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    Clinical Trial Results:
    Two part (double-blind inclisiran versus placebo [Year 1] followed by open-label inclisiran [Year 2]) randomized multicenter study to evaluate safety, tolerability, and efficacy of inclisiran in adolescents (12 to less than 18 years) with homozygous familial hypercholesterolemia and elevated LDL-cholesterol (ORION-13)

    Summary
    EudraCT number
    2020-002755-38
    Trial protocol
    SI   GR   NL   FR  
    Global end of trial date
    18 Nov 2024

    Results information
    Results version number
    v1(current)
    This version publication date
    30 May 2025
    First version publication date
    30 May 2025
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    CKJX839C12302
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT04659863
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Novartis Pharma AG
    Sponsor organisation address
    Novartis Campus, Basel, Switzerland,
    Public contact
    Clinical Disclosure Office, Novartis Pharma AG, 41 613241111, Novartis.email@Novartis.com
    Scientific contact
    Clinical Disclosure Office, Novartis Pharma AG, 41 613241111, Novartis.email@Novartis.com
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    Yes
    EMA paediatric investigation plan number(s)
    EMEA-002214-PIP01-17
    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?
    Yes
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    18 Nov 2024
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    18 Nov 2024
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    The main objective of the trial was to evaluate the efficacy, safety and tolerability of inclisiran in adolescents (aged 12 to <18 years) with homozygous familial hypercholesterolaemia (HoFH). Due to EudraCT system limitations, which EMA is aware of, data using 999 as data points in this record are not an accurate representation of the clinical trial results. Please use https://www.novctrd.com/CtrdWeb/home.nov for complete trial results.
    Protection of trial subjects
    The study was in compliance with the ethical principles derived from the Declaration of Helsinki and the International Conference on Harmonization (ICH) Good Clinical Practice (GCP) guidelines. All the local regulatory requirements pertinent to safety of trial subjects were also followed during the conduct of the trial.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    16 Feb 2021
    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: 2
    Country: Number of subjects enrolled
    France: 1
    Country: Number of subjects enrolled
    Greece: 2
    Country: Number of subjects enrolled
    Lebanon: 1
    Country: Number of subjects enrolled
    Malaysia: 2
    Country: Number of subjects enrolled
    Netherlands: 2
    Country: Number of subjects enrolled
    Türkiye: 2
    Country: Number of subjects enrolled
    United States: 1
    Worldwide total number of subjects
    13
    EEA total number of subjects
    5
    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)
    13
    Adults (18-64 years)
    0
    From 65 to 84 years
    0
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    Thirteen participants were randomized from 9 study centers in 8 countries. The breakdown of countries and study centers for the randomized participants was as follows: Canada (1), France (1), Greece (1), Lebanon (1), Malaysia (1), Netherlands (1), Turkey (2), and United States (1).

    Pre-assignment
    Screening details
    The study had an approximately 4-week screening/run-in period

    Period 1
    Period 1 title
    Part 1 (Double-blind 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
    Part 1- Inclisiran
    Arm description
    Inclisiran sodium 300 mg subcutaneous (sc) injection (given at Days 1, 90 and 270)
    Arm type
    Experimental

    Investigational medicinal product name
    Inclisiran
    Investigational medicinal product code
    KJX839
    Other name
    Pharmaceutical forms
    Solution for injection
    Routes of administration
    Subcutaneous use
    Dosage and administration details
    Inclisiran sodium 300 mg(equivalent to 284 mginclisiran) in 1.5 mL solution

    Arm title
    Part 1 - Placebo
    Arm description
    Placebo sc injection (given at Day 1, 90 and 270)
    Arm type
    Placebo

    Investigational medicinal product name
    Placebo
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for injection
    Routes of administration
    Subcutaneous use
    Dosage and administration details
    Placebo formulation to the active drug formulation

    Number of subjects in period 1
    Part 1- Inclisiran Part 1 - Placebo
    Started
    9
    4
    Completed
    9
    4
    Period 2
    Period 2 title
    Part 2 (Open-label period)
    Is this the baseline period?
    No
    Allocation method
    Not applicable
    Blinding used
    Not blinded

    Arms
    Arm title
    Part 2 – Inclisiran (Total)
    Arm description
    Inclisiran sodium 300 mg sc injection (given at Days 450 and 630). In addition, participants assigned to placebo in Part 1 received inclisiran sodium 300 mg sc injection on Day 360, while participants assigned to inclisiran in Part 1 received placebo sc injection on Day 360
    Arm type
    Experimental

    Investigational medicinal product name
    Inclisiran
    Investigational medicinal product code
    KJX839
    Other name
    Pharmaceutical forms
    Solution for injection
    Routes of administration
    Subcutaneous use
    Dosage and administration details
    Inclisiran sodium 300 mg(equivalent to 284 mginclisiran) in 1.5 mL solution

    Number of subjects in period 2
    Part 2 – Inclisiran (Total)
    Started
    13
    Completed
    13

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Part 1- Inclisiran
    Reporting group description
    Inclisiran sodium 300 mg subcutaneous (sc) injection (given at Days 1, 90 and 270)

    Reporting group title
    Part 1 - Placebo
    Reporting group description
    Placebo sc injection (given at Day 1, 90 and 270)

