Efficacy and Safety of Alirocumab (SAR236553/REGN727) Versus Ezetimibe on Top of Statin in High Cardiovascular Risk Patients With Hypercholesterolemia (ODYSSEY COMBO II)

June 23, 2016 updated by: Sanofi

A Randomized, Double-Blind, Parallel Group Study to Evaluate the Efficacy and Safety of SAR236553/REGN727 Versus Ezetimibe in High Cardiovascular Risk Patients With Hypercholesterolemia Not Adequately Controlled With Their Statin Therapy

Alirocumab (SAR236553/REGN727) is a fully human monoclonal antibody that binds PCSK9 (proprotein convertase subtilisin/kexin type 9).

Primary Objective of the study:

To demonstrate the reduction of low-density lipoprotein cholesterol (LDL-C) by alirocumab as add-on therapy to stable maximally tolerated daily statin therapy in comparison with ezetimibe after 24 weeks of treatment in participants with hypercholesterolemia at high cardiovascular (CV) risk.

Secondary Objectives:

  • To evaluate the effect of alirocumab in comparison with ezetimibe on LDL-C at other time points
  • To evaluate the effect of alirocumab on other lipid parameters
  • To evaluate the safety and tolerability of alirocumab

Study Overview

Detailed Description

The maximum study duration was 115 weeks per participant, including a 3-week screening period, 104-week randomized treatment period and 8-week follow-up period.

Study Type

Interventional

Enrollment (Actual)

