal y la hospitalización a causa de angina inestable que requiere revascularización urgente.
    E.5.1.1Timepoint(s) of evaluation of this end point
    time to first occurence
    tiempo hasta la primera aparición.
    E.5.2Secondary end point(s)
    Time from randomisation to confirmed:
    1. Hospitalization for unstable angina needing urgent revascularization;
    2. Composite endpoint of CV death, non-fatal MI, and non-fatal stroke;
    3. Composite endpoint of all cause death, non-fatal MI, non-fatal stroke, and hospitalization for unstable angina needing urgent coronary revascularization.
    Tiempo desde la aleatorización hasta la confirmación:
    ?Hospitalización a causa de angina inestable que requiere revascularización urgente;
    ?Un criterio de valoración compuesto de muerte CV, IM no mortal y accidente cerebrovascular no mortal;
    ?Un criterio de valoración compuesto de muerte por cualquier causa, IM no mortal, accidente cerebrovascular no mortal y hospitalización por angina inestable que requiere revascularización urgente.
    E.5.2.1Timepoint(s) of evaluation of this end point
    time to first occurence
    tiempo hasta la primera aparición.
    E.6 and E.7 Scope of the trial
    E.6Scope of the trial
    E.6.1Diagnosis No
    E.6.2Prophylaxis No
    E.6.3Therapy No
    E.6.4Safety Yes
    E.6.5Efficacy Yes
    E.6.6Pharmacokinetic Yes
    E.6.7Pharmacodynamic Yes
    E.6.8Bioequivalence No
    E.6.9Dose response No
    E.6.10Pharmacogenetic No
    E.6.11Pharmacogenomic No
    E.6.12Pharmacoeconomic No
    E.6.13Others No
    E.7Trial type and phase
    E.7.1Human pharmacology (Phase I) No
    E.7.1.1First administration to humans No
    E.7.1.2Bioequivalence study No
    E.7.1.3Other No
    E.7.1.3.1Other trial type description
    E.7.2Therapeutic exploratory (Phase II) No
    E.7.3Therapeutic confirmatory (Phase III) Yes
    E.7.4Therapeutic use (Phase IV) No
    E.8 Design of the trial
    E.8.1Controlled Yes
    E.8.1.1Randomised Yes
    E.8.1.2Open No
    E.8.1.3Single blind No
    E.8.1.4Double blind Yes
    E.8.1.5Parallel group Yes
    E.8.1.6Cross over No
    E.8.1.7Other No
    E.8.2 Comparator of controlled trial
    E.8.2.1Other medicinal product(s) No
    E.8.2.2Placebo Yes
    E.8.2.3Other No
    E.8.2.4Number of treatment arms in the trial2
    E.8.3 The trial involves single site in the Member State concerned No
    E.8.4 The trial involves multiple sites in the Member State concerned Yes
    E.8.4.1Number of sites anticipated in Member State concerned33
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA241
    E.8.6 Trial involving sites outside the EEA
    E.8.6.1Trial being conducted both within and outside the EEA Yes
    E.8.6.2Trial being conducted completely outside of the EEA No
    E.8.6.3If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned
    Belgium
    Canada
    China
    Denmark
    France
    Italy
    Japan
    Netherlands
    New Zealand
    Romania
    Slovakia
    Sweden
    Argentina
    Australia
    Brazil
    Colombia
    Czech Republic
    Finland
    Germany
    Hungary
    India
    Korea, Republic of
    Puerto Rico
    Spain
    Thailand
    Israel
    Mexico
    Peru
    Philippines
    Poland
    Russian Federation
    South Africa
    Switzerland
    Taiwan
    Turkey
    United Kingdom
    United States
    E.8.7Trial has a data monitoring committee Yes
    E.8.8 Definition of the end of the trial and justification where it is not the last visit of the last subject undergoing the trial
    End of Trial in a MS of the EU is defined as the time at which it is deemed that sufficient subjects have been recruited and completed the study as stated in the Clinical Trial Application and ethics application in the MS. Poor recruitment (recruiting less than the anticipated number in the CTA) by a MS is not a reason for premature termination but is considered a normal conclusion to the study in that MS. End of Trial in all other participating countries is defined as LSLV.
    El final del ensayo en un EM de la UE se define como el momento en el que se considera suficiente el nº de pacientes que han sido reclutados y que han completado el estudio, según se indica en la solicitud presentada ante las autoridades reguladoras y en la solicitud presentada ante el CEIC en el EM. Un reclutamiento insuficiente de pacientes (< al nº previsto en la CTA) en un EM no es motivo de finalización prematura, sino que se considera una conclusión normal del estudio en dicho EM.
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years3
    E.8.9.1In the Member State concerned months8
    E.8.9.1In the Member State concerned days12
    E.8.9.2In all countries concerned by the trial years3
    E.8.9.2In all countries concerned by the trial months8
    E.8.9.2In all countries concerned by the trial days12
    F. Population of Trial Subjects
    F.1 Age Range
    F.1.1Trial has subjects under 18 No
    F.1.1.1In Utero No
    F.1.1.2Preterm newborn infants (up to gestational age < 37 weeks) No
    F.1.1.3Newborns (0-27 days) No
    F.1.1.4Infants and toddlers (28 days-23 months) No
    F.1.1.5Children (2-11years) No
    F.1.1.6Adolescents (12-17 years) No
    F.1.2Adults (18-64 years) Yes
    F.1.2.1Number of subjects for this age range: 4800
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 7200
    F.2 Gender
    F.2.1Female Yes
    F.2.2Male Yes
    F.3 Group of trial subjects
    F.3.1Healthy volunteers No
    F.3.2Patients Yes
    F.3.3Specific vulnerable populations Yes
    F.3.3.1Women of childbearing potential not using contraception No
    F.3.3.2Women of child-bearing potential using contraception Yes
    F.3.3.3Pregnant women No
    F.3.3.4Nursing women No
    F.3.3.5Emergency situation No
    F.3.3.6Subjects incapable of giving consent personally No
    F.3.3.7Others No
    F.4 Planned number of subjects to be included
    F.4.1In the member state485
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 3923
    F.4.2.2In the whole clinical trial 12000
    F.5 Plans for treatment or care after the subject has ended the participation in the trial (if it is different from the expected normal treatment of that condition)
    none
    ninguno
    G. Investigator Networks to be involved in the Trial
    N. Review by the Competent Authority or Ethics Committee in the country concerned
    N.Competent Authority Decision Authorised
    N.Date of Competent Authority Decision2014-02-12
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2014-01-31
    P. End of Trial
    P.End of Trial StatusCompleted
    P.Date of the global end of the trial2017-01-23
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