    Reporting group values
    Part 1- Inclisiran Part 1 - Placebo Total
    Number of subjects
    9 4 13
    Age Categorical
    Units: participants
        <=18 years
    9 4 13
        Between 18 and 65 years
    0 0 0
        >=65 years
    0 0 0
    Age Continuous
    Units: years
        arithmetic mean (standard deviation)
    14.6 ( 1.54 ) 15.1 ( 2.66 ) -
    Sex: Female, Male
    Units: participants
        Female
    7 2 9
        Male
    2 2 4
    Race/Ethnicity, Customized
    Units: Subjects
        Asian
    1 1 2
        White
    8 3 11

    End points

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    End points reporting groups
    Reporting group title
    Part 1- Inclisiran
    Reporting group description
    Inclisiran sodium 300 mg subcutaneous (sc) injection (given at Days 1, 90 and 270)

    Reporting group title
    Part 1 - Placebo
    Reporting group description
    Placebo sc injection (given at Day 1, 90 and 270)
    Reporting group title
    Part 2 – Inclisiran (Total)
    Reporting group description
    Inclisiran sodium 300 mg sc injection (given at Days 450 and 630). In addition, participants assigned to placebo in Part 1 received inclisiran sodium 300 mg sc injection on Day 360, while participants assigned to inclisiran in Part 1 received placebo sc injection on Day 360

    Primary: Percentage change in LDL-C from baseline to Day 330 (Part 1/Year 1)

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    End point title
    Percentage change in LDL-C from baseline to Day 330 (Part 1/Year 1)
    End point description
    Percentage change in low-density lipoprotein cholesterol (LDL-C) from baseline to Day 330 (Year 1)
    End point type
    Primary
    End point timeframe
    Baseline and Day 330
    End point values
    Part 1- Inclisiran Part 1 - Placebo
    Number of subjects analysed
    9
    4
    Units: percent change in LDL-C
        arithmetic mean (standard deviation)
    -21.6 ( 13.36 )
    11.7 ( 30.52 )
    Statistical analysis title
    Mean difference
    Comparison groups
    Part 1- Inclisiran v Part 1 - Placebo
    Number of subjects included in analysis
    13
    Analysis specification
    Pre-specified
    Analysis type
    Method
    Parameter type
    Mean difference (net)
    Point estimate
    -33.25
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -59.17
         upper limit
    -7.34

    Secondary: Time-adjusted percent change in LDL-C from baseline after Day 90 and up to Day 330 (Part 1/Year 1)

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    End point title
    Time-adjusted percent change in LDL-C from baseline after Day 90 and up to Day 330 (Part 1/Year 1)
    End point description
    Time-adjusted percent change in LDL-C (after Day 90 and up to Day 330), calculated as the average of percent changes from baseline to Days 150, 270 and 330
    End point type
    Secondary
    End point timeframe
    Baseline, after Day 90 up to Day 330
    End point values
    Part 1- Inclisiran Part 1 - Placebo
    Number of subjects analysed
    9
    4
    Units: Time-adjusted percent change in LDL-C
        arithmetic mean (standard deviation)
    -21.0 ( 15.11 )
    13.0 ( 41.88 )
    No statistical analyses for this end point

    Secondary: Percent change in LDL-C from baseline up to Day 720

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    End point title
    Percent change in LDL-C from baseline up to Day 720
    End point description
    Percentage change in LDL-C from baseline to each assessment time up to Day 720.
    End point type
    Secondary
    End point timeframe
    Baseline, up to Day 720
    End point values
    Part 1- Inclisiran Part 2 – Inclisiran (Total) Part 1 - Placebo
    Number of subjects analysed
    9
    13
    4
    Units: Percent change in LDL-C
    arithmetic mean (standard deviation)
        Day 90
    -26.1 ( 13.53 )
    999 ( 999 )
    6.8 ( 16.83 )
        Day 150
    -24.1 ( 14.65 )
    999 ( 999 )
    17.0 ( 41.22 )
        Day 270
    -17.3 ( 21.64 )
    999 ( 999 )
    10.2 ( 54.00 )
        Day 330
    -21.6 ( 13.36 )
    999 ( 999 )
    11.7 ( 30.52 )
        Day 360
    -19.3 ( 14.75 )
    999 ( 999 )
    5.4 ( 28.24 )
        Day 450
    999 ( 999 )
    -11.0 ( 25.28 )
    999 ( 999 )
        Day 510
    999 ( 999 )
    -12.5 ( 22.52 )
    999 ( 999 )
        Day 630
    999 ( 999 )
    -9.4 ( 26.16 )
    999 ( 999 )
        Day 720
    999 ( 999 )
    -12.6 ( 28.45 )
    999 ( 999 )
    No statistical analyses for this end point

