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    Summary
    EudraCT Number:2015-002040-14
    Sponsor's Protocol Code Number:RVX222-CS-015
    National Competent Authority:Croatia - MIZ
    Clinical Trial Type:EEA CTA
    Trial Status:Completed
    Date on which this record was first entered in the EudraCT database:2015-11-10
    Trial 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 ConcernedCroatia - MIZ
    A.2EudraCT number2015-002040-14
    A.3Full title of the trial
    A Phase III Multi-Center, Double-Blind, Randomized, Parallel Group, Placebo-Controlled Clinical Trial in High-Risk Type 2 Diabetes Mellitus (T2DM) Subjects with Coronary Artery Disease (CAD) to Determine Whether Bromodomain Extraterminal Domain (BET) Inhibition Treatment with RVX000222 Increases the Time to Major Adverse Cardiovascular Events (MACE)
    Multicentrično, dvostruko slijepo, randomizirano, placebom kontrolirano kliničko ispitivanje 3. faze u paralelnim skupinama u ispitanika oboljelih od visokorizične šećerne bolesti tipa 2 i bolesti koronarnih arterija radi utvrđivanja da li liječenje inhibicijom bromodomene i ekstraterminalne domene lijekom RVX000222 produljuje vrijeme do ozbiljnog štetnog kardiovaskularnog događaja
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    International clinical trial to determine whether treatment with RVX000222 as compared to placebo increases time to occurrence of cardiac events in patients with Diabetes Mellitus and with a history of atherosclerotic cardiovascular disease.
    Međunarodno kliničko ispitivanje sa svrhom utvrđivanja da li terapija sa lijekom RVX000222 u usporedbi sa placebom produljuje vrijeme do pojave srčanih tegoba u bolesnika oboljelih od šećerne bolesti te sa poviješću aterosklerotske kardiovaskularne bolesti
    A.3.2Name or abbreviated title of the trial where available
    BETonMACE
    A.4.1Sponsor's protocol code numberRVX222-CS-015
    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 SponsorResverlogix Corp.
    B.1.3.4CountryCanada
    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 supportResverlogix Corp
    B.4.2CountryCanada
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationResverlogix Corp
    B.5.2Functional name of contact pointClinical Development
    B.5.3 Address:
    B.5.3.1Street Address44 Montgomery Street, Suite 2150
    B.5.3.2Town/ citySan Francisco
    B.5.3.3Post codeCA 94104
    B.5.3.4CountryUnited States
    B.5.4Telephone number001415470 5600
    B.5.5Fax number001415470 5600
    B.5.6E-mailmsweeney@resverlogix.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.3.1Product nameRVX000222
    D.3.2Product code RVX000222
    D.3.4Pharmaceutical form Capsule, hard
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPOral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNapabetalone
    D.3.9.2Current sponsor codeRVX000222
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    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 Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    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) No
    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 placeboCapsule, hard
    D.8.4Route of administration of the placeboOral use
    E. General Information on the Trial
    E.1 Medical condition or disease under investigation
    E.1.1Medical condition(s) being investigated
    Secondary cardiovascular disease (CVD) prevention in type 2 diabetes mellitus (T2DM) subjects with low high-density lipoprotein cholesterol (HDL-C) at high risk for MACE.
    Prevencija sekundarne kardiovaskularne bolesti u ispitanika oboljelih od šećerne bolesti tipa 2 s niskom razinom kolesterola visoke gustoće (HDL-kol.) i s visokim rizikom od ozbiljnog štetnog kardiovaskularnog događaja
    E.1.1.1Medical condition in easily understood language
    Prevention of cardiovascular events in type 2 diabetes mellitus patients with low high-density lipoprotein cholesterol levels and at high risk for major adverse cardiovascular events
    Prevencija sekundarne kardiovaskularne bolesti u ispitanika oboljelih od šećerne bolesti tipa 2 s niskom razinom kolesterola visoke gustoće i s visokim rizikom od kardiovaskularne bolesti
    E.1.1.2Therapeutic area Diseases [C] - Cardiovascular Diseases [C14]
    MedDRA Classification
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 20.0
    E.1.2Level LLT
    E.1.2Classification code 10051614
    E.1.2Term Arteriosclerotic cardiovascular disease
    E.1.2System Organ Class 100000004866
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 20.0
    E.1.2Level LLT
    E.1.2Classification code 10051615
    E.1.2Term Atherosclerotic cardiovascular disease
    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 evaluate if treatment with RVX000222 as compared to placebo increases time to the first occurrence of narrowly defined MACE. Narrowly defined MACE is defined as a single composite endpoint of CV death or Non-fatal MI or Stroke.
