E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
atherosclerotic cardiovascular disease (ASCVD) |
Malattia cardiovascolare aterosclerotica (ASCVD) |
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E.1.1.1 | Medical condition in easily understood language |
atherosclerotic heart and blood vessel disease (the narrowing of arteries from a buildup of plaque) |
Malattia aterosclerotica del cuore e dei vasi sanguigni (restringimento delle arterie in seguito a formazione di una placca). |
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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 | 21.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10051615 |
E.1.2 | Term | Atherosclerotic cardiovascular disease |
E.1.2 | System Organ Class | 100000004866 |
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E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 20.0 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10076622 |
E.1.2 | Term | Atherosclerotic plaque |
E.1.2 | System Organ Class | 100000004866 |
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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 evaluate the effect of obicetrapib on the risk of major adverse cardiovascular events (MACE), including CV death, non-fatal MI, nonfatal stroke, or non-elective coronary revascularization. |
Valutare l’effetto di obicetrapib sul rischio di eventi avversi cardiovascolari maggiori (MACE), tra cui decesso CV, IM non fatale, ictus non fatale o rivascolarizzazione coronarica non elettiva. |
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E.2.2 | Secondary objectives of the trial |
• CV death, non-fatal MI, or non-fatal stroke; • All-cause mortality, non-fatal MI, non-fatal stroke, or non-elective coronary revascularization; • Any individual component of the primary composite endpoint; • Total CV events; • New-onset diabetes mellitus (NODM); • Percent change in low-density lipoprotein cholesterol (LDL-C); • Percent change in non-high-density lipoprotein cholesterol (non-HDLC); • Percent change in apolipoprotein B (ApoB); and • Absolute change in glycosylated hemoglobin (HbA1c) in participants with diabetes mellitus and HbA1c =7% at Baseline. |
• decesso CV, IM non fatale o ictus non fatale; • mortalità per tutte le cause, IM non fatale, ictus non fatale o rivascolarizzazione coronarica non elettiva; • qualsiasi componente individuale dell’endpoint composito primario; • eventi CV totali; • diabete mellito di nuova insorgenza (NODM); • variazione percentuale del colesterolo legato alle lipoproteine a bassa densità (LDL-C); • variazione percentuale del colesterolo non legato alle lipoproteine ad alta densità (non-HDL-C); • variazione percentuale dell’apolipoproteina B (ApoB); e • variazione assoluta dell’emoglobina glicosilata (HbA1c) in partecipanti con diabete mellito e HbA1c =7% al basale. |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
- Men or women =18 years of age at Screening (Visit 1); - Have a history of ASCVD, defined by at least 1 of the following conditions: o Coronary artery disease o Cerebrovascular disease o Peripheral arterial disease - Are on maximally tolerated lipid-modifying therapy defined as follows: o A statin at a maximally tolerated stable dose; o Ezetimibe for at least 4 weeks prior to Screening (Visit 1); o Bempedoic acid for at least 4 weeks prior to Screening (Visit 1); o A PCSK9-targeted therapy for at least 3 stable doses prior to Screening (Visit 1); o A fibrate at a stable dose for at least 6 weeks prior to Screening (Visit 1) (with the exception of gemfibrozil, which is not allowed); and/or o Statin intolerant participants and participants using a statin at a maximally tolerated stable dose may be on any of the following or combinations of ezetimibe, bempedoic acid, a PCSK9-targeted therapy, or a fibrate as defined in the previous bullets. - Have a fasting serum LDL-C as follows: o Have a fasting