    Secondary: Absolute change in LDL-C from baseline up to Day 720

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    End point title
    Absolute change in LDL-C from baseline up to Day 720
    End point description
    Absolute change in LDL-C from baseline to each assessment time up to Day 720.
    End point type
    Secondary
    End point timeframe
    Baseline, up to Day 720
    End point values
    Part 1- Inclisiran Part 2 – Inclisiran (Total) Part 1 - Placebo
    Number of subjects analysed
    9
    13
    4
    Units: mg/dL
    arithmetic mean (standard deviation)
        Day 90
    -70.6 ( 48.81 )
    999 ( 999 )
    16.5 ( 44.96 )
        Day 150
    -66.1 ( 61.85 )
    999 ( 999 )
    20.3 ( 91.34 )
        Day 270
    -47.1 ( 83.15 )
    999 ( 999 )
    -9.3 ( 134.14 )
        Day 330
    -62.9 ( 52.35 )
    999 ( 999 )
    11.8 ( 69.94 )
        Day 360
    -50.8 ( 44.65 )
    999 ( 999 )
    -4.3 ( 69.84 )
        Day 450
    999 ( 999 )
    -36.6 ( 75.08 )
    999 ( 999 )
        Day 510
    999 ( 999 )
    -46.8 ( 73.04 )
    999 ( 999 )
        Day 630
    999 ( 999 )
    -41.9 ( 92.47 )
    999 ( 999 )
        Day 720
    999 ( 999 )
    -39.8 ( 96.59 )
    999 ( 999 )
    No statistical analyses for this end point

    Secondary: Percent change in Apo B from baseline up to Day 720

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    End point title
    Percent change in Apo B from baseline up to Day 720
    End point description
    Percentage change in apolipoprotein B (Apo B) from baseline to each assessment time up to Day 720.
    End point type
    Secondary
    End point timeframe
    Baseline, up to Day 720
    End point values
    Part 1- Inclisiran Part 2 – Inclisiran (Total) Part 1 - Placebo
    Number of subjects analysed
    9
    13
    4
    Units: Percent change in Apo B
    arithmetic mean (standard deviation)
        Day 150
    -20.3 ( 12.92 )
    999 ( 999 )
    10.0 ( 27.05 )
        Day 330
    -18.5 ( 10.47 )
    999 ( 999 )
    4.5 ( 17.91 )
        Day 360
    -14.8 ( 10.11 )
    999 ( 999 )
    10.6 ( 21.33 )
        Day 510
    999 ( 999 )
    -5.7 ( 25.96 )
    999 ( 999 )
        Day 720 (study completion)
    999 ( 999 )
    -7.3 ( 29.36 )
    999 ( 999 )
    No statistical analyses for this end point

    Secondary: Absolute change in Apo B from baseline up to Day 720

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    End point title
    Absolute change in Apo B from baseline up to Day 720
    End point description
    Absolute change in apolipoprotein B (Apo B) from baseline to each assessment time up to Day 720.
    End point type
    Secondary
    End point timeframe
    Baseline, up to Day 720
    End point values
    Part 1- Inclisiran Part 2 – Inclisiran (Total) Part 1 - Placebo
    Number of subjects analysed
    9
    13
    4
    Units: mg/dL
    arithmetic mean (standard deviation)
        Day 150
    -37.3 ( 33.35 )
    999 ( 999 )
    7.5 ( 48.72 )
        Day 330
    -35.8 ( 30.33 )
    999 ( 999 )
    0.3 ( 35.85 )
        Day 360
    -28.7 ( 27.16 )
    999 ( 999 )
    12.0 ( 32.89 )
        Day 510
    999 ( 999 )
    -18.8 ( 45.81 )
    999 ( 999 )
        Day 720 (study completion)
    999 ( 999 )
    -19.6 ( 51.64 )
    999 ( 999 )
    No statistical analyses for this end point

    Secondary: Percent change in Lp(a) from baseline up to Day 720

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    End point title
    Percent change in Lp(a) from baseline up to Day 720
    End point description
    Percentage change in lipoprotein (a) [Lp(a)] from baseline to each assessment time up to Day 720.
    End point type
    Secondary
    End point timeframe
    Baseline, up to Day 720
    End point values
    Part 1- Inclisiran Part 2 – Inclisiran (Total) Part 1 - Placebo
    Number of subjects analysed
    9
    13
    4
    Units: Percent change in Lp(a)
    arithmetic mean (standard deviation)
        Day 150
    -0.7 ( 24.81 )
    999 ( 999 )
    -4.4 ( 9.20 )
        Day 330
    -0.3 ( 21.27 )
    999 ( 999 )
    -16.5 ( 27.29 )
        Day 360
    -1.7 ( 16.57 )
    999 ( 999 )
    -12.1 ( 31.51 )
        Day 510
    999 ( 999 )
    -7.2 ( 31.39 )
    999 ( 999 )
        Day 720 (study completion)
    999 ( 999 )
    -8.8 ( 22.03 )
    999 ( 999 )
    No statistical analyses for this end point

    Secondary: Absolute change in Lp(a) from baseline up to Day 720

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    End point title
    Absolute change in Lp(a) from baseline up to Day 720
    End point description
    Absolute change in lipoprotein (a) [Lp(a)] from baseline to each assessment time up to Day 720.
    End point type
    Secondary
    End point timeframe
    Baseline, up to Day 720
    End point values
    Part 1- Inclisiran Part 2 – Inclisiran (Total) Part 1 - Placebo
    Number of subjects analysed
    9
    13
    4
    Units: nmol/L
    arithmetic mean (standard deviation)
        Day 150
    8.9 ( 28.41 )
    999 ( 999 )
    -0.3 ( 1.26 )
        Day 330
    2.8 ( 15.01 )
    999 ( 999 )
    5.3 ( 15.86 )
        Day 360
    5.8 ( 7.03 )
    999 ( 999 )
    0.5 ( 9.75 )
        Day 510
    999 ( 999 )
    3.0 ( 14.45 )
    999 ( 999 )
        Day 720 (study completion)
    999 ( 999 )
    -0.3 ( 9.12 )
    999 ( 999 )
    No statistical analyses for this end point