    Procijeniti da li lijek RVX000222 produljuje vrijeme do prve pojave usko definiranog ozbiljnog štetnog kardiovaskularnog događaja u usporedbi s placebom. Usko definirani ozbiljan štetni kardiovaskularni događaj definira se kao jedna kompozitna krajnja točka smrti zbog kardiovaskularnih uzroka, infarkta miokarda bez smrtnog ishoda ili moždanog udara
    E.2.2Secondary objectives of the trial
    - To evaluate if treatment with RVX000222 increases time to the first occurrence of broadly defined MACE in comparison to placebo
    -To evaluate if tretment with RVX000222 increases time to the first occurrence of fatal or non-fatal MI, or fatal or non-fatal stroke
    - To evaluate treatment group difference in all-cause mortality
    - To evaluate changes in lipoprotein concentrations including apoA-I, apolipoprotein B (apoB), LDL-C, HDL-C, and triglyceride (TG) over time within and between treatment groups
    - To evaluate changes in DM variables including glycated hemoglobin (HbA1c), fasting glucose, and fasting insulin over time within and between treatment groups
    - To evaluate changes in ALP over time within and between treatment groups including isoforms for whole population and quartiles of ALP baseline concentration
    - Assess changes in kidney function
    - To evaluate the safety and tolerability
    -Procijeniti produljuje li lijek vrijeme do 1 pojave široko definiranog ozbiljnog štetnog kardiovas. događaja u usporedbi s placebom
    -Procijeniti da li lijek produljuje vrijeme do 1 pojave infarkta miokarda s ili bez smrtnog ishoda ili moždanog udara s ili bez smrtnog ishoda
    -Procijeniti razlike u skupinama liječenja prema smrtnosti zbog svih uzroka
    -Procijeniti promjene u koncentracijama lipoproteina, uključujući apolipoproteine apoA-I i apoB, kolesterol niske gustoće, kolesterol visoke gustoće i trigliceride, tijekom vremena u skupinama liječenja
    -Procijeniti promjene u varijablama šećerne bolesti, uključujući glikirani hemoglobin, razine glukoze natašte i inzulina natašte, tijekom vremena u skupinama liječenja
    -Procijeniti promjene u razini alkalne fosfataze, uključujući izoforme za cijelu populaciju i kvartile početne koncentracije alkalne fosfataze, tijekom vremena u skupinama liječenja
    -Procijeniti promjene u funkciji bubrega
    -Procijeniti sigurnost i podnošljivost lijeka
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    1. Male and female subjects age 18 and over with documented diagnosed T2DM and a CAD event of either unstable angina or myocardial infarction, not less than 7 days and no more than 90 days prior to Visit 1. In order to have sufficient number of clinical
    events, the number of subjects with unstable angina will be limited to 25% of the total
    number of subjects
    -Unstable angina: for a qualifying unstable angina event, each of components (a), (b), and (c) must be satisfied:
    a. Characteristic ischemic pain or discomfort in chest or associated referral areas, occurring at rest or with minimal exertion
    b. ECG changes consistent with acute myocardial ischemia based upon at least one of the following:
    i. new or presumed new ST elevation
    ii. new or presumed new ST depression
    iii. new or presumed new T-wave inversion
    c. Objective evidence of obstructive coronary artery disease based upon at least one of the following:
    i. new or presumed new evidence of myocardial ischemia or infarction by perfusion imaging
    ii. new or presumed new regional wall motion abnormality
    iii. current evidence of at least one epicardial coronary artery stenosis ≥ 70% by coronary angiography
    iv. need for coronary revascularization for the index ACS event, including a
    percutaneous coronary intervention (PCI) with or without coronary stenting
    - Previous MI 7-90 days before screening, treated with or without a percutaneous
    coronary intervention (PCI). For a qualifying event of MI, two of the following
    three criteria must be satisfied:
    a. Characteristic ischemic chest pain or pain in associated referral areas
    b. Dynamic elevation of troponin T or I or CKMB, if troponin T or I is unavailable at the local lab (at least above the upper limit of normal for the laboratory)
    c. Development of new Q-waves in at least two adjacent electrocardiogram (ECG) leads or development of a new dominant R wave in V1
