- ICH GCP
- 미국 임상 시험 레지스트리
- 임상시험 NCT01984424
Goal Achievement After Utilizing an Anti-PCSK9 Antibody in Statin Intolerant Subjects-3 (GAUSS-3)
A Double-blind, Randomized, Multicenter Study to Evaluate the Safety and Efficacy of Evolocumab, Compared With Ezetimibe, in Hypercholesterolemic Subjects Unable to Tolerate an Effective Dose of a HMG-CoA Reductase Inhibitor Due to Muscle Related Side Effects
연구 개요
상태
정황
상세 설명
The study is divided into 3 parts (A, B, C). After an initial 4-week washout period in which any statins, ezetimibe, or other lipid-lowering agents were discontinued, participants were enrolled in phase A, a double-blind, placebo-controlled crossover procedure to rechallenge patients with atorvastatin. Patients were randomly assigned in a 1:1 ratio to receive either atorvastatin (20 mg daily) or matching placebo for the first 10 weeks (period 1), then underwent a 2-week washout period, followed by crossover to the alternate therapy for a second 10-week period (period 2). Patients who experienced intolerable muscle symptoms during the first period did not complete the full 10 weeks of exposure but entered a 2-week washout period before proceeding to period 2.
Participants who did not develop muscle-related side effects were removed from the study, as were patients who reported muscle-related side effects during a placebo period.
After completion of phase A, patients who experienced muscle-related adverse effects while taking atorvastatin but not placebo were eligible for phase B, a 24-week, double-blind randomization to ezetimibe or evolocumab using a double-dummy design in which patients received either injectable placebo and oral ezetimibe or injectable evolocumab and oral placebo. A patient could proceed directly to phase B if they had a documented history of creatine kinase (CK) elevation more than 10 times the upper limit of normal accompanied by muscle symptoms while taking statin therapy, with documented resolution of both CK elevation and symptoms upon discontinuation of statin therapy.
These study procedures were designed to ensure that only patients with reproducible statin-associated muscle symptoms entered phase B of the study. For phase B, participants were randomized 2:1 to receive subcutaneously administered evolocumab (420 mg monthly) or oral ezetimibe (10 mg daily). Randomization in part B was stratified by screening LDL-C level (< 180 mg/dL [4.66 mmol/L] vs. ≥ 180 mg/dL) at study baseline.
Participants who completed phase B and did not discontinue SC investigational product for any reason, including an adverse event, were eligible to proceed to the 2-year open-label extension phase C to evaluate the long-term safety and efficacy of evolocumab in statin-intolerant patients. Participants in phase C were allowed to choose quarterly between evolocumab 420 mg SC QM or evolocumab 140 mg SC every 2 weeks (Q2W).
연구 유형
등록 (실제)
단계
- 3단계
연락처 및 위치
연구 장소
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Gauteng
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Johannesburg, Gauteng, 남아프리카, 2157
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Midrand, Gauteng, 남아프리카, 1685
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Western Cape
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Observatory, Western Cape, 남아프리카, 7925
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Parow, Western Cape, 남아프리카, 7505
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Amsterdam, 네덜란드, 1105 AZ
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Rotterdam, 네덜란드, 3045 PM
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Zwijndrecht, 네덜란드, 3331 LZ
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Oslo, 노르웨이, 0373
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Ålesund, 노르웨이, 6003
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Christchurch, 뉴질랜드, 8011
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Aarhus N, 덴마크, 8200
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Glostrup, 덴마크, 2600
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Berlin, 독일, 13353
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Köln, 독일, 50937
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München, 독일, 80638
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California
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Beverly Hills, California, 미국, 90211
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Huntington Beach, California, 미국, 92648
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Los Angeles, California, 미국, 90048
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San Pedro, California, 미국, 90732
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Georgia
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Atlanta, Georgia, 미국, 30322
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Illinois
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Sterling, Illinois, 미국, 61081
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Kansas
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Kansas City, Kansas, 미국, 66160
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Maryland
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Baltimore, Maryland, 미국, 21201
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Towson, Maryland, 미국, 21204
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Michigan
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Ann Arbor, Michigan, 미국, 48106
- Research Site
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Minnesota