    Secondary: Percent change in non-HDL-C from baseline up to Day 720

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    End point title
    Percent change in non-HDL-C from baseline up to Day 720
    End point description
    Percentage change in non-high density lipoprotein cholesterol (non-HDL-C) from baseline to each assessment time up to Day 720.
    End point type
    Secondary
    End point timeframe
    Baseline, up to Day 720
    End point values
    Part 1- Inclisiran Part 2 – Inclisiran (Total) Part 1 - Placebo
    Number of subjects analysed
    9
    13
    4
    Units: Percent change in non-HDL-C
    arithmetic mean (standard deviation)
        Day 150
    -24.0 ( 13.83 )
    999 ( 999 )
    19.0 ( 43.34 )
        Day 330
    -23.3 ( 10.99 )
    999 ( 999 )
    9.4 ( 34.93 )
        Day 360
    -20.1 ( 10.91 )
    999 ( 999 )
    7.1 ( 24.38 )
        Day 510
    999 ( 999 )
    -11.8 ( 25.33 )
    999 ( 999 )
        Day 720 (study completion)
    999 ( 999 )
    -13.0 ( 23.65 )
    999 ( 999 )
    No statistical analyses for this end point

    Secondary: Absolute change in non-HDL-C from baseline up to Day 720

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    End point title
    Absolute change in non-HDL-C from baseline up to Day 720
    End point description
    Absolute change in non-high density lipoprotein cholesterol (non-HDL-C) from baseline to each assessment time up to Day 720.
    End point type
    Secondary
    End point timeframe
    Baseline, up to Day 720
    End point values
    Part 1- Inclisiran Part 2 – Inclisiran (Total) Part 1 - Placebo
    Number of subjects analysed
    9
    13
    4
    Units: mg/dL
    arithmetic mean (standard deviation)
        Day 150
    -73.8 ( 68.01 )
    999 ( 999 )
    28.8 ( 94.01 )
        Day 330
    -74.4 ( 57.63 )
    999 ( 999 )
    4.3 ( 82.16 )
        Day 360
    -60.0 ( 44.74 )
    999 ( 999 )
    6.0 ( 56.11 )
        Day 510
    999 ( 999 )
    -51.4 ( 81.53 )
    999 ( 999 )
        Day 720 (study completion)
    999 ( 999 )
    -45.8 ( 89.10 )
    999 ( 999 )
    No statistical analyses for this end point

    Secondary: Percent change in total cholesterol from baseline up to Day 720

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    End point title
    Percent change in total cholesterol from baseline up to Day 720
    End point description
    Percentage change in total cholesterol from baseline to each assessment time up to Day 720.
    End point type
    Secondary
    End point timeframe
    Baseline, up to Day 720
    End point values
    Part 1- Inclisiran Part 2 – Inclisiran (Total) Part 1 - Placebo
    Number of subjects analysed
    9
    13
    4
    Units: Percent change in total cholesterol
    arithmetic mean (standard deviation)
        Day 150
    -19.0 ( 12.49 )
    999 ( 999 )
    16.0 ( 37.96 )
        Day 330
    -19.1 ( 10.30 )
    999 ( 999 )
    8.7 ( 30.54 )
        Day 360
    -16.1 ( 9.53 )
    999 ( 999 )
    6.8 ( 21.06 )
        Day 510
    999 ( 999 )
    -9.3 ( 20.73 )
    999 ( 999 )
        Day 720 (study completion)
    999 ( 999 )
    -9.6 ( 20.86 )
    999 ( 999 )
    No statistical analyses for this end point

    Secondary: Absolute change in total cholesterol from baseline up to Day 720

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    End point title
    Absolute change in total cholesterol from baseline up to Day 720
    End point description
    Absolute change in total cholesterol from baseline to each assessment time up to Day 720.
    End point type
    Secondary
    End point timeframe
    Baseline, up to Day 720
    End point values
    Part 1- Inclisiran Part 2 – Inclisiran (Total) Part 1 - Placebo
    Number of subjects analysed
    9
    13
    4
    Units: mg/dL
    arithmetic mean (standard deviation)
        Day 150
    -69.7 ( 67.42 )
    999 ( 999 )
    29.5 ( 99.30 )
        Day 330
    -71.4 ( 56.65 )
    999 ( 999 )
    8.8 ( 84.68 )
        Day 360
    -57.3 ( 43.82 )
    999 ( 999 )
    10.0 ( 59.14 )
        Day 510
    999 ( 999 )
    -46.5 ( 80.87 )
    999 ( 999 )
        Day 720 (study completion)
    999 ( 999 )
    40.4 ( 88.44 )
    999 ( 999 )
    No statistical analyses for this end point