serum LDL-C =80 mg/dL to <100 mg/dL with at least 1 of the following risk enhancers: - Recent MI (>3 and <12 months prior to Randomization); - Type 2 diabetes mellitus; - Fasting triglycerides (TG) >150 mg/dL (>1.7 mmol/L); and/or - Fasting HDL-C <40 mg/dL (<1.0 mmol/L). OR o Have a fasting serum LDL-C =100 mg/dL. - Have fasting TG <400 mg/dL (<4.52 mmol/L) at Screening (Visit 1); and - Have an estimated glomerular filtration rate (eGFR) =30 mL/min/1.73 m2 calculated using the Chronic Kidney Disease Epidemiology Collaboration equation at Screening (Visit 1). Other protocol-defined criteria apply. |
- Uomini o donne di età =18 anni allo Screening (Visita 1). - Anamnesi di ASCVD, definita da almeno 1 delle seguenti condizioni: o Cardiopatia coronarica: o Malattia cerebrovascolare: o Arteriopatia periferica: - In trattamento con terapia modificante i lipidi alla dose massima tollerata, definita come segue: o una statina a una dose stabile massima tollerata; o ezetimibe per almeno 4 settimane precedenti lo Screening (Visita 1); o acido bempedoico per almeno 4 settimane precedenti lo Screening (Visita 1); o una terapia mirata con PCSK9 per almeno 3 dosi stabili precedenti lo Screening (Visita 1); o un fibrato a una dose stabile per almeno 6 settimane precedenti lo Screening (Visita 1) (ad eccezione di gemfibrozil, che non è consentito); e/o o i/le partecipanti intolleranti alle statine e i partecipanti che utilizzano una statina a una dose stabile massima tollerata possono essere trattati/e con uno qualsiasi dei seguenti o con combinazioni di ezetimibe, acido bempedoico, una terapia mirata con PCSK9 o un fibrato, come definito nei punti precedenti. - Livello di LDL-C sierico a digiuno come segue: o Livello di LDL-C sierico a digiuno compreso tra =80 mg/dl e <100 mg/dl con almeno 1 dei seguenti potenziatori di rischio: ¿ IM recente (>3 e <12 mesi precedenti la Randomizzazione); ¿ diabete mellito di tipo 2; ¿ trigliceridi (TG) a digiuno >150 mg/dl (>1,7 mmol/l); e/o ¿ HDL-C a digiuno <40 mg/dl (<1,0 mmol/l). OPPURE o Livello di LDL-C sierico a digiuno =100 mg/dl. - Livelli di TG a digiuno <400 mg/dl (<4,52 mmol/l) allo Screening (Visita 1); e - Velocità di filtrazione glomerulare stimata (eGFR) =30 ml/min/1,73 m2, calcolata utilizzando l’equazione sviluppata dalla Chronic Kidney Disease Epidemiology Collaboration allo Screening (Visita 1). Si applicano altri criteri definiti da protocollo |
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E.4 | Principal exclusion criteria |
1. Have current or any previous history of New York Heart Association class III or IV HF or left ventricular ejection fraction <30%; 2. Have been hospitalized for HF within 5 years prior to Screening (Visit1); 3. Have had any of the following clinical events within 3 months prior toScreening (Visit 1): o Non-fatal MI; o Non-fatal stroke; o Non-elective coronary revascularization; and/or o Hospitalization for unstable angina and/or chest pain; 4. Have uncontrolled severe hypertension, defined as either systolicblood pressure =160 mmHg or diastolic blood pressure =100 mmHgprior to Randomization, taken as the average of triplicatemeasurements. One triplicate retest will be allowed during the same visit, at which point if the retest result is no longer exclusionary, the participant may be randomized; 5. Have a formal diagnosis of homozygous familial hypercholesterolemia; 6. Have active liver disease, defined as any known current infectious, neoplastic, or metabolic pathology of the liver; unexplained elevations in alanine aminotransferase (ALT) or aspartate aminotransferase (AST) >3 × upper limit of normal (ULN); or total bilirubin >2 × ULN at Screening (Visit 1); 7. Have an HbA1c =10% at Screening (Visit 1); 8. Have a thyroid-stimulating hormone >1.5 × ULN at Screening (Visit1); 9. Have a creatine kinase >3 × ULN at Screening (Visit 1); Other protocol-defined criteria apply. |