    2. Documented diagnosis of T2DM (one or more of the following criteria must be met):
    -Documented history of T2DM
    -History of taking diabetes medication
    -HbA1c ≥6.5% at Visit 1
    3. For males HDL-C of <40 mg/dL (1.04 mmol/L) and for females HDL-C of <45 mg/dL (1.17 mmol/L) at Visit 1.
    4. In the opinion of the Investigator, subjects currently not on high intensity statin therapy will be able to start rosuvastatin according to the protocol at Visit 1.
    5. In the opinion of the Investigator, subjects currently on statin therapy other than atorvastatin or rosuvastatin can be switched to rosuvastatin according to the protocol at Visit 1. High intensity statin therapy doses should remain unchanged during the study period if at all possible.
    6. Female subjects must meet one of the following:
    -If of childbearing potential, female subjects must have a negative urine pregnancy test and be willing and able to use medically acceptable non-hormonal method of birth control (non-hormonal intrauterine device, condom, or diaphragm) or remain abstinent from Screening until Follow-up Visit.
    -Be of non-child-bearing potential: post-surgical sterilization or post-menopausal.
    7. Have given signed informed consent to participate in this study.
    1. Bolesnice i bolesnici stariji od 18 godina s dokumentiranom dijagnozom šećerne bolesti tipa 2 i događajem povezanim s bolešću koronarnih arterija ili bilo nestabilnom anginom bilo infarktom miokarda između najmanje 7 i najviše 90 dana prije 1. posjeta. Da bi se dobio dovoljan broj kliničkih događaja, broj ispitanika s nestabilnom anginom ograničit će se na 25% od ukupnog broja ispitanika:
    -nestabilna angina: za kvalifikacijski događaj nestabilne angine moraju se zadovoljiti sve tri sljedeće komponente (a), (b) i (c):
    a. karakteristični ishemijski bolovi ili nelagoda u grudima ili u povezanim područjima koji se javljaju u mirovanju ili uz minimalan napor
    b. promjene na EKG-u konzistentne s akutnom ishemijom miokarda na temelju barem jednog od sljedećeg:
    i. nova ili pretpostavljeno nova elevacija ST-segmenta
    ii. nova ili pretpostavljeno nova depresija ST-segmenta
    iii. nova ili pretpostavljeno nova inverzija T-vala
    c. objektivni dokaz opstruktivne bolesti koronarne arterije na temelju barem jednog od sljedećeg:
    i. novi ili pretpostavljeno novi dokaz ishemije miokarda ili infarkta na perfuzijskoj scintigrafiji
    ii. nova ili pretpostavljeno nova abnormalnost pokretljivosti dijela srčane stjenke
    iii. postojeći dokaz najmanje jedne stenoze epikardijalne koronarne arterije ≥ 70 % na koronarnoj angiografiji
    iv. potreba za koronarnom revaskularizacijom zbog indeksnog događaja akutnog koronarnog sindroma, uključujući i perkutanu koronarnu intervenciju sa ili bez ugradnje koronarnih stentova
    - Infarkt miokarda u 7 do 90 dana prije probira liječen sa ili bez perkutane koronarne intervencija. Za kvalifikacijski događaj infarkta miokarda također se moraju ispuniti dva od sljedeća tri kriterija:
    a. karakteristični ishemijski bolovi u prsima ili bolovi s karakterističnim širenjem u vrat, lijevu ruku i leđa
    b. dinamičko povišenje razine troponina T ili I ili izoenzima CK-MB, ako testovi troponina T ili I nisu dostupni u lokalnom laboratoriju (najmanje iznad gornje granice normale za laboratorij)
    c. pojava novih Q-valova na najmanje dva susjedna odvoda elektrokardiograma ili pojava novog dominantnog R-vala u odvodu V1.