720

Phase

  • Phase 3

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

      • Brampton, Canada, L6T 3J1
        • Investigational Site Number 124902
      • Mirabel, Canada, J7J 2K8
        • Investigational Site Number 124914
      • Montreal, Canada, H1T 3Y7
        • Investigational Site Number 124903
      • Toronto, Canada, M9V 4B4
        • Investigational Site Number 124918
      • Esbjerg, Denmark, 6700
        • Investigational Site Number 208913
      • Glostrup, Denmark, 2600
        • Investigational Site Number 208914
      • Hellerup, Denmark, 2900
        • Investigational Site Number 208905
      • Herlev, Denmark, 2730
        • Investigational Site Number 208911
      • Hvidovre, Denmark, 2650
        • Investigational Site Number 208907
      • København S, Denmark, 2300
        • Investigational Site Number 208901
      • Køge, Denmark, 4600
        • Investigational Site Number 208906
      • Roskilde, Denmark, 4000
        • Investigational Site Number 208908
      • Silkeborg, Denmark, 8600
        • Investigational Site Number 208903
      • Dijon, France, 21079
        • Investigational Site Number 250906
      • Montpellier Cedex 5, France, 34295
        • Investigational Site Number 250907
      • Nantes, France, 44093
        • Investigational Site Number 250903
      • Nimes, France, 30900
        • Investigational Site Number 250905
      • Budapest, Hungary, 1036
        • Investigational Site Number 348908
      • Budapest, Hungary, 1134
        • Investigational Site Number 348901
      • Budapest, Hungary, 1134
        • Investigational Site Number 348903
      • Debrecen, Hungary, 4032
        • Investigational Site Number 348905
      • Szekesfehervar, Hungary, 8000
        • Investigational Site Number 348906
      • Holon, Israel, 58100
        • Investigational Site Number 376908
      • Kfar Saba, Israel, 44281
        • Investigational Site Number 376903
      • Ofakim, Israel, 80300
        • Investigational Site Number 376906
      • Petach Tikva, Israel
        • Investigational Site Number 376902
      • Rehovot, Israel, 76100
        • Investigational Site Number 376904
      • Safed, Israel, 13100
        • Investigational Site Number 376907
      • Tel Aviv, Israel, 64239
        • Investigational Site Number 376901
      • Anyang-Si, Korea, Republic of, 431-070
        • Investigational Site Number 410908
      • Busan, Korea, Republic of, 602-715
        • Investigational Site Number 410920
      • Daegu, Korea, Republic of, 700-712
        • Investigational Site Number 410926
      • Gwangju, Korea, Republic of, 501-757
        • Investigational Site Number 410923
      • Seoul, Korea, Republic of, 110-744
        • Investigational Site Number 410909
      • Seoul, Korea, Republic of, 120-752
        • Investigational Site Number 410922
      • Seoul, Korea, Republic of, 135-710
        • Investigational Site Number 410921
      • Seoul, Korea, Republic of, 135-720
        • Investigational Site Number 410905
      • Seoul, Korea, Republic of, 137-701
        • Investigational Site Number 410901
      • Seoul, Korea, Republic of, 138-736
        • Investigational Site Number 410914
      • Seoul, Korea, Republic of, 156-707
        • Investigational Site Number 410924
      • Suwon, Korea, Republic of, 443-721
        • Investigational Site Number 410915
      • Uijeongbu, Korea, Republic of, 480-717
        • Investigational Site Number 410913
      • Wonju, Korea, Republic of, 220-701
        • Investigational Site Number 410927
      • Barnaul, Russian Federation, 656055
        • Investigational Site Number 643906
      • Kemerovo, Russian Federation, 650002
        • Investigational Site Number 643903
      • Moscow, Russian Federation, 111539
        • Investigational Site Number 643927
      • Moscow, Russian Federation, 111539
        • Investigational Site Number 643928
      • Moscow, Russian Federation, 115404
        • Investigational Site Number 643931
      • Moscow, Russian Federation, 119048
        • Investigational Site Number 643924
      • Moscow, Russian Federation, 121374
        • Investigational Site Number 643932
      • Moscow, Russian Federation, 121552
        • Investigational Site Number 643908
      • Moscow, Russian Federation, 129090
        • Investigational Site Number 643904
      • Orenburg, Russian Federation, 450000
        • Investigational Site Number 643911
      • Ryazan, Russian Federation, 390026
        • Investigational Site Number 643921
      • Saint-Petersburg, Russian Federation, 197110
        • Investigational Site Number 643925
      • Saint-Petersburg, Russian Federation, 198205
        • Investigational Site Number 643922
      • Saratov, Russian Federation, 410028
        • Investigational Site Number 643929
      • St-Petersburg, Russian Federation, 199106
        • Investigational Site Number 643914
      • Alberton, South Africa, 1450
        • Investigational Site Number 710917
      • Bloemfontein, South Africa, 9301
        • Investigational Site Number 710909
      • Bloemfontein, South Africa, 9301
        • Investigational Site Number 710914
      • Cape Town, South Africa, 7500
        • Investigational Site Number 710905
      • Cape Town, South Africa, 7925
        • Investigational Site Number 710904
      • Middelburg, South Africa, 1055
        • Investigational Site Number 710918
      • Pretoria, South Africa, 0002
        • Investigational Site Number 710913
      • Somerset West, South Africa, 7130
        • Investigational Site Number 710915
      • Kiev, Ukraine, 02091
        • Investigational Site Number 804905
      • Uzhhorod, Ukraine, 88009
        • Investigational Site Number 804902
    • Alabama
