- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03398005
A Phase 3 STudy of CaPRe In LOwering Very hiGh TriglYcerides (TRILOGY 1) (TRILOGY 1)
A Phase 3, Multi-center, Placebo-controlled, Randomized, Double-blind 26-week Study to Assess the Safety and Efficacy of CaPre® in Patients With Severe Hypertriglyceridemia.
The primary objective of this study is to determine the efficacy of CaPre 4 g daily, compared to placebo, in lowering fasting triglyceride (TG) levels in patients with fasting TG levels ≥500 mg/dL and ≤1500 mg/dL (≥5.7 mmol/L and ≤17.0 mmol/L) after 12 weeks of treatment.
Approximately 615 subjects will be screened to obtain 245 randomized subjects following a 2.5:1 treatment allocation ratio (CaPre: placebo).
Study Overview
Study Type
Enrollment (Actual)
Phase
- Phase 3
Contacts and Locations
Study Locations
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Alabama
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Birmingham, Alabama, United States, 35242
- Research Site
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Arizona
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Tucson, Arizona, United States, 85712
- Research Site
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Arkansas
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Conway, Arkansas, United States, 72034
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California
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El Cajon, California, United States, 92020
- Research Site
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Fresno, California, United States, 93702
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Garden Grove, California, United States, 92844
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Lomita, California, United States, 90717
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Newport Beach, California, United States, 92663
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Tustin, California, United States, 92780
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Florida
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Boca Raton, Florida, United States, 33487
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Clearwater, Florida, United States, 33765
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Fort Myers, Florida, United States, 33912
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Hialeah, Florida, United States, 33012
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Homestead, Florida, United States, 33030
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Jacksonville, Florida, United States, 32256
- Research Site
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Kendall, Florida, United States, 33175
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Lake Worth, Florida, United States, 33461
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Miami, Florida, United States, 33126
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Miami, Florida, United States, 33173
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Miami, Florida, United States, 33165
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Miami, Florida, United States, 33144
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Miami, Florida, United States, 33125
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Miami, Florida, United States, 33135
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Miami, Florida, United States, 33155
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Miami Springs, Florida, United States, 33166
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North Miami Beach, Florida, United States, 33162
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Orlando, Florida, United States, 32825
- Research Site
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Pembroke Pines, Florida, United States, 33026
- Research Site
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Tamarac, Florida, United States, 33321
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Tampa, Florida, United States, 33603
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Wellington, Florida, United States, 33449
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West Palm Beach, Florida, United States, 33401
- Research Site
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West Palm Beach, Florida, United States, 33409
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Georgia
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Atlanta, Georgia, United States, 30345
- Research Site
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Gainesville, Georgia, United States, 30501
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Savannah, Georgia, United States, 31406
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Snellville, Georgia, United States, 30078
- Research Site
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Sugar Hill, Georgia, United States, 30518
- Research Site
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Idaho
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Meridian, Idaho, United States, 83642
- Research Site
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Meridian, Idaho, United States, 83646
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Illinois
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Gurnee, Illinois, United States, 60031
- Research Site
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Indiana
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Anderson, Indiana, United States, 46011
- Research Site
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Kentucky
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Louisville, Kentucky, United States, 40213
- Research Site
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Louisiana
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Eunice, Louisiana, United States, 70535
- Research Site
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Michigan
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Cadillac, Michigan, United States, 49601
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Mississippi
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Jackson, Mississippi, United States, 39202
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Olive Branch, Mississippi, United States, 38654
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Missouri
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Saint Louis, Missouri, United States, 63117
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Nebraska
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Omaha, Nebraska, United States, 68114
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North Carolina
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Greensboro, North Carolina, United States, 27408
- Research Site
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Mooresville, North Carolina, United States, 28117
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Ohio
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Canton, Ohio, United States, 44710
- Research Site
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Marion, Ohio, United States, 43302
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Maumee, Ohio, United States, 43537
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Oklahoma
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Norman, Oklahoma, United States, 73069
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Pennsylvania
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Beaver, Pennsylvania, United States, 15009
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South Carolina
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Spartanburg, South Carolina, United States, 29301
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Tennessee
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Chattanooga, Tennessee, United States, 37421
- Research Site
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Memphis, Tennessee, United States, 38119
- Research Site
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Texas
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Arlington, Texas, United States, 76012
- Research Site
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Houston, Texas, United States, 77084
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Houston, Texas, United States, 77089
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Lampasas, Texas, United States, 76550
- Research Site
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San Antonio, Texas, United States, 78258
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Utah
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Salt Lake City, Utah, United States, 84107
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West Jordan, Utah, United States, 84088
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Virginia
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Danville, Virginia, United States, 24541
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Washington
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Bellevue, Washington, United States, 98007
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Wisconsin
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Kenosha, Wisconsin, United States, 53144
- Research Site
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Subjects ≥18 years of age.