    2. Dokumentirana dijagnoza šećerne bolesti tipa 2 (mora biti ispunjen najmanje jedan od sljedećih kriterija):
    a. dokumentirana povijest šećerne bolesti tipa 2
    b. povijest uzimanja lijekova za šećernu bolest
    c. vrijednost HbA1c ≥ 6,5 % na 1. posjetu.
    3. HDL-kol. od < 40 mg/ml (1,04 mmol/l) za muškarce i < 45 mg/ml (1,17 mmol/l) za žene na 1. posjetu.
    4. Bolesnici koji trenutačno ne primaju intenziviranu statinsku terapiju, ali će prema mišljenju ispitivača od 1. posjeta moći početi primati rosuvastatin u skladu s planom ispitivanja.
    5. Bolesnici koji trenutačno primaju drugu statinsku terapiju osim atorvastatina ili rosuvastatina, ali će prema mišljenju ispitivača od 1. posjeta moći preći na primanje rosuvastatina u skladu s planom ispitivanja. Ako je moguće, tijekom ispitivanja se doze intenzivirane statinske terapije ne bi trebale mijenjati.
    6. Bolesnice moraju ispuniti jedan od sljedećih kriterija:
    a. ako mogu zatrudnjeti, moraju imati negativan test na trudnoću iz urina te biti voljne i sposobne koristiti medicinski prihvatljivu nehormonalnu metodu kontracepcije (nehormonalni unutarmaternični usadak, kondom ili dijafragma) ili se suzdržavati od spolnih odnosa od probira do posjeta za praćenje;
    b. nemogućnost da zatrudne zbog kirurške sterilizacije ili stanja postmenopauze.
    7. Potpisan informirani pristanak za sudjelovanje u ispitivanju.
    E.4Principal exclusion criteria
    1. Heart disease which, in the opinion of the investigator, will within 90 days of Visit 1 likely require coronary bypass, PCI, cardiac transplantation, surgical repair and/or replacement.
    2. Previous or current diagnosis of severe heart failure (New York Heart Association Class IV) or a documented left ventricular ejection fraction (LVEF) of <25% as determined by contrast left ventriculography, radionuclide ventriculography or echocardiography. The absence of a LVEF measurement in a subject without a previous or current diagnosis of heart failure does not prohibit entry into the study.
    3. Subjects with evidence of cardiac electrophysiologic instability including a history of uncontrolled ventricular arrhythmias, uncontrolled atrial fibrillation/flutter or uncontrolled supraventricular tachycardias with a ventricular response heart rate of >100 beats per minute at rest within 4 weeks prior to Visit 1.
    4. Coronary artery bypass grafting (CABG) within 90 days prior to Visit 1.
    5. Evidence of severe renal impairment as determined by any one of the following:
    -an eGFR <30 mL/min/1.7m2 at Visit 1
    -a current need for dialysis
    6. Uncontrolled hypertension defined as 2 consecutive measurements of sitting blood pressure of systolic >180 mm Hg or diastolic >100 mm Hg at Visit 1.
    7. Current or recent (within 12 months prior to Visit 1) treatment with immunosuppressants (e.g., cyclosporine).
    8. Use of fibrates at any dose or niacin/nicotinic acid 250 mg or more within 30 days prior to Visit 1.
    9. A known allergy or sensitivity to any ingredient in the investigational medicinal product.
    10. History of intolerance to atorvastatin or rosuvastatin.This exclusion criterion applies to subjects with a history of intolerance to the statin to which they would be assigned at screening
    11. Triglycerides >400 mg/dL (4.52 mmol/L) at Visit 1.
    12. Any medical or surgical condition which might significantly alter the absorption, distribution, metabolism or excretion of medication including, but not limited to any of the following: untreated or incompletely treated thyroid dysfunction, cholecystitis, Crohn’s disease, ulcerative colitis, or any gastric bypass alteration.