    Secondary: Percent change in triglycerides from baseline up to Day 720

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    End point title
    Percent change in triglycerides from baseline up to Day 720
    End point description
    Percentage change in triglycerides from baseline to each assessment time up to Day 720.
    End point type
    Secondary
    End point timeframe
    Baseline, up to Day 720
    End point values
    Part 1- Inclisiran Part 2 – Inclisiran (Total) Part 1 - Placebo
    Number of subjects analysed
    9
    13
    4
    Units: Percent change in triglycerides
    arithmetic mean (standard deviation)
        Day 150
    0.3 ( 31.92 )
    999 ( 999 )
    -15.7 ( 5.97 )
        Day 330
    -9.6 ( 30.66 )
    999 ( 999 )
    -5.8 ( 31.90 )
        Day 360
    11.4 ( 24.72 )
    999 ( 999 )
    14.1 ( 54.93 )
        Day 510
    999 ( 999 )
    4.7 ( 37.21 )
    999 ( 999 )
        Day 720 (study completion)
    999 ( 999 )
    2.9 ( 26.02 )
    999 ( 999 )
    No statistical analyses for this end point

    Secondary: Absolute change in triglycerides from baseline up to Day 720

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    End point title
    Absolute change in triglycerides from baseline up to Day 720
    End point description
    Absolute change in triglycerides from baseline to each assessment time up to Day 720.
    End point type
    Secondary
    End point timeframe
    Baseline, up to Day 720
    End point values
    Part 1- Inclisiran Part 2 – Inclisiran (Total) Part 1 - Placebo
    Number of subjects analysed
    9
    13
    4
    Units: mg/dL
    arithmetic mean (standard deviation)
        Day 150
    -3.4 ( 23.80 )
    999 ( 999 )
    -15.0 ( 7.53 )
        Day 330
    -9.4 ( 21.98 )
    999 ( 999 )
    -2.3 ( 25.01 )
        Day 360
    8.7 ( 24.15 )
    999 ( 999 )
    28.0 ( 72.23 )
        Day 510
    999 ( 999 )
    3.3 ( 34.32 )
    999 ( 999 )
        Day 720 (study completion)
    999 ( 999 )
    3.9 ( 27.40 )
    999 ( 999 )
    No statistical analyses for this end point

    Secondary: Percent change in HDL-C from baseline up to Day 720

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    End point title
    Percent change in HDL-C from baseline up to Day 720
    End point description
    Percentage change in high density lipoprotein cholesterol (HDL-C) from baseline to each assessment time up to Day 720.
    End point type
    Secondary
    End point timeframe
    Baseline, up to Day 720
    End point values
    Part 1- Inclisiran Part 2 – Inclisiran (Total) Part 1 - Placebo
    Number of subjects analysed
    9
    13
    4
    Units: Percent change in HDL-C
    arithmetic mean (standard deviation)
        Day 150
    10.0 ( 13.22 )
    999 ( 999 )
    -0.1 ( 20.06 )
        Day 330
    7.5 ( 12.93 )
    999 ( 999 )
    10.9 ( 12.48 )
        Day 360
    6.7 ( 20.60 )
    999 ( 999 )
    9.2 ( 21.20 )
        Day 510
    999 ( 999 )
    12.3 ( 17.63 )
    999 ( 999 )
        Day 720 (study completion)
    999 ( 999 )
    13.9 ( 18.81 )
    999 ( 999 )
    No statistical analyses for this end point

    Secondary: Absolute change in HDL-C from baseline up to Day 720

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    End point title
    Absolute change in HDL-C from baseline up to Day 720
    End point description
    Absolute change in high density lipoprotein cholesterol (HDL-C) from baseline to each assessment time up to Day 720.
    End point type
    Secondary
    End point timeframe
    Baseline, up to Day 720
    End point values
    Part 1- Inclisiran Part 2 – Inclisiran (Total) Part 1 - Placebo
    Number of subjects analysed
    9
    13
    4
    Units: mg/dL
    arithmetic mean (standard deviation)
        Day 150
    4.1 ( 5.18 )
    999 ( 999 )
    0.8 ( 7.50 )
        Day 330
    3.0 ( 5.05 )
    999 ( 999 )
    4.5 ( 5.07 )
        Day 360
    2.7 ( 7.75 )
    999 ( 999 )
    4.0 ( 8.76 )
        Day 510
    999 ( 999 )
    4.9 ( 7.94 )
    999 ( 999 )
        Day 720 (study completion)
    999 ( 999 )
    5.4 ( 7.81 )
    999 ( 999 )
    No statistical analyses for this end point

