A Clinical Trial to Assess the Efficacy and Safety of MK-0653C in Japanese Participants With Hypercholesterolemia (MK-0653C-383)

A Phase III, Randomized, Active Comparator-controlled Clinical Trial to Study the Efficacy and Safety of MK-0653C in Japanese Patients With Hypercholesterolemia

Status

Completed

Phases

Phase 3

Study type

Interventional

Source

ClinicalTrials.gov

Registry ID

NCT02550288

Enrollment

309

Registered

2015-09-15

Start date

2015-09-29

Completion date

2016-05-30

Last updated

2024-05-16

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Hypercholesterolemia

Brief summary

This study will evaluate the efficacy and safety of MK-0653C (Ezetimibe \[EZ\] 10 mg/Atorvastatin \[Atora\] 10mg or 20 mg) compared to EZ 10 mg, Atora 10 mg, or Atora 20 mg alone when administered to Japanese participants with hypercholesterolemia. The primary hypothesis is that MK-0653C (EZ 10 mg/Atorva 10 mg) is superior to EZ 10 mg and is superior to Atorva 10 mg and that MK-0653C (EZ 10 mg/Atorva 20 mg) is superior to EZ 10 mg and is superior to Atorva 20 mg in percent change from baseline in low-density lipoprotein cholesterol (LDL-C) after 12 weeks of treatment.

Interventions

DRUGEzetimibe 10 mg

DRUGAtorvastatin 10 mg

DRUGPlacebo for Ezetimibe 10 mg tablet

DRUGPlacebo for Atorvastatin 10 mg capsule

BEHAVIORALDiet control/Daily Exercise

Diet and Daily exercise program as per Japan Atherosclerosis Society Guideline 2012 (JAS2012)

Study design

Allocation

RANDOMIZED

Intervention model

PARALLEL

Primary purpose

TREATMENT

Masking

DOUBLE (Subject, Investigator)

Eligibility

Sex/Gender

ALL

Age

20 Years to 80 Years

Healthy volunteers

Inclusion criteria

* Japanese outpatient with hypercholesterolemia. * Females must be non-reproductive potential or agree to remain abstinent or use (or partner use) two acceptable methods of birth control from date of signed informed consent to the 14 days after the last dose of study drug * Agree to maintain a stable diet that is consistent with the Japan Atherosclerosis Society Guideline 2012 (JAS2012) for prevention of atherosclerotic cardiovascular diseases for the duration of the study

Exclusion criteria

* Uncontrolled hypertension * Type 1 or uncontrolled type 2 diabetes mellitus (treated or untreated) * History of coronary artery disease (CAD) Homozygous familial hypercholesterolemia or has undergone LDL apheresis * Had a gastrointestinal tract bypass, or other significant intestinal malabsorption * History of cancer within the past 5 years except for successfully treated dermatological basal cell or squamous cell carcinoma or in situ cervical cancer * Human immunodeficiency virus (HIV) positive * History of drug/ alcohol abuse within the past 5 years or psychiatric illness not adequately controlled and stable on pharmacotherapy * Consumes more than 25 g of alcohol per day * Consumes more than 1L of grapefruit juice per day * Currently following an excessive weight reduction diet * Engaging in a vigorous exercise regimen (e.g.; marathon training, body building training etc.) or intends to start training during the study * Hypersensitivity or intolerance to ezetimibe or atorvastatin * History of myopathy or rhabdomyolysis with ezetimibe or any statin * Pregnant or lactating * Taking any other investigational drugs and/or has taken any investigational drugs within 30 days