1. Anamnesi attuale o pregressa di scompenso cardiaco di classe III o IV secondo la New York Heart Association o frazione di eiezione ventricolare sinistra <30%. 2. Ricovero ospedaliero per insufficienza cardiaca (IC) nei 5 anni precedenti lo Screening (Visita 1). 3. Manifestazione di uno qualsiasi dei seguenti eventi clinici nei 3 mesi precedenti lo Screening (Visita 1): o IM non fatale; o ictus non fatale; o rivascolarizzazione coronarica non elettiva; e/o o ricovero ospedaliero per angina instabile e/o dolore toracico. 4. Ipertensione grave non controllata, definita come pressione arteriosa sistolica =160 mmHg o pressione arteriosa diastolica =100 mmHg prima della randomizzazione, misurata come media delle misurazioni in triplicato. Sarà consentita una ripetizione in triplicato del test durante la stessa visita; a quel punto, laddove il risultato della ripetizione del test non fosse più esclusorio, il/la partecipante potrà essere randomizzato/a. 5. Diagnosi formale di ipercolesterolemia familiare omozigote. 6. Malattia epatica attiva, definita come qualsiasi nota patologia epatica infettiva, neoplastica o metabolica in corso; aumenti inspiegabili dell’alanina aminotransferasi (ALT) o dell’aspartato aminotransferasi (AST) >3 volte il limite superiore dell’intervallo normale (ULN); oppure bilirubina totale >2 volte il l’ULN allo Screening (Visita 1). 7. Valore di HbAlc =10% allo Screening (Visita 1). 8. Livello di ormone tireostimolante >1,5 volte l’ULN allo Screening (Visita 1). 9. Livello di creatinchinasi >3 volte l’ULN allo Screening (Visita 1). Si applicano altri criteri definiti da protocollo |
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E.5 End points |
E.5.1 | Primary end point(s) |
EFFICACY 1) the time from Randomization to the first confirmed occurrence of any component of the composite endpoint, including the following: - CV death; - Non-fatal MI; - Non-fatal stroke; or - Non-elective coronary revascularization. SAFETY 2) AEs and events of special interest (ESIs); 3) Vital signs; 4) Electrocardiograms; and 5) Clinical laboratory assessment |
EFFICACIA 1) Tempo dalla randomizzazione al primo evento confermato tra gli endpoint compositi inclusi i seguenti: - morte cardiovascolare - infarto del miocardio non fatale - ictus non fatale, o - rivascolarizzazione coronarica non elettiva
SICUREZZA 2) Eventi avversi (AEs) e eventi di particolare interesse (ESIs) 3) segni vitali 4) elettrocardiogrammi, e 5) Valutazioni cliniche di laboratorio |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
1) Baseline to EOS 2) V1 to EOT and EOS 3) V1, V2, V4, V5, V6+Q6M, EOT 4) Visit 2, EOT 5) V1, V2, V4, V5, V6+Q6M, EOT |
1) Dalla baseline alla EOS 2) Dalla V1 alla EOT e EOS 3) V1, V2, V4, V5, V6+Q6M, EOT 4) V2, EOT 5) V1, V2, V4, V5, V6+Q6M, EOT |
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E.5.2 | Secondary end point(s) |
The secondary efficacy endpoints, in hierarchical order, include the following: 1) The time from Randomization until the first confirmed occurrence of a composite of CV death, non-fatal MI, or non-fatal stroke; 2) The time from Randomization until the first confirmed occurrence of a composite of all-cause mortality, non-fatal MI, non-fatal stroke, or nonelective coronary revascularization; 3) The time from Randomization until the first confirmed occurrence of CV death; 4) The time from Randomization until the first confirmed occurrence of non-fatal MI; 5) The time from Randomization until the first confirmed occurrence non-fatal stroke; 6) The time from Randomization until the first confirmed occurrence of non-elective coronary revascularization; 7) A total event analysis, defined as the number of CV death events, and first and subsequent/recurrent events of non-fatal MIs, non-fatal strokes, and non-elective coronary revascularization from Randomization until the EOS Visit; 8) The time from Randomization until the first confirmed occurrence of NODM; 9) Percent change in LDL-C from Baseline to Day 365 and to the EOT Visit; 10) Percent change in non-HDL-C from Baseline to Day 365 and to the EOT Visit; 11) Percent change in ApoB from Baseline to Day 365; and 12) Percent change in HbA1c in participants with diabetes mellitus and HbA1c =7% at Baseline, from Baseline to Day 365 and to the EOT Visit |