- Isolated hypertriglyceridemia, with triglycerides ≥500 mg/dL and <1500 mg/dL (≥5.7 mmol/L and <17.0 mmol/L) OR Mixed hyperlipidemia, with serum triglycerides ≥500 and <1500 mg/dL treated with a statin, CAI or PCSK9I inhibitor, alone or in combination, that has been stable for 6 weeks prior to randomization. If the subject is not being treated and not contraindicated, a statin and/or CAI treatment may be initiated at the discretion of the Investigator at time of screening.
- Willingness to maintain current physical activity level and follow the NCEP-TLC diet throughout the study.
- Be informed of the nature of the study and give written consent prior to any study procedure.
Exclusion Criteria:
- Allergy or intolerance to OM3 fatty acids, OM3-acid ethyl esters, OM3 phospholipids, fish, shell fish, or any component of the study medication.
- Known lipoprotein lipase impairment or deficiency, or apo CII deficiency.
- Subjects with lysosomal acid lipase deficiency.
- Body mass index greater than 45 kg/m2.
Subjects who are pregnant, lactating, and subjects of childbearing potential who are either planning to become pregnant or who are not using acceptable birth control methods during study participation. Subjects of childbearing potential are subjects who have experienced menarche and do not otherwise meet the criteria for subjects not of childbearing potential, defined as:
- Subjects who have had surgical sterilization (hysterectomy or bilateral oophorectomy or tubal ligation); or
- Subjects who are postmenopausal, i.e., who have had a cessation of menses for at least 12 months without an alternative medical cause. A follicle stimulating hormone (FSH) test ≥40 mIU/mL may be used to confirm the post-menopausal state in women not using hormonal contraception or hormonal replacement therapy.
Subjects of childbearing potential must test negative for pregnancy at the time of enrollment and agree to use an acceptable contraceptive method or remain abstinent during the study or for at least 8 weeks following the last dose of study medication, whichever is longer.
- Subjects taking tamoxifen, estrogens, or progestins, or other medications or nutritional supplements with mechanisms modifying estrogen or progestogen pathways, who have had dosage changes within 4 weeks prior to Visit 1.
- Use of oral or injected corticosteroids or anabolic steroids within 6 weeks prior to randomization.
- History of pancreatitis within the last 6 months prior to Visit 1.
- History of symptomatic gallstone disease within the last 5 years, unless treated with cholecystectomy.
- Diabetics requiring changes in medical therapy (other than short acting insulin dosage adjustments) within 6 weeks prior to Visit 1 or who have HbA1c greater than 9.5% at Visit 1.
- Clinical or biochemical evidence of hyperthyroidism not stable with medication for at least 6 weeks prior to Visit 1.
- Uncontrolled hypothyroidism or thyroid stimulating hormone (TSH) level more than 1.5 × upper limit of normal (ULN).
- Thyroid hormone replacement therapy that has not been stable for more than 6 weeks prior to Visit 1.
- History of cancer (other than basal cell carcinoma) within 2 years prior to Visit 1.
- Cardiovascular event (i.e., myocardial infarction, acute coronary syndrome, new onset angina, stroke, transient ischemic attack, exacerbation of congestive heart failure requiring hospitalization or a change in treatment), life threatening arrhythmia, or revascularization procedure within 6 months prior to Visit 1.
- Use of other prohibited drugs: weight loss prescription medications; human immunodeficiency virus (HIV) protease inhibitors; cyclophosphamide; isotretinoin; routine or anticipated use of systemic corticosteroids (local, topical, inhalation, or nasal corticosteroids are permitted); or anabolic steroids.