    Secondary: Percent change in VLDL-C from baseline up to Day 720

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    End point title
    Percent change in VLDL-C from baseline up to Day 720
    End point description
    Percentage change in very low density lipoprotein cholesterol (VLDL-C) from baseline to each assessment time up to Day 720.
    End point type
    Secondary
    End point timeframe
    Baseline, up to Day 720
    End point values
    Part 1- Inclisiran Part 2 – Inclisiran (Total) Part 1 - Placebo
    Number of subjects analysed
    9
    13
    4
    Units: Percent change in VLDL-C
    arithmetic mean (standard deviation)
        Day 150
    -7.0 ( 70.31 )
    999 ( 999 )
    74.5 ( 108.97 )
        Day 330
    -29.0 ( 49.96 )
    999 ( 999 )
    2.0 ( 113.44 )
        Day 360
    -17.0 ( 60.36 )
    999 ( 999 )
    34.6 ( 56.37 )
        Day 510
    999 ( 999 )
    9.5 ( 98.44 )
    999 ( 999 )
        Day 720 (study completion)
    999 ( 999 )
    -1.4 ( 69.03 )
    999 ( 999 )
    No statistical analyses for this end point

    Secondary: Absolut change in VLDL-C from baseline up to Day 720

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    End point title
    Absolut change in VLDL-C from baseline up to Day 720
    End point description
    Absolute change in very low density lipoprotein cholesterol (VLDL-C) from baseline to each assessment time up to Day 720.
    End point type
    Secondary
    End point timeframe
    Baseline, up to Day 720
    End point values
    Part 1- Inclisiran Part 2 – Inclisiran (Total) Part 1 - Placebo
    Number of subjects analysed
    9
    13
    4
    Units: mg/dL
    arithmetic mean (standard deviation)
        Day 150
    -7.7 ( 11.39 )
    999 ( 999 )
    8.5 ( 20.37 )
        Day 330
    -11.6 ( 11.71 )
    999 ( 999 )
    -7.5 ( 18.21 )
        Day 360
    -9.2 ( 17.89 )
    999 ( 999 )
    10.3 ( 21.00 )
        Day 510
    999 ( 999 )
    -4.6 ( 18.41 )
    999 ( 999 )
        Day 720 (study completion)
    999 ( 999 )
    -6.0 ( 18.81 )
    999 ( 999 )
    No statistical analyses for this end point

    Secondary: Percent change in Apo A1 from baseline up to Day 720

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    End point title
    Percent change in Apo A1 from baseline up to Day 720
    End point description
    Percentage change in apolipoprotein A1 (Apo A1) from baseline to each assessment time up to Day 720.
    End point type
    Secondary
    End point timeframe
    Baseline, up to Day 720
    End point values
    Part 1- Inclisiran Part 2 – Inclisiran (Total) Part 1 - Placebo
    Number of subjects analysed
    9
    13
    4
    Units: Percent change in Apo A1
    arithmetic mean (standard deviation)
        Day 150
    -0.9 ( 10.72 )
    999 ( 999 )
    -1.3 ( 2.27 )
        Day 330
    -2.1 ( 10.87 )
    999 ( 999 )
    9.0 ( 7.02 )
        Day 360
    3.1 ( 16.49 )
    999 ( 999 )
    13.7 ( 12.99 )
        Day 510
    999 ( 999 )
    12.8 ( 12.08 )
    999 ( 999 )
        Day 720 (study completion)
    999 ( 999 )
    6.5 ( 10.10 )
    999 ( 999 )
    No statistical analyses for this end point

    Secondary: Absolute change in Apo A1 from baseline up to Day 720

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    End point title
    Absolute change in Apo A1 from baseline up to Day 720
    End point description
    Absolute change in apolipoprotein A1 (Apo A1) from baseline to each assessment time up to Day 720.
    End point type
    Secondary
    End point timeframe
    Baseline, up to Day 720
    End point values
    Part 1- Inclisiran Part 2 – Inclisiran (Total) Part 1 - Placebo
    Number of subjects analysed
    9
    13
    4
    Units: mg/dL
    arithmetic mean (standard deviation)
        Day 150
    -1.2 ( 14.10 )
    999 ( 999 )
    -1.3 ( 2.36 )
        Day 330
    -2.7 ( 13.47 )
    999 ( 999 )
    10.3 ( 7.41 )
        Day 360
    4.2 ( 18.82 )
    999 ( 999 )
    16.0 ( 14.79 )
        Day 510
    999 ( 999 )
    14.9 ( 13.25 )
    999 ( 999 )
        Day 720 (study completion)
    999 ( 999 )
    7.4 ( 12.40 )
    999 ( 999 )
    No statistical analyses for this end point

    Secondary: Percent change in PCSK9 from baseline up to Day 720

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    End point title
    Percent change in PCSK9 from baseline up to Day 720
    End point description
    Percentage change in proprotein convertase subtilisin/kexin type 9 (PCSK9) from baseline to each assessment time up to Day 720.
    End point type
    Secondary
    End point timeframe
    Baseline, up to Day 720
    End point values
    Part 1- Inclisiran Part 2 – Inclisiran (Total) Part 1 - Placebo
    Number of subjects analysed
    9
    13
    4
    Units: Percent change in PCSK9
    arithmetic mean (standard deviation)
        Day 90
    -56.8 ( 13.73 )
    999 ( 999 )
    -17.3 ( 14.77 )
        Day 150
    -60.4 ( 12.62 )
    999 ( 999 )
    -1.7 ( 11.11 )
        Day 330
    -65.3 ( 12.51 )
    999 ( 999 )
    -5.1 ( 19.60 )
        Day 360
    -59.7 ( 9.05 )
    999 ( 999 )
    -2.8 ( 22.65 )
        Day 510
    999 ( 999 )
    -68.1 ( 10.57 )
    999 ( 999 )
        Day 720 (study completion)
    999 ( 999 )
    -64.1 ( 12.12 )
    999 ( 999 )
    No statistical analyses for this end point