      • Birmingham, Alabama, United States, 35209
        • Investigational Site Number 840980
    • Arizona
      • Phoenix, Arizona, United States, 85032
        • Investigational Site Number 840918
      • Tucson, Arizona, United States
        • Investigational Site Number 840925
    • California
      • Anaheim, California, United States, 92801
        • Investigational Site Number 840959
      • Beverly Hills, California, United States, 90211
        • Investigational Site Number 840301
      • Chino, California, United States, 91710
        • Investigational Site Number 840933
      • Lincoln, California, United States, 95648
        • Investigational Site Number 840991
      • Los Angeles, California, United States, 90057
        • Investigational Site Number 840979
      • Palm Springs, California, United States, 92262
        • Investigational Site Number 840952
      • Thousand Oaks, California, United States, 91360
        • Investigational Site Number 840930
      • Vista, California, United States, 92083
        • Investigational Site Number 840921
    • Florida
      • Boynton Beach, Florida, United States, 33472
        • Investigational Site Number 840962
      • Bradenton, Florida, United States, 34203
        • Investigational Site Number 840987
      • Clearwater, Florida, United States, 33756
        • Investigational Site Number 840302
      • Jacksonville, Florida, United States, 32223
        • Investigational Site Number 840935
      • Miami, Florida, United States, 33126
        • Investigational Site Number 840903
      • Miami, Florida, United States
        • Investigational Site Number 840920
      • Ocala, Florida, United States, 34471
        • Investigational Site Number 840943
      • Oveido, Florida, United States, 32765
        • Investigational Site Number 840981
      • Port Orange, Florida, United States, 32127
        • Investigational Site Number 840961
      • Sarasota, Florida, United States, 34239
        • Investigational Site Number 840303
      • St. Petersburg, Florida, United States
        • Investigational Site Number 840986
      • St. Petersburg, Florida, United States
        • Investigational Site Number 840988
    • Idaho
      • Meridian, Idaho, United States, 83646
        • Investigational Site Number 840995
    • Indiana
      • Evansville, Indiana, United States, 47714
        • Investigational Site Number 840902
    • Kansas
      • Topeka, Kansas, United States, 66606
        • Investigational Site Number 840960
    • Maryland
      • Oxon Hill, Maryland, United States, 20745
        • Investigational Site Number 840940
    • Massachusetts
      • Fall River, Massachusetts, United States, 02720
        • Investigational Site Number 840966
    • Missouri
      • Kansas City, Missouri, United States, 64114
        • Investigational Site Number 840917
      • St. Louis, Missouri, United States, 63131
        • Investigational Site Number 840998
    • Montana
      • Butte, Montana, United States, 59701
        • Investigational Site Number 840946
    • Nebraska
      • Lincoln, Nebraska, United States, 68510
        • Investigational Site Number 840914
    • New Mexico
      • Albuquerque, New Mexico, United States, 87106
        • Investigational Site Number 840949
    • New York
      • New Windsor, New York, United States, 12553
        • Investigational Site Number 840974
    • North Carolina
      • Greenville, North Carolina, United States, 27834
        • Investigational Site Number 840955
      • Lexington, North Carolina, United States, 27292
        • Investigational Site Number 840938
      • Smithfield, North Carolina, United States, 27577
        • Investigational Site Number 840976
      • Winston-Salem, North Carolina, United States, 27103
        • Investigational Site Number 840985
    • Ohio
      • Cincinnati, Ohio, United States, 45219
        • Investigational Site Number 840963
      • Lyndhust, Ohio, United States, 44124
        • Investigational Site Number 840970
      • Marion, Ohio, United States, 43302
        • Investigational Site Number 840906
      • Marion, Ohio, United States, 43302
        • Investigational Site Number 840997
      • Perrysburg, Ohio, United States, 43551
        • Investigational Site Number 840964
    • South Carolina
      • Charleston, South Carolina, United States, 29412
        • Investigational Site Number 840913
      • Greer, South Carolina, United States, 29651
        • Investigational Site Number 840912
      • Summerville, South Carolina, United States, 29485
        • Investigational Site Number 840992
    • Tennessee
      • Bristol, Tennessee, United States, 37620
        • Investigational Site Number 840932
      • Nashville, Tennessee, United States, 37205
        • Investigational Site Number 840944
    • Texas
      • Fort Worth, Texas, United States, 76104
        • Investigational Site Number 840994
      • Houston, Texas, United States, 77070
        • Investigational Site Number 840973
      • Houston, Texas, United States, 77074
        • Investigational Site Number 840939
      • Sugar Land, Texas, United States, 77479
        • Investigational Site Number 840945
      • Tomball, Texas, United States, 77375
        • Investigational Site Number 840971
    • Utah
      • Orem, Utah, United States, 84058
        • Investigational Site Number 840982
    • Virginia
      • Norfolk, Virginia, United States, 23502
        • Investigational Site Number 840931
      • Richmond, Virginia, United States, 23227
        • Investigational Site Number 840984
    • Washington
      • Renton, Washington, United States, 98055
        • Investigational Site Number 840928
      • Spokane, Washington, United States, 99204
        • Investigational Site Number 840990