    13. Evidence of cirrhosis from liver imaging or biopsy, a history of hepatic encephalopathy, esophageal or gastric varices, active hepatitis, or prior porta-caval shunt procedure, or a Child-Pugh score of at least 5 points.
    -Any one of the following liver enzymes that is >1.5x the upper limit of normal range (ULN) by central lab at Visit 1
    a. Alanine aminotransferase (ALT)
    b. Aspartate aminotransferase (AST)
    14. A total bilirubin that is >ULN by central lab at Visit 1.
    15. History of malignancy of any organ system, treated or untreated, within the past 2 years whether or not there is evidence of local recurrence or metastases, with the exception of localized basal cell carcinoma of the skin.
    16. History or evidence of drug or alcohol abuse within 12 months of Visit 1, in the opinion of the investigator.
    17. Female subjects who are pregnant.
    18. Any condition which, in the opinion of the investigator, may place the subject at higher risk from his/her participation in the study, or is likely to prevent the subject from complying with the requirements of the study or completing the study.
    19. Use of other investigational drugs and devices within 30 days or 5 half-lives of Visit 1, whichever is longer.
    20. History of noncompliance with medical regimens or unwillingness to comply with the study protocol.
    21. Any condition that, in the opinion of the investigator, would confound the evaluation and interpretation of efficacy and/or safety data.
    22. Persons directly involved in the execution of this protocol.
    1. Bolest srca koja će prema mišljenju ispitivača u 90 dana od 1. posjeta zahtijevati koronarnu premosnicu, perkutanu koronarnu intervenciju, presađivanje srca, kiruršku sanaciju i/ili zamjenu.
    2. Prošla ili trenutna dijagnoza ozbiljnog zatajenja srca (klase IV prema ljestvici NYHA) ili dokumentirana ejekcijska frakcija lijeve klijetke od < 25 % utvrđena kontrastnom ventikulografijom, radionuklidnom ventikulografijom ili ehokardiografijom. Nepostojanje mjerenja ejekcijske frakcije lijeve klijetke u ispitanika bez prošle ili trenutne dijagnoze zatajenja srca ne sprječava uključivanje u ispitivanje.
    3. Ispitanici s elektrofiziološkom nestabilnošću srca, uključujući anamnezu nekontroliranih ventrikularnih aritmija, nekontrolirane atrijske fibrilacije/undulacije ili nekontroliranih supraventrikularnih tahikardija s odgovorom ventrikula > 100 otkucaja u minuti u stanju mirovanja u 4 tjedna prije 1. posjeta.
    4. Premoštenje koronarne arterije presatkom (CABG) u 90 dana prije 1. posjeta.
    5. Dokaz ozbiljnog poremećaja bubrega utvrđen jednim od sljedećeg:
    -procijenjenom stopom glomerularne filtracije < 30 ml/min/1,7m2 na 1. posjetu
    -trenutačnom potrebom za dijalizom.
    6. Nekontrolirana hipertenzija definirana kao 2 uzastopna mjerenja krvnog tlaka u sjedećem položaju sa sistoličkim tlakom > 180 mm Hg ili dijastoličkim tlakom > 100 mm Hg na 1. posjetu.
    7. Tekuće ili nedavno (u 12 mjeseci prije 1. posjeta) liječenje imunosupresivima (na primjer, s ciklosporinom).
    8. Primjena fibrata u bilo kojoj dozi ili niacinske/nikotinske kiseline od 250 mg ili više u 30 dana prije 1. posjeta.
    9. Poznata alergija ili osjetljivost na bilo koji sastojak ispitivanog medicinskog proizvoda.
    10. Povijest netolerancije atorvastatina ili rosuvastatina.Taj kriterij za neuključivanje odnosi se na bolesnike s poviješću nepodnošenja statina, čije primanje bi im bilo dodijeljeno na probiru.
    11. Trigliceridi > 400 mg/dl (4,52 mmol/l) na 1. posjetu.
    12. Bilo koje medicinsko ili kirurško stanje koje bi moglo značajno utjecati na apsorpciju, distribuciju, metabolizam ili izlučivanje lijeka, uključujući, ali se ne ograničavajući na bilo što od sljedećeg: neliječena ili nepotpuno izliječena disfunkcija štitnjače, kolecistitis, Crohnova bolest, ulcerozni kolitis ili bilo koji kirurški barijatrijski zahvat.