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Rochester, Minnesota, 미국, 55905
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Missouri
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Saint Louis, Missouri, 미국, 63110
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New York
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New York, New York, 미국, 10029
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North Carolina
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Durham, North Carolina, 미국, 27710
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Ohio
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Cleveland, Ohio, 미국, 44195
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Pennsylvania
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York, Pennsylvania, 미국, 17405
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South Carolina
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Charleston, South Carolina, 미국, 29425
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Texas
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Houston, Texas, 미국, 77030
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Birmingham, 영국, B15 2TH
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Glasgow, 영국, G12 8TA
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Newcastle upon Tyne, 영국, NE1 4LP
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Bologna, 이탈리아, 40138
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Cagliari, 이탈리아, 09134
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Cinisello Balsamo (MI), 이탈리아, 20092
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Ferrara, 이탈리아, 44100
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Perugia, 이탈리아, 06129
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Pisa, 이탈리아, 56124
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Hradec Kralove, 체코, 500 05
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Praha 2, 체코, 128 08
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Praha 4, 체코, 140 21
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Quebec, 캐나다, G1V 4M6
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British Columbia
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Vancouver, British Columbia, 캐나다, V5Z 1M9
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Ontario
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Hamilton, Ontario, 캐나다, L8L 2X2
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London, Ontario, 캐나다, N6A 4V2
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Peterborough, Ontario, 캐나다, K9J 0B2
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Quebec
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Montreal, Quebec, 캐나다, H2W 1R7
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St-Charles-Borromee, Quebec, 캐나다, J6E 6J2
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Nantes Cedex 1, 프랑스, 44093
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Paris Cedex 13, 프랑스, 75651
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Vénissieux, 프랑스, 69200
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New South Wales
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Camperdown, New South Wales, 호주, 2015
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Queensland
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Woolloongabba, Queensland, 호주, 4102
- Research Site
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South Australia
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Ashford, South Australia, 호주, 5035
- Research Site
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참여기준
자격 기준
공부할 수 있는 나이
건강한 자원 봉사자를 받아들입니다
연구 대상 성별
설명
Inclusion Criteria:
- Male or female ≥ 18 to ≤ 80 years of age
- Subject not at LDL-C goal
- History of statin intolerance
- Lipid lowering therapy has been stable prior to enrolment for at least 4 weeks
- Fasting triglycerides ≤ 400 mg/dL
Exclusion Criteria:
- New York Heart Association (NYHA) III or IV heart failure
- Uncontrolled cardiac arrhythmia
- Uncontrolled hypertension
- Type 1 diabetes
- Poorly controlled type 2 diabetes
- Uncontrolled hypothyroidism or hyperthyroidism
공부 계획
연구는 어떻게 설계됩니까?
디자인 세부사항
- 주 목적: 치료
- 할당: 무작위
- 중재 모델: 병렬 할당
- 마스킹: 네 배로
무기와 개입
참가자 그룹 / 팔 |
개입 / 치료 |
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다른: Part A: Atorvastatin 20 mg => Placebo
Participants received atorvastatin 20 mg orally for 10 weeks (period 1) followed by placebo orally for 10 weeks (period 2), separated by a 2-week washout period.
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Atorvastatin was supplied as over-encapsulated 20 mg tablets
다른 이름들:
Placebo matching to atorvastatin supplied as over-encapsulated tablets
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다른: Part A: Placebo => Atorvastatin 20 mg
Participants received placebo orally for 10 weeks (period 1) followed by atorvastatin 20 mg orally for 10 weeks (period 2), separated by a 2-week washout period.
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Atorvastatin was supplied as over-encapsulated 20 mg tablets
다른 이름들:
Placebo matching to atorvastatin supplied as over-encapsulated tablets
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활성 비교기: Part B: Ezetimibe
Participants received 10 mg ezetimibe orally only a day and placebo to evolocumab by subcutaneous injection once a month for 24 weeks.
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Ezetimibe was supplied as 10 mg tablets, over-encapsulated for blinding.