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion criteria:

Participants with hypercholesterolemia and established coronary heart disease (CHD) or CHD risk equivalents who were not adequately controlled with a maximally tolerated daily dose of statin at stable dose for at least 4 weeks prior to the screening visit (Week -2).

Exclusion criteria:

  • Age < 18 or legal age of adulthood, whichever was greater
  • Participants without established CHD or CHD risk equivalents
  • LDL-C <70 mg/dL (<1.81 mmol/L) and participants with a history of documented cardiovascular disease
  • LDL-C <100 mg/dL (<2.59 mmol/L) and participants without a history of documented CV disease
  • Fasting serum triglycerides >400 mg/dL (>4.52 mmol/L)

The above information was not intended to contain all considerations relevant to a participant's potential participation in a clinical trial.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Quadruple

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Alirocumab 75 /up to 150 mg Q2W
Alirocumab 75 mg every 2 weeks (Q2W) and oral placebo capsule for ezetimibe daily added to stable Lipid Modifying Therapy (LMT) for 104 weeks. Alirocumab dose up-titrated to 150 mg from Week 12 when LDL-C level ≥70 mg/dL (1.81 mmol/L) at Week 8.
1 mL subcutaneous injection in the abdomen, thigh, or outer area of the upper arm by self-injection or by another designated person using the autoinjector.
Other Names:
  • Praluent
  • REGN727/SAR236553
One capsule once daily orally at approximately the same time of the day with or without food.
Statin (rosuvastatin, simvastatin or atorvastatin) at stable dose.
Active Comparator: Ezetimibe 10 mg
Ezetimibe 10 mg capsule daily and subcutaneous placebo for alirocumab Q2W added to stable LMT for 104 weeks.
One over-encapsulated tablet orally once daily at approximately the same time of the day with or without food.
Statin (rosuvastatin, simvastatin or atorvastatin) at stable dose.
1 mL subcutaneous injection in the abdomen, thigh, or outer area of the upper arm by self-injection or by another designated person using the autoinjector.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Percent Change From Baseline in Calculated LDL-C at Week 24 - Intent-to-treat (ITT) Analysis
Time Frame: From Baseline to Week 52
Adjusted Least-squares (LS) means and standard errors at Week 24 were obtained from a mixed-effect model with repeated measures (MMRM) to account for missing data. All available post-baseline data from week 4 to week 52 regardless of status on- or off-treatment were used in the model (ITT analysis).
From Baseline to Week 52