    13. Potvrđena ciroza jetre biopsijom jetre ili metodama snimanja, anamneza hepatalne encefalopatije, varikoziteti jednjaka ili želuca, aktivni hepatitis, prethodno operacijsko skretanje krvnog optoka (portokavalna skretnica) ili Child-Pughov zbroj od najmanje 5 bodova.
    -Bilo koji od sljedećih jetrenih enzima čija je razina za 1,5 puta veća od gornje granice normale na 1. posjetu prema rezultatima iz središnjeg laboratorija:
    i. alanin aminotransferaza (ALT)
    ii. aspartat aminotransferaza (AST).
    14. Ukupni bilirubin veći od gornje granice normale na 1. posjetu prema rezultatima iz središnjeg laboratorija.
    15. Anamneza malignih bolesti u bilo kojem organskom sustavu, liječenih ili neliječenih, u prethodne 2 godine bez obzira na to postoji li dokaz lokaliziranog povrata ili metastaza, uz iznimku lokaliziranoga karcinoma bazalnih stanica kože.
    16. Anamneza ili dokaz zloporabe droga ili alkohola u 12 mjeseci prije 1 posjeta, prema mišljenju ispitivača.
    17. Trudnice.
    18. Bilo koje stanje koje bi prema mišljenju ispitivača bolesnika moglo izložiti povećanom riziku zbog sudjelovanja u ispitivanju ili bi mu vjerojatno onemogućilo usklađivanje sa zahtjevima ispitivanja ili završavanje ispitivanja.
    19. Korištenje drugog ispitivanog lijeka ili uređaja u 30 dana ili 5 poluvremena raspadanja od 1. posjeta.
    20. Povijest nepridržavanja liječničkih uputa ili nevoljnost za usklađivanje s planom ispitivanja.
    21. Bilo koje stanje koje bi prema mišljenju ispitivača moglo utjecati na procjenu i tumačenje podataka o učinkovitosti i/ili sigurnosti.
    22. Osobe koje su izravno uključene u provođenje plana ispitivanja.
    E.5 End points
    E.5.1Primary end point(s)
    The primary endpoint will be time from randomization to the first occurrence of adjudication-confirmed MACE narrowly defined as a single composite endpoint of CV Death or Non-fatal MI or Stroke.
    Vrijeme od randomizacije do prve pojave na procjeni potvrđenog usko definiranog ozbiljnoga štetnoga kardiovaskularnog događaja kao jedne kompozitne krajnje točke smrti zbog kardiovaskularnih uzroka, infarkta miokarda bez smrtnog ishoda ili moždanog udara.
    E.5.1.1Timepoint(s) of evaluation of this end point
    Primary endpoints will be assessed until end of study treatment (104 weeks) or when the 250th event occurs, whichever occurs first.
    Primarne krajnje točke ispitivanja će se evaluirati do završetka terapijske faze ispitivanja (104 tjedna) ili do nastupa 250.-og događaja, što god nastupilo prije.
    E.5.2Secondary end point(s)
    1. Time from randomization to the first occurrence of adjudication-confirmed MACE broadly defined between treatment groups.
    Broadly defined MACE is the occurrence of any of the following events:
    -CV death
    -Non-fatal MI
    -Hospitalization for CVD events which include:
    -Unstable angina AND evidence of new or presumed new progressive obstructive coronary disease, OR
    -Emergency revascularization procedures at any time and urgent revascularization procedures ≥30 days after the index events prior to randomization
    - Stroke
    2. Time from randomization to fatal or non-fatal MI, or fataal or non-fatal stroke
    3. Time from randomization to CV Death or Non-fatal MI
    4. Time from randomization to Non-fatal MI
    5. Time from randomization to CV Death
    6. Time from randomization to Stroke
    7. All-cause mortality
    Other Secondary Endpoints:
    -The percent change in apoA-I, apoB, LDL-C, HDL-C, and TG over time within and between treatment groups
    -The change from baseline in HbA1c, fasting glucose, and fasting insulin within and between treatment groups
    -Changes in ALP within and between treatment groups for all subjects and according to quartiles of ALP baseline concentration
    -Changes from baseline in kidney function in subgroup population with estimated glomerular filtration rate <60 mL/min/1.7 m2 within and between treatment groups
    1. Vrijeme od randomizacije do prve pojave na procjeni potvrđenoga široko definiranog ozbiljnoga štetnoga kardiovaskularnog događaja u skupinama liječenja.
