- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03705234
A Randomized Trial Assessing the Effects of Inclisiran on Clinical Outcomes Among People With Cardiovascular Disease (ORION-4)
HPS-4/TIMI 65/ORION-4: A Double-blind Randomized Placebo-controlled Trial Assessing the Effects of Inclisiran on Clinical Outcomes Among People With Atherosclerotic Cardiovascular Disease
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
The ORION-4 study aims to provide evidence about both the efficacy and safety of inclisiran. Inclisiran is a PCKS9 synthesis inhibitor which has been found to reduce LDL-cholesterol by about 50-60%. ORION-4 will investigate the effects of inclisiran on major adverse cardiovascular events.
The study is intended to be conducted at approximately 180 clinical sites in the UK and the USA. Approximately 15,000 participants aged 40 years or older for men, and 55 years or older for women, with pre-existing atherosclerotic cardiovascular disease will be randomized between inclisiran sodium 300 mg and matching placebo (given by subcutaneous injection on the day of randomization, at 3 months and then every 6-months) in a 1:1 ratio for a planned median duration of about 5 years.
Study Type
Enrollment (Actual)
Phase
- Phase 3
Contacts and Locations
Study Contact
- Name: Louise Bowman
- Phone Number: +44 (0)1865 743743
- Email: orion4@ndph.ox.ac.uk
Study Contact Backup
- Name: Marion Mafham
- Phone Number: +44 (0)1865 743743
- Email: orion4@ndph.ox.ac.uk
Study Locations
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Oxfordshire
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Oxford, Oxfordshire, United Kingdom, OX3 7LF
- CTSU, University of Oxford
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Massachusetts
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Boston, Massachusetts, United States, 02115
- TIMI Study Group
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria
History or evidence of at least one of the following:
- Prior MI; or
- Prior ischemic stroke; or
- Peripheral artery disease as evident by prior lower extremity artery revascularization or aortic aneurysm repair.
Minimum age is 40 years for men and 55 years for women
Exclusion Criteria
None of the following must be satisfied (based on self-reported medical history):
- Acute coronary syndrome or stroke less than 4 weeks before the Screening visit or during the Run-in period;
- Coronary revascularization procedure planned within the next 6 months;
- Known chronic liver disease;
- Current or planned renal dialysis or transplantation;
- Previous exposure to inclisiran or participation in a randomized trial of inclisiran;
- Previous (within about 3 months), current or planned treatment with a monoclonal antibody targeting PCSK9, or with a drug known to be contra-indicated with inclisiran (none currently known);
- Known to be poorly compliant with clinic visits or prescribed medication;
- Medical history that might limit the individual's ability to take trial treatments for the duration of the study (e.g. severe respiratory disease; cancer or evidence of spread within approximately the last 5 years, other than non-melanoma skin cancer; or history of alcohol or substance misuse) or may put the individual at significant risk in the opinion of the investigator (or their authorised deputy) if he/she were to participate in the trial;
- Women of child-bearing potential, current pregnancy, or lactation;
- Current participation in a clinical trial with an unlicensed drug or device; or
- Staff personnel directly involved with the study and any family member of the investigational study staff.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Quadruple
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Inclisiran
Inclisiran sodium 300 milligrams (mg) will be administered as a SC injection at randomization, 3 months and then every 6 months.
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Inclisiran is a small interfering ribonucleic acid (RNA) that inhibits PCSK9 synthesis.
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Placebo Comparator: Placebo
Placebo will be administered as SC injections of saline solution at randomization, 3 months and then every 6 months.
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Placebo will be supplied as sterile normal saline (0.9% sodium chloride in water for injection).
Other Names:
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Number of participants with a major adverse cardiovascular event (MACE)
Time Frame: Median follow-up of 5-years
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Defined as time to first occurrence - during the scheduled treatment period - of:
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Median follow-up of 5-years
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Secondary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Number of participants with MACE among those recorded to be taking high-intensity statin at baseline
Time Frame: Median follow-up of 5-years
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Median follow-up of 5-years
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Number of participants with a composite of CHD death or myocardial infarction
Time Frame: Median follow-up of 5-years
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Median follow-up of 5-years
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Number of participants with cardiovascular death
Time Frame: Median follow-up of 5-years
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Median follow-up of 5-years
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Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Louise Bowman, University of Oxford
- Principal Investigator: Martin Landray, University of Oxford
- Principal Investigator: Marion Mafham, University of Oxford
- Principal Investigator: David Preiss, University of Oxford
Publications and helpful links
General Publications
Helpful Links
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
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
Additional Relevant MeSH Terms
Other Study ID Numbers
- CTSU_MDCO_PCS-17-01
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
IPD Sharing Time Frame
IPD Sharing Access Criteria
IPD Sharing Supporting Information Type
- STUDY_PROTOCOL
- SAP
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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