- Use of any lipid-altering drug therapy, other than statins, CAI (such as ezetimibe) or PCSK9I inhibitors, alone or in combination, including niacin at a dose greater than 200 mg/day, fibrates, bile acid sequestrants, OM3 drugs (e.g., Lovaza or its generics,Vascepa, Epanova, Omtryg), OM3 supplements (e.g., fish oil, krill oil products), or any other herbal products or dietary supplements with potential lipid-altering effects. These products must be discontinued at least 6 weeks prior to randomization.
- Resection of an aortic aneurysm or endovascular aortic repair within 6 months prior to Visit 1.
- Recent history (within 6 months prior to Visit 1) or current significant nephrotic syndrome or ≥3 gram proteinuria daily, pulmonary, gastrointestinal, or immunologic disease.
- Poorly controlled hypertension (systolic blood pressure ≥170 mmHg and/or diastolic blood pressure ≥100 mmHg). Subjects with hypertension adequately controlled with medication are eligible provided that their antihypertensive therapy has been stable for at least 4 weeks prior to Visit 1.
- Recent history (past 12 months) of drug abuse or alcohol abuse, or alcohol use greater than 2 units per day (a unit of alcohol is defined as a 12-ounce (350 mL) beer, 5 ounce (150 mL) wine, or 1.5-ounce (45 mL) of 80-proof alcohol for drinks).
- Hepatobiliary disease or serum alanine aminotransferase (ALT) or aspartate aminotransferase (AST) >5× ULN; if ALT/AST is >3× ULN, the levels must have been stable for 3 months prior to Visit 1.
- Severe renal disease as defined by less than 30 mL/min serum creatinine clearance calculated using the Cockcroft-Gault formula.
- Significant coagulopathy as defined by a known hereditary deficiency of coagulation factors or platelet function or an unexplained elevation of the prothrombin time (PT) international normalized ratio (INR) of ≥1.5. Subjects using warfarin [Coumadin®] or heparin are allowed. Subjects receiving other anticoagulants dabigatran, rivaroxaban, or apixaban are allowed. Subjects receiving acetylsalicylic acid (ASA) alone or in combination with other anti platelet agents (e.g., clopidogrel, prasugrel, ticagrelor) are also allowed.
- Unexplained creatine kinase concentration 3 × ULN.
- Creatine kinase elevation owing to known hereditary or acquired muscle disease.
- Exposure to any investigational product, within 4 weeks prior to Visit 1.
- Presence of any other condition the Investigator believes would interfere with the subject's ability to provide informed consent, comply with study instructions, or which might confound the interpretation of the study results or put the subject at undue risk.
- Any life-threatening disease expected to result in death within 2 years, require frequent hospitalizations, extensive surgery or changes in medications or diet.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
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Placebo Comparator: Placebo
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4 x 1 g capsules administered orally once a day for 26 weeks
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Experimental: CaPre
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4 x 1 g capsules administered orally once a day for 26 weeks
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Time Frame |
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Percent change in fasting TG levels from baseline (average of Week -2, -1, and 0) to Week 12 (average of Week 11 and 12) in patients with fasting TG levels ≥500 mg/dL and ≤1500 mg/dL (≥5.7 mmol/L and ≤17.0 mmol/L).
Time Frame: Week 12
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Week 12
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Secondary Outcome Measures
Outcome Measure |
Time Frame |
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Percent change from baseline (average of Week -2, -1, and 0) to Week 12 (average of Week 11 and 12) in non-HDL-C.
Time Frame: Week 12
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Week 12
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Percent change from baseline (Week -1 and 0) to Week 12 (average of Week 11 and 12) in VLDL-C (β-quantification).
Time Frame: Week 12
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Week 12
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Percent change from baseline (average of Week -2, -1, and 0) to Week 12 (average of Week 11 and 12) in HDL-C.
Time Frame: Week 12
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Week 12
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Percent change from baseline (average of Week -1 and 0) to Week 12 (average of Week 11 and 12) in LDL-C (β-quantification).
Time Frame: Week 12
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Week 12
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Other Outcome Measures
Outcome Measure |
Time Frame |
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Percent change from baseline (average of Week -2, -1, and 0) to all measured visits other than Week 12 (Week 4, Week 18 and Week 26) in TG (persistence of the effect of CaPre on TG).
