E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Hyperlipidaemia, evaluation of low-density lipoprotein cholesterol reduction and safety of AZD8233 vs. placebo |
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E.1.1.1 | Medical condition in easily understood language |
Hyperlipidaemia is an abnormal level of lipids (fats) in the blood |
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E.1.1.2 | Therapeutic area | Diseases [C] - Cardiovascular Diseases [C14] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 20.0 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10062060 |
E.1.2 | Term | Hyperlipidaemia |
E.1.2 | System Organ Class | 10027433 - Metabolism and nutrition disorders |
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E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
• To assess the safety and tolerability of AZD8233 as compared with placebo in participants with hyperlipidaemia receiving maximally tolerated statin and/or ezetimibe therapy as defined by the investigator • To assess the effect of AZD8233 versus placebo on serum LDL-C at the end of Week 28 compared with baseline, in participants with hyperlipidaemia, receiving maximally tolerated statin and/or ezetimibe therapy as defined by the investigator |
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E.2.2 | Secondary objectives of the trial |
-To assess the effect of AZD8233 versus placebo on plasma PCSK9 at the end of Week 28 compared with baseline, in participants with hyperlipidaemia, receiving maximally tolerated statin and/or ezetimibe therapy as defined by the investigator - To evaluate the PK of AZD8233 - To evaluate the immunogenicity of AZD8233 |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
-Participant must be 18 to 75 years of age, inclusive, at the time of signing the informed consent -Participants who have a fasting LDL-C ≥ 70 mg/dL (1.8 mmol/L) but < 190 mg/dL (4.9 mmol/L) at screening -Participants who have fasting triglycerides < 400 mg/dL (< 4.52 mmol/L) at screening -Participants are receiving a stable dose (≥ 3 months) of maximally tolerated statin and/or ezetimibe therapy -Male or female of non-childbearing potential -Signed and dated written informed consent prior to any mandatory study specific procedures, sampling, and analyses |
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E.4 | Principal exclusion criteria |
- eGFR < 40 mL/min/1.73m2 using the CKD-EPI - History or presence of gastrointestinal, hepatic or renal disease or any other conditions known to interfere with absorption, distribution, metabolism or excretion of drugs - Any uncontrolled or serious disease, or any medical (eg,. known major active infection or major haematological, renal, metabolic, gastrointestinal or endocrine dysfunction) or surgical condition that, in the opinion of the investigator, may either interfere with participation in the clinical study and/or put the participant at significant risk (according to the investigator’s judgment) if he/she participates in the clinical study - Poorly controlled T2DM, defined as HbA1c > 10% - Acute ischaemic cardiovascular events including stroke within 30 days, or heart failure with New York Heart Association (NYHA) Class III to IV - Blood dyscrasias with increased risk of bleeding including idiopathic thrombocytopenic purpura and thrombotic thrombocytopenic purpura or symptoms of increased risk of bleeding (frequent bleeding gums or nose bleeds) - High-risk of bleeding diathesis or anti-platelet therapy other than low dose aspirin (≤100mg/day). - Malignancy within the last 10 years - Recipient of any major organ transplant - LDL or plasma apheresis within 12 months prior to randomisation - Uncontrolled hypertension defined as average supine SBP > 160 mmHg or DBP > 90 mmHg - Heart rate after 10 minutes supine rest < 50 or > 100 bpm - Any laboratory values with the following deviations at the Screening Visit; test may be repeated at the discretion of the investigator if abnormal: • Any positive result on screening for serum hepatitis B surface antigen, hepatitis C antibody, and human immunodeficiency virus (HIV) • ALT > 1.5 × ULN • AST > 1.5 × ULN • TBL > ULN • ALP > 1.5 × ULN • WBC < lower limit of normal (LLN). • Haemoglobin < 12 g/dL in males or < 11 g/dL in females • Platelet count ≤ LLN • aPTT > ULN or Prothrombin Time > ULN • UACR > 11 mg/mmol (100 mg/g) • UPCR > 300 mg/g
-Any clinically important abnormalities in rhythm, conduction or morphology of the resting ECG and any clinically important abnormalities in the 12-lead ECG -QTcF > 470 ms; high degree atrioventricular (AV)-block grade II-III and sinus node dysfunction with significant sinus pause untreated with pacemaker; and cardiac tachyarrhythmias -History of drug and/or alcohol abuse or a positive screen for drugs of abuse -use of warfarin, direct or indirect thrombin inhibitors or factor Xa inhibitors -Mipomersen, or lomitapide within 12 months prior to randomisation -Any fibrate therapy other than fenofibrate; if the participant is on fenofibrate therapy, the dose should be stable for at least 6 weeks prior to randomisation -Previous administration of AZD8233/AZD6615) or inclisiran (LEQVIO ® Novartis) -Use of evolocumab (REPATHA® Amgen) and alirocumab (PRALUENT® Regeneron) within 3 months of screening |
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E.5 End points |
E.5.1 | Primary end point(s) |
Safety and tolerability will be evaluated in terms of AEs, vital signs, ECG, and clinical laboratory evaluations, including platelet count The relative change in serum LDL-C from baseline to the end of Week 28 |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
safety and tolerability: throughout the study efficacy: D197 |
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E.5.2 | Secondary end point(s) |
• The relative change in PCSK9 from baseline to the end of Week 28 • Model population PK parameters to be reported in a separate report • Development of ADA and titre (if participants are ADA positive) during treatment and follow-up |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
PSCK9: D197 PK: D29, D85, D99, D141, D197 ADA: D1, D29, D57, D85, D113, D141, D169, D197, D281 |
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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 | No |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | Yes |
E.6.7 | Pharmacodynamic | Yes |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | Yes |
E.6.11 | Pharmacogenomic | Yes |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | Yes |
E.6.13.1 | Other scope of the trial description |
Immunogenicity:Blood samples collection for immunogenicity assessments (ADA).
Exploratory biomarkers analysis: Blood and urine samples collection for potential future exploratory research aimed at exploring biomarkers involved in PK, PD, safety and tolerability related to AZD8233 treatment or cardiometabolic diseases.
Optional: DNA storage from blood samples for future exploratory research into genes/genetic variation that may influence response to treatment. |
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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) | Yes |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
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 | Yes |
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 | 10 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 70 |
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 |
United States |
Denmark |
Hungary |
Netherlands |
Poland |
Slovakia |
Spain |
Czechia |
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E.8.7 | Trial has a data monitoring committee | No |
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
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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 | 11 |
E.8.9.1 | In the Member State concerned days | 26 |
E.8.9.2 | In all countries concerned by the trial months | 11 |
E.8.9.2 | In all countries concerned by the trial days | 26 |