E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
|
E.1.1.1 | Medical condition in easily understood language |
Patients with partial lipodystrophy |
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E.1.1.2 | Therapeutic area | Diseases [C] - Nutritional and Metabolic Diseases [C18] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 18.1 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10053857 |
E.1.2 | Term | Partial lipodystrophy |
E.1.2 | System Organ Class | 10040785 - Skin and subcutaneous tissue disorders |
|
E.1.3 | Condition being studied is a rare disease | Yes |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
To evaluate the efficacy of ISIS 304801 (300 mg once weekly) as compared to placebo on the percent change in fasting TG from baseline to Month 3. |
|
E.2.2 | Secondary objectives of the trial |
To evaluate the efficacy of ISIS 304801 as compared to placebo on:
• Absolute change from Baseline in fasting TG at 3, 6 and 12 months
• Percent of patients who achieve a ≥ 40% reduction in fasting TG at 3, 6 and 12 months
• Change from Baseline in hemoglobin A1c (HbA1c) at 6, 9 and 12 months
• Change from Baseline in fasting plasma glucose (FPG) at 6, 9 and 12 months
• Change from Baseline in liver volume and hepatic steatosis (as assessed by magnetic resonance imaging [MRI]) at 6 and 12 months
To evaluate the effects of ISIS 304801 as compared to placebo on:
• Safety and tolerability
• Prospectively adjudicated acute pancreatitis events (Atlanta classification) and Major Adverse Cardiovascular Events (MACE) |
|
E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1. Clinical diagnosis of partial lipodystrophy based on deficiency of subcutaneous body fat in a partial fashion assessed by physical examination, and at least one (1) MAJOR criterion and one (1) MINOR criterion (below):
MAJOR Criteria
a. Low skinfold thickness in anterior thigh by caliper measurement: men (≤ 10 mm) and women (≤ 22 mm) OR
b. Genetic diagnosis of familial PL (e.g., mutations in LMNA, PPAR-γ, AKT2, PLIN1 genes)
MINOR Criteria
a. Insulin resistance defined as fasting insulin ≥ 20 mcU/mL
b. Diabetes mellitus
c. Acanthosis nigricans
d. Polycystic ovary syndrome (PCOS) or PCOS-like symptoms (hirsutism, oligomenorrhea, and/or polycystic ovaries)
e. History of pancreatitis associated with hypertriglyceridemia
f. History of hepatic steatosis or steatohepatitis
g. Similar fat distribution and/or history of fat loss in a first degree relative
h. Prominent muscularity and phlebomegaly (enlarged veins) in the extremities
i. Disproportionate hyperphagia
2. Fasting TG ≥ 500 mg/dL (≥ 5.7 mmol/L) at Screening. |
|
E.4 | Principal exclusion criteria |
1. A diagnosis of generalized lipodystrophy
2. Current or history of autoimmune diseases (even with a diagnosis of PL) unless approved by the Investigator and Sponsor Medical Monitor
3. Acute pancreatitis within 4 weeks of Screening
4. History within 6 months of Screening of acute or unstable cardiac ischemia (myocardial infarction, acute coronary syndrome, new onset angina), stroke, transient ischemic attack or unstable congestive heart failure requiring a change in medication
5. Major surgery within 3 months of Screening
6. Previous treatment with ISIS-APOCIII Rx
7. Have any other conditions in the opinion of the investigator which could interfere with the patient participating in our completing the study |
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E.5 End points |
E.5.1 | Primary end point(s) |
The primary efficacy analysis will be the comparison of percent changes from Baseline to the primary analysis time point in fasting TG between ISIS 304801 300 mg once weekly group and placebo group |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
The primary analysis time point is at the end of Month 3 where the value is defined as the average of Week 12 and Week 13 fasting assessments
|
|
E.5.2 | Secondary end point(s) |
The secondary endpoints include:
• Absolute change from Baseline in fasting TG at 3, 6 and 12 months
• Proportion of patients who achieve a ≥ 40% reduction in fasting TG at 3, 6 and 12 months
• Change from Baseline in HbA1c at 6, 9 and 12 months
• Change from Baseline in fasting plasma glucose at 6, 9 and 12 months
• Change from Baseline in liver volume and hepatic steatosis (as assessed by MRI) at 6 and 12 months |
|
E.5.2.1 | Timepoint(s) of evaluation of this end point |
At the end of Month 3 where the value is defined as the average of Week 12 (Day 78) and Week 13 (Day 85) fasting assessments. The value at Month 6 is defined as the average of Week 25 and Week 26 and the value at Month 12 is defined
as the average of Week 51 and Week 52 fasting assessments. |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | Yes |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | Yes |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | No |
E.7.3 | Therapeutic confirmatory (Phase III) | Yes |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | No |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | Yes |
E.8.1.5 | Parallel group | No |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | Yes |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 2 |
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.8.4.1 | Number of sites anticipated in Member State concerned | 3 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 23 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
Australia |
Belgium |
Brazil |
Canada |
France |
Germany |
Italy |
Netherlands |
Poland |
Portugal |
Russian Federation |
Spain |
Turkey |
United Kingdom |
United States |
|
E.8.7 | Trial 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
|
|
E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | |
E.8.9.1 | In the Member State concerned months | 32 |
E.8.9.1 | In the Member State concerned days | |
E.8.9.2 | In all countries concerned by the trial months | 32 |