Time Frame: Week 4; Week 18; Week 24
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Week 4; Week 18; Week 24
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Proportion of subjects with a fasting TG level below 500 mg/dL (<5.7 mmol/L) at Week 12 and at Week 26.
Time Frame: Week 12; Week 26
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Week 12; Week 26
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Percent change from baseline (average of Week -2, -1, and 0) to Week 12 (average of Week 11 and Week 12) and Week 26 in TC.
Time Frame: Week 12; Week 26
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Week 12; Week 26
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Percent change from baseline (average of Week -1 and 0) to Week 12 (average of Week 11 and 12) and to Week 26 in RLP-C.
Time Frame: Week 12; Week 26
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Week 12; Week 26
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Percent change from baseline (average of Week -1 and 0) to Week 26 in LDL-C (β-quantification) and VLDL-C (β-quantification).
Time Frame: Week 26
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Week 26
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Percent change from baseline (average of Week -2, -1, and 0) to Week 26 in non-HDL-C and HDL-C.
Time Frame: Week 26
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Week 26
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Percent change from baseline (Week 0) to Week 12 and to Week 26 in apo B, apo A1, apo B/apo A1 ratio, apo CIII and apo A5.
Time Frame: Week 12; Week 26
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Week 12; Week 26
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Percent change from baseline (Week 0) to Week 12 and to Week 26 in lipoprotein particles concentration and size (LDL, non-HDL, HDL, IDL and VLDL).
Time Frame: Week 12; Week 26
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Week 12; Week 26
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Percent change from baseline (Week 0) to Week 12 and to Week 26 in oxidized LDL.
Time Frame: Week 12; Week 26
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Week 12; Week 26
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Percent change from baseline (Week 0) to Week 12 and to Week 26 in fasting serum glucose, insulin and HbA1c.
Time Frame: Week 12; Week 26
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Week 12; Week 26
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Percent change from baseline (Week 0) to Week 12 and to Week 26 in HOMA-IR and HOMA-β.
Time Frame: Week 12; Week 26
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Week 12; Week 26
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Percent change from baseline (Week 0) to Week 12 and to Week 26 in hs-CRP and Lp-PLA2.
Time Frame: Week 12; Week 26
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Week 12; Week 26
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Change from baseline (Week 0) to Week 4, Week 12, Week 18 and to Week 26 in Total plasma EPA concentration and Total plasma DHA concentration.
Time Frame: Week 4; Week 12; Week 18; Week 26
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Week 4; Week 12; Week 18; Week 26
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Percent change from baseline (Week 0) to Week 4, Week 12, Week 18 and to Week 26 in Total plasma EPA concentration and Total plasma DHA concentration.
Time Frame: Week 4; Week 12; Week 18; Week 26
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Week 4; Week 12; Week 18; Week 26
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Change from baseline (Week 0) to Week 12 and to Week 26 in OM3 Index.
Time Frame: Week 12; Week 26
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Week 12; Week 26
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Percent change from baseline (Week 0) to Week 12 and to Week 26 in OM3 Index.
Time Frame: Week 12; Week 26
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Week 12; Week 26
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Change from baseline (Week 0) to Week 12 and to Week 26 in AA.
Time Frame: Week 12; Week 26
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Week 12; Week 26
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Percent change from baseline (Week 0) to Week 12 and to Week 26 in AA.
Time Frame: Week 12; Week 26
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Week 12; Week 26
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Change from baseline (Week 0) to Week 12 and to Week 26 in omega-6/omega-3 ratio.
Time Frame: Week 12; Week 26
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Week 12; Week 26
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Percent change from baseline (Week 0) to Week 12 and to Week 26 in omega-6/omega-3 ratio.
Time Frame: Week 12; Week 26
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Week 12; Week 26
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Change from baseline (Week 0) to Week 12 and to Week 26 in EPA/AA ratio.
Time Frame: Week 12; Week 26
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Week 12; Week 26
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Percent change from baseline (Week 0) to Week 12 and to Week 26 in EPA/AA ratio.
Time Frame: Week 12; Week 26
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Week 12; Week 26
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Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Dariush Mozaffarian, MD, DrPH, Tufts Friedman School of Nutrition Science and Policy
Publications and helpful links
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- ACA-CAP-001
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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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