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Goal Achievement After Utilizing an Anti-PCSK9 Antibody in Statin Intolerant Subjects-3 (GAUSS-3)

2018년 11월 1일 업데이트: Amgen

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

The primary objective of this study was to evaluate the effect of 24 weeks of evolocumab administered subcutaneously (SC) every month, compared with ezetimibe, on low-density lipoprotein cholesterol (LDL-C) levels in adults with high cholesterol who are unable to tolerate an effective dose of a statin due to muscle-related side effects (MRSE).

연구 개요

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

중재적

등록 (실제)

511

단계

  • 3단계

연락처 및 위치

이 섹션에서는 연구를 수행하는 사람들의 연락처 정보와 이 연구가 수행되는 장소에 대한 정보를 제공합니다.

연구 장소

    • Gauteng
      • Johannesburg, Gauteng, 남아프리카, 2157
        • Research Site
      • Midrand, Gauteng, 남아프리카, 1685
        • Research Site
    • Western Cape
      • Observatory, Western Cape, 남아프리카, 7925
        • Research Site
      • Parow, Western Cape, 남아프리카, 7505
        • Research Site
      • Amsterdam, 네덜란드, 1105 AZ
        • Research Site
      • Rotterdam, 네덜란드, 3045 PM
        • Research Site
      • Zwijndrecht, 네덜란드, 3331 LZ
        • Research Site
      • Oslo, 노르웨이, 0373
        • Research Site
      • Ålesund, 노르웨이, 6003
        • Research Site
      • Christchurch, 뉴질랜드, 8011
        • Research Site
      • Aarhus N, 덴마크, 8200
        • Research Site
      • Glostrup, 덴마크, 2600
        • Research Site
      • Berlin, 독일, 13353
        • Research Site
      • Köln, 독일, 50937
        • Research Site
      • München, 독일, 80638
        • Research Site
    • California
      • Beverly Hills, California, 미국, 90211
        • Research Site
      • Huntington Beach, California, 미국, 92648
        • Research Site
      • Los Angeles, California, 미국, 90048
        • Research Site
      • San Pedro, California, 미국, 90732
        • Research Site
    • Georgia
      • Atlanta, Georgia, 미국, 30322
        • Research Site
    • Illinois
      • Sterling, Illinois, 미국, 61081
        • Research Site
    • Kansas
      • Kansas City, Kansas, 미국, 66160
        • Research Site
    • Maryland
      • Baltimore, Maryland, 미국, 21201
        • Research Site
      • Towson, Maryland, 미국, 21204
        • Research Site
    • Michigan
      • Ann Arbor, Michigan, 미국, 48106
        • Research Site
    • Minnesota
      • Rochester, Minnesota, 미국, 55905
        • Research Site
    • Missouri
      • Saint Louis, Missouri, 미국, 63110
        • Research Site
    • New York
      • New York, New York, 미국, 10029
        • Research Site
    • North Carolina
      • Durham, North Carolina, 미국, 27710
        • Research Site
    • Ohio
      • Cleveland, Ohio, 미국, 44195
        • Research Site
    • Pennsylvania
      • York, Pennsylvania, 미국, 17405
        • Research Site
    • South Carolina
      • Charleston, South Carolina, 미국, 29425
        • Research Site
    • Texas
      • Houston, Texas, 미국, 77030
        • Research Site
      • Birmingham, 영국, B15 2TH
        • Research Site
      • Glasgow, 영국, G12 8TA
        • Research Site
      • Newcastle upon Tyne, 영국, NE1 4LP
        • Research Site
      • Bologna, 이탈리아, 40138
        • Research Site
      • Cagliari, 이탈리아, 09134
        • Research Site
      • Cinisello Balsamo (MI), 이탈리아, 20092
        • Research Site
      • Ferrara, 이탈리아, 44100
        • Research Site
      • Perugia, 이탈리아, 06129
        • Research Site
      • Pisa, 이탈리아, 56124
        • Research Site
      • Hradec Kralove, 체코, 500 05
        • Research Site
      • Praha 2, 체코, 128 08
        • Research Site
      • Praha 4, 체코, 140 21
        • Research Site
      • Quebec, 캐나다, G1V 4M6
        • Research Site
    • British Columbia
      • Vancouver, British Columbia, 캐나다, V5Z 1M9
        • Research Site
    • Ontario
      • Hamilton, Ontario, 캐나다, L8L 2X2
        • Research Site
      • London, Ontario, 캐나다, N6A 4V2
        • Research Site
      • Peterborough, Ontario, 캐나다, K9J 0B2
        • Research Site
    • Quebec
      • Montreal, Quebec, 캐나다, H2W 1R7
        • Research Site
      • St-Charles-Borromee, Quebec, 캐나다, J6E 6J2
        • Research Site
      • Nantes Cedex 1, 프랑스, 44093
        • Research Site
      • Paris Cedex 13, 프랑스, 75651
        • Research Site
      • Vénissieux, 프랑스, 69200
        • Research Site
    • New South Wales
      • Camperdown, New South Wales, 호주, 2015
        • Research Site
    • Queensland
      • Woolloongabba, Queensland, 호주, 4102
        • Research Site
    • South Australia
      • Ashford, South Australia, 호주, 5035
        • Research Site

참여기준

연구원은 적격성 기준이라는 특정 설명에 맞는 사람을 찾습니다. 이러한 기준의 몇 가지 예는 개인의 일반적인 건강 상태 또는 이전 치료입니다.