    Secondary: Absolut change in PCSK9 from baseline up to Day 720

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    End point title
    Absolut change in PCSK9 from baseline up to Day 720
    End point description
    Absolute change in proprotein convertase subtilisin/kexin type 9 (PCSK9) from baseline to each assessment time up to Day 720.
    End point type
    Secondary
    End point timeframe
    Baseline, up to Day 720
    End point values
    Part 1- Inclisiran Part 2 – Inclisiran (Total) Part 1 - Placebo
    Number of subjects analysed
    9
    13
    4
    Units: ng/mL
    arithmetic mean (standard deviation)
        Day 90
    -278.7 ( 113.31 )
    999 ( 999 )
    -98.5 ( 87.46 )
        Day 150
    -296.3 ( 118.18 )
    999 ( 999 )
    -6.1 ( 64.82 )
        Day 330
    -323.1 ( 129.32 )
    999 ( 999 )
    -35.3 ( 100.97 )
        Day 360
    -292.6 ( 100.44 )
    999 ( 999 )
    -14.0 ( 127.42 )
        Day 510
    999 ( 999 )
    -347.3 ( 106.3 )
    999 ( 999 )
        Day 720 (study completion)
    999 ( 999 )
    -327.7 ( 110.4 )
    999 ( 999 )
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Adverse events were reported from first dose of study treatment until end of study treatment plus 90 days post treatment or 30 days after last study visit, whichever was longer, up to a maximum duration of approximately 2 years.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    27.1
    Reporting groups
    Reporting group title
    Part 1- Inclisiran
    Reporting group description
    Inclisiran sodium 300 mg subcutaneous (sc) injection (given at Days 1, 90 and 270)

    Reporting group title
    Part 2 – Inclisiran (Total)
    Reporting group description
    Inclisiran sodium 300 mg sc injection (given at Days 450 and 630). In addition, participants assigned to placebo in Part 1 received inclisiran sodium 300 mg sc injection on Day 360, while participants assigned to inclisiran in Part 1 received placebo sc injection on Day 360

    Reporting group title
    Part 1 - Placebo
    Reporting group description
    Placebo sc injection (given at Day 1, 90 and 270)

