E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Patients following acute percutaneous coronary intervention for STEMI or NSTEMI insufficiently treated with high-intensity oral lipid lowering therapy |
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E.1.1.1 | Medical condition in easily understood language |
patients following myocardial infarctions insufficiently treated with high-intensity oral lipid lowering therapy |
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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 | LLT |
E.1.2 | Classification code | 10064345 |
E.1.2 | Term | ST segment elevation myocardial infarction |
E.1.2 | System Organ Class | 10007541 - Cardiac disorders |
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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 | 10064347 |
E.1.2 | Term | Non ST segment elevation myocardial infarction |
E.1.2 | System Organ Class | 10007541 - Cardiac 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 determine the proportion of patients (%) who successfully achieve the ESC LDL-C guideline targets (LDL-C < 55 mg/dl) after 8 weeks of treatment with the triple therapy of atorvastatin plus ezetimibe and additive bempedoic acid (180 mg/d) in a group of patients that did not reach the ESC LDL-C guideline targets after 6 weeks of treatment with dual therapy including atorvastatin (at least 40 mg/d or equivalent) plus ezetimibe (10 mg/d). |
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E.2.2 | Secondary objectives of the trial |
1) To determine the proportion of patients (%) who successfully achieve ESC LDL-C guideline targets (LDL-C < 55 mg/dl) after treatment with dual therapy including atorvastatin (at least 40 mg/d or equivalent) plus ezetimibe (10 mg/d) for 6 and 14weeks 2) To determine the proportion of patients (%) who successfully achieve the ESC LDL-C guideline targets after 14 weeks of treatment 3) To determine the proportion of patients (%) who achieve AHA/ACC guideline recommended treatment targets of LDL-C < 70 mg/dl after 14 weeks of treatment in the triple therapy group 4) To examine the change in lipid levels during the study 5) To examine the adherence to medication by the proportion of non-compliant patients (%) taking less than 90% of the allocated study medication 6) To examine the change in Quality of Life
Assessment of safety: Safety assessments will consist of monitoring and recording of all adverse events (AEs) and serious adverse events (SAEs) and safety lab.
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1. Men, women, inter/diverse* aged ≥ 18 and ≤ 85 years 2. Signed written informed consent 3. NSTEMI or STEMI with successful PCI within 7 days prior to screening 4. Therapy naïve LDL-C > 100 mg/dl 5. Ensured compliance: patient should be able to cooperate with protocol regimen and follow-up 6. *Patients without childbearing potential defined as follows: • at least 6 weeks after surgical sterilization by bilateral tubal ligation or bilateral oophorectomy or • hysterectomy or uterine agenesis or • ≥ 50 years and in postmenopausal state for > 1 year or • < 50 years and in postmenopausal state for > 1 year with serum FSH > 40 IU/l and serum estrogen < 30 ng/l or a negative estrogen test, both at screening or *Patients of childbearing potential: • who are practising sexual abstinence (periodic abstinence and withdrawal are not acceptable) or • who have same sexual relationships only and/or have sexual relationships with sterile partners or • who are sexually active with fertile partner, have a negative pregnancy test dur-ing screening and agree to use reliable methods of contraception** from the time of screening until end of the clinical trial and for a period of 4 days following the last administration of study medication. **The following methods of contraception are acceptable (failure rate of < 1% per year/highly effective): - combined (estrogen and progesterone containing) hormonal contraception (oral/intravaginal/transdermal) associated with inhibition of ovulation, - progestogen-only hormonal contraception (oral, injectable, implantable) as-sociated with inhibition of ovulation, - intrauterine device (IUD), - intrauterine hormone-releasing system (IUS)
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E.4 | Principal exclusion criteria |
1. History of gout 2. Scheduled surgery within the next 4 months 3. Patients who cannot come to revisits 4. Participation in another clinical trial within 30 days before study start or during the trial 5. Hypersensitivity to any of the components of the medications used 6. Pregnancy / Breast-feeding 7. Patients with severe renal disorders (defined as eGFR <30 ml/min/1,73 m2) or patients requiring dialysis with endstage renal disease 8. Patients with history of tendon disorders or tendon rupture 9. Person who is placed in an mental institution by court or official order |
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E.5 End points |
E.5.1 | Primary end point(s) |
Proportion of patients (%) in group A who successfully achieve the ESC LDL-C guideline targets after stage II defined as the proportion of patients (%) who successfully achieve the ESC LDL-C guideline targets (LDL-C < 55 mg/dl) following 8 weeks of treatment with the triple therapy of atorvastatin plus ezetimibe and additive bempedoic acid (180 mg/d) in the group of patients that did not reach the LDL-C guideline targets after 6 weeks of treatment with dual therapy including atorvastatin (at least 40 mg/d or equivalent) plus ezetimibe (10 mg/d).
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
following 8 weeks of treatment with the triple therapy of atorvastatin plus ezetimibe and additive bempedoic acid (180 mg/d) |
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E.5.2 | Secondary end point(s) |
1) Proportion of patients (%) who successfully achieve ESC LDL-C guideline targets (LDL-C < 55 mg/dl) after treatment with dual therapy including atorvastatin (at least 40 mg/d or equivalent) plus ezetimibe (10 mg/d) for 6 and for 14 weeks 2) Proportion of patients (%) who successfully achieve the ESC LDL-C guideline targets after 14 weeks of treatment. 3) Proportion of patients (%) who achieve AHA/ACC guideline recommended treatment targets of LDL-C < 70 mg/dl after 14 weeks of treatment in the triple therapy group 4) Mean change from baseline to week 6 and to week 14 in LDL-C, total cholesterol, HDL-C, triglycerides, uric acid, creatine kinase, systolic and diastolic blood pressure, pulse 5) Proportion of non-compliant patients (%) taking less than 90% of the allocated study medication 6) Mean change from baseline to week 6 and to week 14 in Quality of Life 7) Monitoring and recording of all AEs and SAEs (triple therapy group and double therapy group from dispense of IMP onwards (V2)), safety lab |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
1) from baseline to week 6 and week 14 2) after 14 weeks of treatment 3) after 14 weeks of treatment in the triple therapy group 4) from baseline to week 6 and to week 14 5) from start of treatment until EOT 6) from baseline to week 6 and week 14 7) from start of treatment (V2) until FU |
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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 | No |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | No |
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 | No |
E.8.1.1 | Randomised | No |
E.8.1.2 | Open | Yes |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | No |
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) | Information not present in EudraCT |
E.8.2.2 | Placebo | Information not present in EudraCT |
E.8.2.3 | Other | Information not present in EudraCT |
E.8.2.4 | Number of treatment arms in the trial | 1 |
E.8.3 |
The trial involves single site in the Member State concerned
| Yes |
E.8.4 | The trial involves multiple sites in the Member State concerned | No |
E.8.5 | The trial involves multiple Member States | No |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | No |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
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 | 22 |
E.8.9.1 | In the Member State concerned days | |