자격 기준

공부할 수 있는 나이

18년 (성인, 고령자)

건강한 자원 봉사자를 받아들입니다

아니

연구 대상 성별

모두

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

이 섹션에서는 연구 설계 방법과 연구가 측정하는 내용을 포함하여 연구 계획에 대한 세부 정보를 제공합니다.

연구는 어떻게 설계됩니까?

디자인 세부사항

  • 주 목적: 치료
  • 할당: 무작위
  • 중재 모델: 병렬 할당
  • 마스킹: 네 배로

무기와 개입

참가자 그룹 / 팔
개입 / 치료
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.
Atorvastatin was supplied as over-encapsulated 20 mg tablets
다른 이름들:
  • 리피토
Placebo matching to atorvastatin supplied as over-encapsulated tablets
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.
Atorvastatin was supplied as over-encapsulated 20 mg tablets
다른 이름들:
  • 리피토
Placebo matching to atorvastatin supplied as over-encapsulated tablets
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.
Ezetimibe was supplied as 10 mg tablets, over-encapsulated for blinding.
다른 이름들:
  • 제티아
Placebo matching to evolocumab supplied as single-use prefilled autoinjector/pen(s)
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.
Placebo matching to Ezetimibe supplied as over-encapsulated tablets.
Evolocumab supplied as single-use prefilled autoinjector/pen(s)
다른 이름들:
  • 레파타
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.
Evolocumab supplied as single-use prefilled autoinjector/pen(s)
다른 이름들:
  • 레파타

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
Baseline and weeks 22 and 24
Percent Change From Baseline in LDL-C at Week 24
기간: Baseline and week 24
Baseline and week 24

2차 결과 측정

결과 측정
기간
Change From Baseline in LDL-C at the Mean of Weeks 22 and 24
기간: Baselie and weeks 22 and 24
Baselie and weeks 22 and 24
Change From Baseline in LDL-C at Week 24
기간: Baseline and week 24
Baseline and week 24
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
Weeks 22 and 24
Percentage of Participants Who Achieved LDL-C at Week 24 of Less Than 70 mg/dL
기간: Week 24
Week 24
Percent Change From Baseline in Total Cholesterol at the Mean of Weeks 22 and 24
기간: Baseline and weeks 22 and 24
Baseline and weeks 22 and 24
Percent Change From Baseline in Total Cholesterol at Week 24
기간: Baseline and week 24
Baseline and week 24
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
Baseline and weeks 22 and 24
Percent Change From Baseline in Non-HDL-C at Week 24
기간: Baseline and week 24
Baseline and week 24
Percent Change From Baseline in Apolipoprotein B at the Mean of Weeks 22 and 24
기간: Baseline and weeks 22 and 24
Baseline and weeks 22 and 24
Percent Change From Baseline in Apolipoprotein B at Week 24
기간: Baseline and week 24
Baseline and week 24
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
Baseline and weeks 22 and 24
Percent Change From Baseline in Total Cholesterol/HDL-C Ratio at Week 24
기간: Baseline and week 24
Baseline and week 24
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
Baseline and Weeks 22 and 24
Percent Change From Baseline in Apolipoprotein B/Apolipoprotein A1 Ratio at Week 24
기간: Baseline and week 24
Baseline and week 24
Percent Change From Baseline in Lipoprotein(a) at the Mean of Weeks 22 and 24
기간: Baseline and Weeks 22 and 24
Baseline and Weeks 22 and 24
Percent Change From Baseline in Lipoprotein(a) at Week 24
기간: Baseline and week 24
Baseline and week 24
Percent Change From Baseline in Triglycerides at the Mean of Weeks 22 and 24
기간: Baseline and weeks 22 and 24
Baseline and weeks 22 and 24
Percent Change From Baseline in Triglycerides at Week 24
기간: Baseline and week 24
Baseline and week 24
Percent Change From Baseline in High-density Lipoprotein Cholesterol (HDL-C) at Week 24
기간: Baseline and weeks 22 and 24
Baseline and weeks 22 and 24
Percent Change From Baseline in HDL-C at Week 24
기간: Baseline and week 24
Baseline and week 24
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
Baseline and weeks 22 and 24
Percent Change From Baseline in VLDL-C at Week 24
기간: Baseline and week 24
Baseline and week 24

공동 작업자 및 조사자

여기에서 이 연구와 관련된 사람과 조직을 찾을 수 있습니다.

스폰서

간행물 및 유용한 링크

연구에 대한 정보 입력을 담당하는 사람이 자발적으로 이러한 간행물을 제공합니다. 이것은 연구와 관련된 모든 것에 관한 것일 수 있습니다.

연구 기록 날짜

이 날짜는 ClinicalTrials.gov에 대한 연구 기록 및 요약 결과 제출의 진행 상황을 추적합니다. 연구 기록 및 보고된 결과는 공개 웹사이트에 게시되기 전에 특정 품질 관리 기준을 충족하는지 확인하기 위해 국립 의학 도서관(NLM)에서 검토합니다.

연구 주요 날짜

연구 시작 (실제)

2013년 12월 10일

기본 완료 (실제)

2015년 11월 10일

연구 완료 (실제)

2017년 11월 21일

연구 등록 날짜

최초 제출

2013년 11월 8일

QC 기준을 충족하는 최초 제출

2013년 11월 8일

처음 게시됨 (추정)

2013년 11월 14일

연구 기록 업데이트

마지막 업데이트 게시됨 (실제)

2018년 11월 29일

QC 기준을 충족하는 마지막 업데이트 제출

2018년 11월 1일

마지막으로 확인됨

2018년 11월 1일

추가 정보

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

구독하다