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Percent Change From Baseline in Non-High Density Lipoprotein Cholesterol (Non-HDL-C) at Week 24 - ITT Analysis
Time Frame: From Baseline to Week 52
Adjusted LS means and standard errors at Week 24 from MMRM model including all available post-baseline data from Week 4 to Week 52 regardless of status on- or off-treatment.
From Baseline to Week 52
Percent Change From Baseline in Total Cholesterol (Total-C) at Week 24 - ITT Analysis
Time Frame: From Baseline to Week 52
Adjusted LS means and standard errors at Week 24 from MMRM model including all available post-baseline data from Week 4 to Week 52 regardless of status on- or off-treatment.
From Baseline to Week 52
Percent Change From Baseline in Non-HDL-C at Week 12 - ITT Analysis
Time Frame: From Baseline to Week 52
Adjusted LS means and standard errors at Week 12 from MMRM model including all available post-baseline data from Week 4 to Week 52 regardless of status on- or off-treatment.
From Baseline to Week 52
Percent Change From Baseline in Total-C at Week 12 - ITT Analysis
Time Frame: From Baseline to Week 52
Adjusted LS means and standard errors at Week 12 from MMRM model including all available post-baseline data from Week 4 to Week 52 regardless of status on- or off-treatment.
From Baseline to Week 52
Percent Change From Baseline in HDL-C at Week 24 - ITT Analysis
Time Frame: From Baseline to Week 52
Adjusted LS means and standard errors at Week 24 from MMRM model including all available post-baseline data from Week 4 to Week 52 regardless of status on- or off-treatment.
From Baseline to Week 52
Percent Change From Baseline in HDL-C at Week 12 - ITT Analysis
Time Frame: From Baseline to Week 52
Adjusted LS means and standard errors at Week 12 from MMRM model including all available post-baseline data from Week 4 to Week 52 regardless of status on- or off-treatment.
From Baseline to Week 52
Percent Change From Baseline in Lipoprotein(a) at Week 24 - ITT Analysis
Time Frame: From baseline to Week 52
Adjusted means and standard errors at Week 24 were obtained from multiple imputation approach followed by robust regression model for handling of missing data. All available post-baseline data from Week 4 to Week 52 regardless of status on- or off-treatment were included in the imputation model.
From baseline to Week 52
Percent Change From Baseline in Apo A-1 at Week 12 - ITT Analysis
Time Frame: From Baseline to Week 52
Adjusted LS means and standard errors at Week 12 from MMRM model including all available post-baseline data from Week 4 to Week 52 regardless of status on- or off-treatment.
From Baseline to Week 52
Percent Change From Baseline in Fasting Triglycerides at Week 24 - ITT Analysis
Time Frame: From Baseline to Week 52
Adjusted means and standard errors at Week 24 from multiple imputation approach followed by robust regression model including all available post-baseline data from Week 4 to Week 52 regardless of status on- or off-treatment.
From Baseline to Week 52
Percent Change From Baseline in Apolipoprotein A-1 (Apo A-1) at Week 24 - ITT Analysis
Time Frame: From Baseline to Week 52
Adjusted LS means and standard errors at Week 24 from MMRM model including all available post-baseline data from Week 4 to Week 52 regardless of status on- or off-treatment.
From Baseline to Week 52
Percent Change From Baseline in Fasting Triglycerides at Week 12 - ITT Analysis
Time Frame: From Baseline to Week 52
Adjusted means and standard errors at Week 12 from multiple imputation approach followed by robust regression model including all available post-baseline data from Week 4 to Week 52 regardless of status on- or off-treatment.
From Baseline to Week 52
Percent Change From Baseline in Calculated LDL--C at Week 24 - On--Treatment Analysis
Time Frame: From Baseline to Week 52
Adjusted LS means and standard errors at Week 24 were obtained from MMRM model including available post-baseline on-treatment data from Week 4 to Week 52 (i.e. up to 21 days after last injection or 3 days after the last capsule, whichever came first).
From Baseline to Week 52
Percent Change From Baseline in Calculated LDL-C at Week 12 - ITT Analysis
Time Frame: From Baseline to Week 52
Adjusted LS means and standard errors at Week 12 from a MMRM including all available post-baseline data from week 4 to week 52 regardless of status on- or off-treatment.
From Baseline to Week 52
Percent Change From Baseline in Calculated LDL-C at Week 12 - On-Treatment Analysis
Time Frame: From Baseline to Week 52
Adjusted LS means and standard errors at Week 12 from MMRM model including available post-baseline on-treatment data from Week 4 to Week 52 (i.e. up to 21 days after last injection or 3 days after the last capsule, whichever came first).
From Baseline to Week 52
Percent Change From Baseline in Apolipoprotein B (Apo-B) at Week 24 - ITT Analysis
Time Frame: From Baseline to Week 52
Adjusted LS means and standard errors at Week 24 from MMRM model including all available post-baseline data from Week 4 to Week 52 regardless of status on- or off-treatment.
From Baseline to Week 52
Percent Change From Baseline in Apo B at Week 24 - On-Treatment Analysis
Time Frame: From Baseline to Week 52
Adjusted LS means and standard errors at Week 24 from MMRM model including available post-baseline on-treatment data from Week 4 to Week 52 (i.e. up to 21 days after last injection or 3 days after the last capsule, whichever came first).
From Baseline to Week 52
Percent Change From Baseline in Non-HDL-C at Week 24 - On-Treatment Analysis
Time Frame: From Baseline up to Week 52
Adjusted LS means and standard errors at Week 24 from MMRM model including available post-baseline on-treatment data from Week 4 to Week 52 (i.e. up to 21 days after last injection or 3 days after the last capsule, whichever came first).
From Baseline up to Week 52
Percent Change From Baseline in Apo-B at Week 12 - ITT Analysis
Time Frame: From Baseline to Week 52
Adjusted LS means and standard errors at Week 12 from MMRM model including all available post-baseline data from Week 4 to Week 52 regardless of status on- or off-treatment.
From Baseline to Week 52
Percent Change From Baseline in Calculated LDL-C at Week 52 - ITT Analysis
Time Frame: From Baseline to Week 52
Adjusted LS means and standard errors at Week 52 from a MMRM model including all available post-baseline data from week 4 to week 52 regardless of status on- or off-treatment.
From Baseline to Week 52
Percentage of Participants Achieving Calculated LDL-C <70 mg/dL (1.81 mmol/L) at Week 24 - ITT Analysis
Time Frame: Up to Week 52
Adjusted percentages at Week 24 were obtained from multiple imputation approach for handling of missing data. All available post-baseline data from week 4 to week 52 regardless of status on- or off-treatment were included in the imputation model.
Up to Week 52
Percentage of Participants Achieving Calculated LDL-C <70 mg/dL (1.81 mmol/L) at Week 24 - On-Treatment Analysis
Time Frame: Up to Week 52
Adjusted percentages at Week 24 from multiple imputation approach including available post-baseline on-treatment data from week 4 to week 52 (i.e. up to 21 days after last injection or 3 days after the last capsule, whichever came first).
Up to Week 52
Percent Change From Baseline in Lipoprotein(a) at Week 12 - ITT Analysis
Time Frame: From Baseline to Week 52
Adjusted means and standard errors at Week 12 from multiple imputation approach followed by robust regression model including all available post-baseline data from Week 4 to Week 52 regardless of status on- or off-treatment.
From Baseline to Week 52