다른 이름들:
Placebo matching to evolocumab supplied as single-use prefilled autoinjector/pen(s)
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실험적: Part B: Evolocumab
Participants received 420 mg evolocumab by subcutaneous injection once a month and placebo to ezetimibe orally once a day for 24 weeks.
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Placebo matching to Ezetimibe supplied as over-encapsulated tablets.
Evolocumab supplied as single-use prefilled autoinjector/pen(s)
다른 이름들:
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실험적: Part C: Open-label Evolocumab
Participants who completed part B and were eligible to proceed to open-label extension part C and could choose quarterly between evolocumab 420 mg once a month or evolocumab 140 mg every 2 weeks for up to 2 years.
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Evolocumab supplied as single-use prefilled autoinjector/pen(s)
다른 이름들:
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연구는 무엇을 측정합니까?
주요 결과 측정
결과 측정 |
기간 |
|---|---|
|
Percent Change From Baseline in LDL-C at the Mean of Weeks 22 and 24
기간: Baseline and weeks 22 and 24
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Baseline and weeks 22 and 24
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Percent Change From Baseline in LDL-C at Week 24
기간: Baseline and week 24
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Baseline and week 24
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2차 결과 측정
결과 측정 |
기간 |
|---|---|
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Change From Baseline in LDL-C at the Mean of Weeks 22 and 24
기간: Baselie and weeks 22 and 24
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Baselie and weeks 22 and 24
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Change From Baseline in LDL-C at Week 24
기간: Baseline and week 24
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Baseline and week 24
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Percentage of Participants Who Achieved a Mean LDL-C at Weeks 22 and 24 of Less Than 70 mg/dL
기간: Weeks 22 and 24
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Weeks 22 and 24
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Percentage of Participants Who Achieved LDL-C at Week 24 of Less Than 70 mg/dL
기간: Week 24
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Week 24
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Percent Change From Baseline in Total Cholesterol at the Mean of Weeks 22 and 24
기간: Baseline and weeks 22 and 24
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Baseline and weeks 22 and 24
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Percent Change From Baseline in Total Cholesterol at Week 24
기간: Baseline and week 24
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Baseline and week 24
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Percent Change From Baseline in Non-high-density Lipoprotein Cholesterol (Non-HDL-C) at the Mean of Weeks 22 and 24
기간: Baseline and weeks 22 and 24
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Baseline and weeks 22 and 24
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Percent Change From Baseline in Non-HDL-C at Week 24
기간: Baseline and week 24
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Baseline and week 24
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Percent Change From Baseline in Apolipoprotein B at the Mean of Weeks 22 and 24
기간: Baseline and weeks 22 and 24
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Baseline and weeks 22 and 24
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Percent Change From Baseline in Apolipoprotein B at Week 24
기간: Baseline and week 24
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Baseline and week 24
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Percent Change From Baseline in Total Cholesterol/HDL-C Ratio at the Mean of Weeks 22 and 24
기간: Baseline and weeks 22 and 24
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Baseline and weeks 22 and 24
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Percent Change From Baseline in Total Cholesterol/HDL-C Ratio at Week 24
기간: Baseline and week 24
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Baseline and week 24
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Percent Change From Baseline in Apolipoprotein B/Apolipoprotein A1 Ratio at the Mean of Weeks 22 and 24
기간: Baseline and Weeks 22 and 24
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Baseline and Weeks 22 and 24
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Percent Change From Baseline in Apolipoprotein B/Apolipoprotein A1 Ratio at Week 24