    Serious adverse events
    Part 1- Inclisiran Part 2 – Inclisiran (Total) Part 1 - Placebo
    Total subjects affected by serious adverse events
         subjects affected / exposed
    0 / 9 (0.00%)
    0 / 13 (0.00%)
    0 / 4 (0.00%)
         number of deaths (all causes)
    0
    0
    0
         number of deaths resulting from adverse events
    0
    0
    0
    Frequency threshold for reporting non-serious adverse events: 0%
    Non-serious adverse events
    Part 1- Inclisiran Part 2 – Inclisiran (Total) Part 1 - Placebo
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    7 / 9 (77.78%)
    8 / 13 (61.54%)
    1 / 4 (25.00%)
    Investigations
    Carotid intima-media thickness increased
         subjects affected / exposed
    0 / 9 (0.00%)
    1 / 13 (7.69%)
    0 / 4 (0.00%)
         occurrences all number
    0
    1
    0
    Injury, poisoning and procedural complications
    Concussion
         subjects affected / exposed
    1 / 9 (11.11%)
    0 / 13 (0.00%)
    0 / 4 (0.00%)
         occurrences all number
    1
    0
    0
    Head injury
         subjects affected / exposed
    1 / 9 (11.11%)
    0 / 13 (0.00%)
    0 / 4 (0.00%)
         occurrences all number
    1
    0
    0
    Ligament sprain
         subjects affected / exposed
    0 / 9 (0.00%)
    1 / 13 (7.69%)
    0 / 4 (0.00%)
         occurrences all number
    0
    1
    0
    Nervous system disorders
    Headache
         subjects affected / exposed
    0 / 9 (0.00%)
    2 / 13 (15.38%)
    0 / 4 (0.00%)
         occurrences all number
    0
    2
    0
    General disorders and administration site conditions
    Injection site reaction
         subjects affected / exposed
    2 / 9 (22.22%)
    0 / 13 (0.00%)
    0 / 4 (0.00%)
         occurrences all number
    3
    0
    0
    Injection site erythema
         subjects affected / exposed
    1 / 9 (11.11%)
    1 / 13 (7.69%)
    0 / 4 (0.00%)
         occurrences all number
    2
    1
    0
    Influenza like illness
         subjects affected / exposed
    1 / 9 (11.11%)
    1 / 13 (7.69%)
    0 / 4 (0.00%)
         occurrences all number
    3
    2
    0
    Pyrexia
         subjects affected / exposed
    2 / 9 (22.22%)
    0 / 13 (0.00%)
    0 / 4 (0.00%)
         occurrences all number
    2
    0
    0
    Gastrointestinal disorders
    Abdominal pain upper
         subjects affected / exposed
    2 / 9 (22.22%)
    1 / 13 (7.69%)
    0 / 4 (0.00%)
         occurrences all number
    2
    3
    0
    Vomiting
         subjects affected / exposed
    1 / 9 (11.11%)
    0 / 13 (0.00%)
    0 / 4 (0.00%)
         occurrences all number
    1
    0
    0
    Toothache
         subjects affected / exposed
    1 / 9 (11.11%)
    0 / 13 (0.00%)
    0 / 4 (0.00%)
         occurrences all number
    1
    0
    0
    Reproductive system and breast disorders
    Vaginal discharge
         subjects affected / exposed
    0 / 9 (0.00%)
    0 / 13 (0.00%)
    1 / 4 (25.00%)
         occurrences all number
    0
    0
    1
    Skin and subcutaneous tissue disorders
    Xanthoma
         subjects affected / exposed
    0 / 9 (0.00%)
    1 / 13 (7.69%)
    0 / 4 (0.00%)
         occurrences all number
    0
    1
    0
    Angioedema
         subjects affected / exposed
    0 / 9 (0.00%)
    0 / 13 (0.00%)
    1 / 4 (25.00%)
         occurrences all number
    0
    0
    1
    Rash macular
         subjects affected / exposed
    1 / 9 (11.11%)
    0 / 13 (0.00%)
    0 / 4 (0.00%)
         occurrences all number
    1
    0
    0
    Urticaria
         subjects affected / exposed
    0 / 9 (0.00%)
    0 / 13 (0.00%)
    1 / 4 (25.00%)
         occurrences all number
    0
    0
    1
    Musculoskeletal and connective tissue disorders
    Costochondritis
         subjects affected / exposed
    0 / 9 (0.00%)
    1 / 13 (7.69%)
    0 / 4 (0.00%)
         occurrences all number
    0
    1
    0
    Infections and infestations
    Oral herpes
         subjects affected / exposed
    0 / 9 (0.00%)
    0 / 13 (0.00%)
    1 / 4 (25.00%)
         occurrences all number
    0
    0
    1
    Influenza
         subjects affected / exposed
    0 / 9 (0.00%)
    2 / 13 (15.38%)
    0 / 4 (0.00%)
         occurrences all number
    0
    3
    0
    Gingivitis
         subjects affected / exposed
    0 / 9 (0.00%)
    0 / 13 (0.00%)
    1 / 4 (25.00%)
         occurrences all number
    0
    0
    1
    Gastroenteritis
         subjects affected / exposed
    1 / 9 (11.11%)
    0 / 13 (0.00%)
    1 / 4 (25.00%)
         occurrences all number
    1
    0
    1
    Conjunctivitis
         subjects affected / exposed
    1 / 9 (11.11%)
    0 / 13 (0.00%)
    0 / 4 (0.00%)
         occurrences all number
    1
    0
    0
    COVID-19
         subjects affected / exposed
    4 / 9 (44.44%)
    1 / 13 (7.69%)
    1 / 4 (25.00%)
         occurrences all number
    4
    1
    1
    Upper respiratory tract infection
         subjects affected / exposed
    0 / 9 (0.00%)
    1 / 13 (7.69%)
    0 / 4 (0.00%)
         occurrences all number
    0
    1
    0
    Urinary tract infection
         subjects affected / exposed
    0 / 9 (0.00%)
    1 / 13 (7.69%)
    0 / 4 (0.00%)
         occurrences all number
    0
    1
    0
    Viral infection
         subjects affected / exposed
    1 / 9 (11.11%)
    0 / 13 (0.00%)
    0 / 4 (0.00%)
         occurrences all number
    2
    0
    0
    Metabolism and nutrition disorders
    Vitamin D deficiency
         subjects affected / exposed
    1 / 9 (11.11%)
    0 / 13 (0.00%)
    0 / 4 (0.00%)
         occurrences all number
    1
    0
    0

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    01 Oct 2020
    The purpose of Amendment 1 was to modify participant eligibility criteria regarding HoFH. Based on the mechanism of action of inclisiran and in order to avoid exposing patients who are unlikely to respond to study medication, patients with a null (negative) mutation in both LDLR alleles were excluded from study participation and all participants were required to have a genetic diagnosis of HoFH. Additionally, participants with a history of poor response to therapy with any monoclonal antibody directed towards PCSK9 were excluded. Amendment 1 was issued before the original protocol was sent to the IRBs/IECs and Health Authorities, i.e., before any participants were screened or randomized.
    17 Feb 2023
    The purpose of Amendment 2 was to add an interim analysis (IA) for the PK data collected on Day 1.

    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.
    Due to EudraCT system limitations, which EMA is aware of, data using 999 as data points in this record are not an accurate representation of the clinical trial results. Please use https://www.novctrd.com/CtrdWeb/home.nov for complete trial results.
    For support, Contact us.
    The status and protocol content of GB trials is no longer updated since 1 January 2021. For the UK, as of 31 January 2021, EU Law applies only to the territory of Northern Ireland (NI) to the extent foreseen in the Protocol on Ireland/NI. Legal notice
    As of 31 January 2023, all EU/EEA initial clinical trial applications must be submitted through CTIS . Updated EudraCT trials information and information on PIP/Art 46 trials conducted exclusively in third countries continues to be submitted through EudraCT and published on this website.

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