    Široko definirani ozbiljan štetni kardiovaskularni događaj je bilo koji od sljedećih događaja:
    -smrt zbog kardiovaskularnih uzroka
    -infarkt miokarda bez smrtnog ishoda
    -hospitalizacija zbog događaja povezanih s kardiovaskularnom bolešću, uključujući:
    -nestabilnu anginu i dokaze ili pretpostavke nove progresivne opstrukcije koronarnih žila, ili
    -postupke hitne revaskularizacije zbog neposredne opasnosti za život u bilo kojem trenutku i postupke manje hitne revaskularizacije u ≥ 30 dana nakon indeksnog događaja prije randomizacije
    -moždani udar.
    2. Vrijeme od randomizacije do prve pojave infarkta miokarda sa ili bez smrtnog ishoda ili moždanog udara sa ili bez smrtnog ishoda
    3. Vrijeme od randomizacije do smrti zbog kardiovaskularnih uzroka ili infarkta miokarda bez smrtnog ishoda.
    4. Vrijeme od randomizacije do infarkta miokarda bez smrtnog ishoda..
    5. Vrijeme od randomizacije do smrti zbog kardiovaskularnih uzroka.
    6. Vrijeme od randomizacije do moždanog udara.
    7. Smrtnost od svih uzroka.

    Ostale sekundarne krajnje točke
    -Postotak promjene vrijednosti lipoproteina apoA-I i apoB, kolesterola niske (LDL-kol.) i visoke (HDL-kol.) gustoće te triglicerida tijekom vremena u skupinama liječenja.
    -Promjene u odnosu na početne vrijednosti glikiranog hemoglobina (HbA1c), razine glukoze natašte i inzulina natašte u skupinama liječenja.
    -Promjene u razini alkalne fosfataze (ALP) u skupinama liječenja za sve ispitanike prema kvartilima početne koncentracije alkalne fosfataze.
    -Promjene u odnosu na početne vrijednosti u funkciji bubrega u podskupini populacije s početnom procijenjenom glomerularnom filtracijom < 60 ml//min/1,7 m2 u skupinama liječenja.

    E.5.2.1Timepoint(s) of evaluation of this end point
    Secondary endpoints will be assessed when the 250th event occurs
    Sekundarne krajnje točke ispitivanja će se evaluirati do nastupa 250.-og događaja
    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 Yes
    E.6.4Safety Yes
    E.6.5Efficacy Yes
    E.6.6Pharmacokinetic No
    E.6.7Pharmacodynamic No
    E.6.8Bioequivalence No
    E.6.9Dose response No
    E.6.10Pharmacogenetic No
    E.6.11Pharmacogenomic Yes
    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 concerned5
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA86
    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
    Argentina
    Australia
    Belgium
    Bulgaria
    Croatia
    Germany
    Hungary
    Israel
    Mexico
    Netherlands
    Poland
    Russian Federation
    Serbia
    Slovakia
    Taiwan
    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
    LVLS
    Zadnji posjet zadnjeg ispitanika
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years2
    E.8.9.1In the Member State concerned months9
    E.8.9.1In the Member State concerned days7
    E.8.9.2In all countries concerned by the trial years2
    E.8.9.2In all countries concerned by the trial months9
    E.8.9.2In all countries concerned by the trial days7
    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: 1440
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 960
    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 state95
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 1716
    F.4.2.2In the whole clinical trial 2400
    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
    Nema
    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 Decision2015-10-27
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2015-09-17
    P. End of Trial
    P.End of Trial StatusCompleted
    P.Date of the global end of the trial2019-07-04
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