기간: Baseline and week 24
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Baseline and week 24
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Percent Change From Baseline in Lipoprotein(a) at the Mean of Weeks 22 and 24
기간: Baseline and Weeks 22 and 24
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Baseline and Weeks 22 and 24
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Percent Change From Baseline in Lipoprotein(a) at Week 24
기간: Baseline and week 24
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Baseline and week 24
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Percent Change From Baseline in Triglycerides at the Mean of Weeks 22 and 24
기간: Baseline and weeks 22 and 24
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Baseline and weeks 22 and 24
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Percent Change From Baseline in Triglycerides at Week 24
기간: Baseline and week 24
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Baseline and week 24
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Percent Change From Baseline in High-density Lipoprotein Cholesterol (HDL-C) at Week 24
기간: Baseline and weeks 22 and 24
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Baseline and weeks 22 and 24
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Percent Change From Baseline in HDL-C at Week 24
기간: Baseline and week 24
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Baseline and week 24
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Percent Change From Baseline in Very Low-density Lipoprotein Cholesterol (VLDL-C) at the Mean of Weeks 22 and 24
기간: Baseline and weeks 22 and 24
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Baseline and weeks 22 and 24
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Percent Change From Baseline in VLDL-C at Week 24
기간: Baseline and week 24
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Baseline and week 24
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공동 작업자 및 조사자
스폰서
간행물 및 유용한 링크
일반 간행물
- Cho L, Dent R, Stroes ESG, Stein EA, Sullivan D, Ruzza A, Flower A, Somaratne R, Rosenson RS. Persistent Safety and Efficacy of Evolocumab in Patients with Statin Intolerance: a Subset Analysis of the OSLER Open-Label Extension Studies. Cardiovasc Drugs Ther. 2018 Aug;32(4):365-372. doi: 10.1007/s10557-018-6817-7.
- Schmidt AF, Carter JL, Pearce LS, Wilkins JT, Overington JP, Hingorani AD, Casas JP. PCSK9 monoclonal antibodies for the primary and secondary prevention of cardiovascular disease. Cochrane Database Syst Rev. 2020 Oct 20;10(10):CD011748. doi: 10.1002/14651858.CD011748.pub3.
- Nissen SE, Stroes E, Dent-Acosta RE, Rosenson RS, Lehman SJ, Sattar N, Preiss D, Bruckert E, Ceska R, Lepor N, Ballantyne CM, Gouni-Berthold I, Elliott M, Brennan DM, Wasserman SM, Somaratne R, Scott R, Stein EA; GAUSS-3 Investigators. Efficacy and Tolerability of Evolocumab vs Ezetimibe in Patients With Muscle-Related Statin Intolerance: The GAUSS-3 Randomized Clinical Trial. JAMA. 2016 Apr 19;315(15):1580-90. doi: 10.1001/jama.2016.3608.
연구 기록 날짜
연구 주요 날짜
연구 시작 (실제)
기본 완료 (실제)
연구 완료 (실제)
연구 등록 날짜
최초 제출
QC 기준을 충족하는 최초 제출
처음 게시됨 (추정)
연구 기록 업데이트
마지막 업데이트 게시됨 (실제)
QC 기준을 충족하는 마지막 업데이트 제출
마지막으로 확인됨
추가 정보
이 연구와 관련된 용어
추가 관련 MeSH 약관
기타 연구 ID 번호
- 20120332
- 2013-000935-29 (EudraCT 번호)
이 정보는 변경 없이 clinicaltrials.gov 웹사이트에서 직접 가져온 것입니다. 귀하의 연구 세부 정보를 변경, 제거 또는 업데이트하도록 요청하는 경우 register@clinicaltrials.gov. 문의하십시오. 변경 사항이 clinicaltrials.gov에 구현되는 즉시 저희 웹사이트에도 자동으로 업데이트됩니다. .
Atorvastatin에 대한 임상 시험
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Centro Cardiologico MonzinoFederico II University; Università Politecnica delle Marche; Ospedali dei Colli모병
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Vestre Viken Hospital TrustOslo University Hospital; The Hospital of Vestfold완전한
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Kumamoto University완전한
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Changhai HospitalThe First Affiliated Hospital of Soochow University아직 모집하지 않음
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CHU de Quebec-Universite LavalCanadian Institutes of Health Research (CIHR); Biovalorem모집하지 않고 적극적으로
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Badr University아직 모집하지 않음
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Lund University HospitalSouth Sweden Breast Cancer Group완전한
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Liaoning University of Traditional Chinese MedicineMinistry of Science and Technology of the People´s Republic of China완전한