Gli endpoints secondari sono in ordine gerarchico i seguenti: 1) Il tempo dalla randomizzazione al primo evento confermato tra decesso CV, IM non fatale o ictus non fatale; 2) Il tempo dalla randomizzazione al primo evento confermato di mortalità per tutte le cause, IM non fatale, ictus non fatale o rivascolarizzazione coronarica non elettiva; 3) Il tempo dalla randomizzazione al primo evento confermato di decesso CV 4) Il tempo dalla randomizzazione al primo evento confermato di IM non fatale 5) Il tempo dalla randomizzazione al primo evento confermato di ictus non fatale; 6) Il tempo dalla randomizzazione al primo evento confermato di rivascolarizzazione coronarica non elettiva 7) Analisi degli eventi CV totali; definita come numero dei decessi CV, e primi e successivi IM non fatale, ictus non fatale e rivascolarizzazione coronarica non elettiva dalla randomizzazione alla EOS 8) Il tempo dalla randomizzazione al primo evento confermato didiabete mellito di nuova insorgenza (NODM); 9) variazione percentuale del colesterolo legato alle lipoproteine a bassa densità (LDL-C) dal giorno 365 alla EOT; 10) variazione percentuale del colesterolo non legato alle lipoproteine ad alta densità (non-HDL-C)dal giorno 365 alla EOT; 11) variazione percentuale dell’apolipoproteina B (ApoB);dal giorno 365 e 12) variazione assoluta dell’emoglobina glicosilata (HbA1c) in partecipanti con diabete mellito e HbA1c =7% al basale dal giorno 365 alla EOT. |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
1,2,3,4,5,6,8) Baseline to EOS 7) EOS 9,10,12) Baseline, Day 365/EOT 11) Baseline to Day 365 |
1,2,3,4,5,6,8) Dalla baseline alla EOS 7) EOS 9,10,12) Baseline, giorno 365/EOT 11) Dalla baseline al giorno 365 |
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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 | 6 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 200 |
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 | Information not present in EudraCT |
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 |
Bulgaria |
Canada |
China |
Czechia |
Germany |
Hungary |
Israel |
Italy |
Japan |
Netherlands |
Poland |
Slovakia |
United Kingdom |
United States |
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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
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LSLV (The DSMB will review 1 interim analysis during the study after approximately 671 events have been adjudicated, corresponding to approximately 70% of the planned total number of events for the study. After this interim analysis, the DSMB may recommend that the study continues, the study continues with sample size modifications, or the study is stopped for overwhelming efficacy, futility, or safety concerns) |
LSLV (Il DSMB rivedrà una analisi ad interim durante lo studio dopo circa 671 eventi, corrispondenti a circa il 70% di tutti gli eventi previsti nello studio. In seguito a questa analisi ad interim, il DSMB può raccomandare che lo studio continui, che continui con una modifica della numerosità o che lu studio sia stoppato per chiara efficacia, futilità o preocupazioni sulla sicurezza. |
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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 | 4 |
E.8.9.1 | In the Member State concerned months | 8 |
E.8.9.1 | In the Member State concerned days | 0 |
E.8.9.2 | In all countries concerned by the trial years | 5 |
E.8.9.2 | In all countries concerned by the trial months | 1 |
E.8.9.2 | In all countries concerned by the trial days | 0 |