Other Outcome Measures

Outcome Measure
Measure Description
Time Frame
Percent Change From Baseline in Calculated LDL-C at Week 52 - On-Treatment Analysis
Time Frame: From Baseline to Week 52
Adjusted LS means and standard errors at Week 52 from MMRM model including available post-baseline on-treatment data from Week 4 to Week 52 (i.e. up to 21 days after last injection or 3 days after the last capsule, whichever came first).
From Baseline to Week 52
Percent Change From Baseline in Calculated LDL-C at Week 104 - ITT Analysis
Time Frame: From Baseline to Week 104
Adjusted LS means and standard errors at Week 104 from MMRM including all available post-baseline data from Week 4 to Week 104 regardless of status on-or off-treatment.
From Baseline to Week 104
Percent Change From Baseline in Calculated LDL-C at Week 104 - On-Treatment Analysis
Time Frame: From Baseline to Week 104
Adjusted LS means and standard errors at Week 104 from MMRM model including available post-baseline on-treatment data from Week 4 to Week 104 (i.e. up to 21 days after last injection or 3 days after the last capsule, whichever came first).
From Baseline to Week 104

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

August 1, 2012

Primary Completion (Actual)

May 1, 2014

Study Completion (Actual)

July 1, 2015

Study Registration Dates

First Submitted

July 16, 2012

First Submitted That Met QC Criteria

July 16, 2012

First Posted (Estimate)

July 18, 2012

Study Record Updates

Last Update Posted (Estimate)

August 4, 2016

Last Update Submitted That Met QC Criteria

June 23, 2016

Last Verified

June 1, 2016

More Information

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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