Design outcomes

Primary

Measure	Time frame	Description
Percent Change From Baseline in Low-density Lipoprotein Cholesterol (LDL-C) at Week 12	Baseline and Week 12	Participants had LDL-C levels assessed at baseline and after 12 weeks of study drug administration. The change from baseline was calculated.
Percentage of Participants Who Experience 1 or More Gastrointestinal-related Adverse Events (AEs)	up to 14 weeks	Gastrointestinal-related AEs included all preferred terms within system organ class of Gastrointestinal Disorders except Chapped Lips and Toothache.
Percentage of Participants Who Experience 1 or More Gallbladder-related AEs	up to 14 weeks	Gallbladder-related AEs included Bile Duct Obstruction, Bile Duct Stone, Bile Duct Stenosis, Biliary Colic, Cholangitis, Cholecystectomy, Cholecystitis, Cholelithiasis, Gallbladder Disorder, Gallbladder Perforation, Hepatic Pain, and Hydrocholecystis.
Percentage of Participants Who Experience 1 or More Allergic Reaction or Rash AEs	up to 14 weeks	Allergic Reaction or Rash AEs included Allergy to Arthropod Sting, Anaphylactoid Reaction, Anaphylactic Reaction, Anaphylatic Shock, Anaphylactoid Shock, Angioedema, Conjunctivitis Allergic, Contrast Media Reaction, Dermatitis, Dermatitis Allergic, Dermatitis Atopic, Dermatitis Bullous, Dermatitis Contact, Dermatitis Psoriasiform, Drug Hypersensitivity, Eczema, Eosinophila, Erythema, Eye Allergy, Face Oedema, Hypersensitivity, Mechanical Urticaria, Palmar Erythema, Periorbital Oedema, Photodermatosis, Photosensitivity Allergic reaction, Photosensitivity Reaction, Pigmentation Disorder, Pruritus, Pruritus Generalised, Rash, Rash Erythematous, Rash Follicular, Rash Generalised, Rash Maculo-Papular, Rash Papulosquamous, Rash Pruritic, Rash Pustular, Rash Vesicular, Rhinitis, Rhinitis Allergic, Rosacea, Skin Exfoliation, Skin Disorder, Skin Hyperpigmentation, Skin Lesion, Skin Mass, Skin Ulcer, Subcutaneous Nodule, Swelling Face, Systemic Lupus Erythematosus Rash, Urticaria.
Percentage of Participants Who Experience 1 or More Hepatitis-related AEs	up to 14 weeks	Hepatitis-related AEs included Cholestasis, Cytolytic Hepatitis, Hepatic Cyst, Hepatic Failure, Hepatic Lesion, Hepatic Necrosis, Hepatitis, Hepatitis Cholestatic, Hepatitis Fulminant, Hepatitis Infectious, Hepatocellular Injury, Hepatomegaly, Jaundice, Jaundice Cholestatic.
Percentage of Participants Who Experience Consecutive Elevations in Alanine Aminotransferase (ALT) ≥3 Times Upper Limit of Normal (ULN)	up to 12 weeks	Participants had ALT levels assessed throughout the 12 week treatment period. Participants who had 2 consecutive assessments of ALT that were 3 x ULN or greater were recorded. The ALT ULN was 40 U/L.
Percentage of Participants Who Experience Consecutive Elevations in Aspartate Aminotransferase (AST) ≥3 Times ULN	up to 12 weeks	Participants had AST levels assessed throughout the 12 week treatment period. Participants who had 2 consecutive assessments of AST that were 3 x ULN or greater were recorded. The AST ULN was 40 U/L.
Percentage of Participants Who Experience Consecutive Elevations in ALT and/or AST ≥3 Times ULN	up to 12 weeks	Participants had ALT and AST levels assessed throughout the 12 week treatment period. Participants who had 2 consecutive assessments of ALT and/or AST that were 3 x ULN or greater were recorded. The ALT and AST ULNs were 40 U/L.
Percentage of Participants Who Experience Consecutive Elevations in ALT ≥5 Times ULN	up to 12 weeks	Participants had ALT levels assessed throughout the 12 week treatment period. Participants who had an assessment of ALT that was 5x ULN or greater were recorded. The ALT ULN was 40 U/L.
Percentage of Participants Who Experience Consecutive Elevations in AST ≥5 Times ULN	up to 12 weeks	Participants had AST levels assessed throughout the 12 week treatment period. Participants who had an assessment of AST that was 5x ULN or greater were recorded. AST ULN was 40 U/L.
Percentage of Participants Who Have Consecutive Elevations in ALT and/or AST ≥5 Times ULN	up to 12 weeks	Participants had ALT and AST levels assessed throughout the 12 week treatment period. Participants who had 2 consecutive assessments of ALT and/or AST that were 5 x ULN or greater were recorded. The ALT and AST ULNs were 40 U/L.
Percentage of Participants Who Experience Consecutive Elevations in ALT ≥10 Times ULN	up to 12 weeks	Participants had ALT levels assessed throughout the 12 week treatment period. Participants who had an assessment of ALT that was 10x ULN or greater were recorded. The ALT ULN was 40 U/L.
Percentage of Participants Who Experience Consecutive Elevations in AST ≥10 Times ULN	up to 12 weeks	Participants had AST levels assessed throughout the 12 week treatment period. Participants who had 2 consecutive assessments of AST that were 10x ULN or greater were recorded. The AST ULN was 40 U/L.
Percentage of Participants Who Have Consecutive Elevations in ALT and/or AST ≥10 Times ULN	up to 12 weeks	Participants had ALT and AST levels assessed throughout the 12 week treatment period. Participants who had 2 consecutive assessments of ALT and/or AST that were 10x ULN or greater were recorded. The ALT and AST ULNs were 40 U/L.
Percentage of Participants With Potential Hy's Law Condition	up to 12 weeks	Percentage of Participants with Potential Hy's Law Condition (defined as serum ALT or serum AST elevations \>3xULN, with serum alkaline phosphatase \<2xULN and total bilirubin (TBL) ≥2xULN) was summarized. The ALT and AST ULNs were 40 U/L. The ULN for alkaline phosphatase was 359 IU/L and the ULN for total bilirubin was 1.2 mg/dL.
Percentage of Participants Who Have Elevations in Creatine Kinase (CK) ≥10xULN	up to 12 weeks	Participants had creatine phosphokinase (CK) levels assessed throughout the 12 week treatment period. Participants who had any CK level that was ≥10 x ULN were recorded. The CK ULNs for males and females were 287 IU/L and 163 IU/L, respectively.
Percentage of Participants Who Have Elevations in CK ≥10xULN With Muscle Symptoms	up to 12 weeks	Participants had CK levels assessed throughout the 12 week treatment period. Participants who had any CK level that was ≥10 x ULN and had associated muscle symptoms present within +/- 7 days were recorded. The CK ULNs for males and females were 287 IU/L and 163 IU/L, respectively.
Percentage of Participants Who Have Elevations in CK ≥10xULN and Drug-Related Muscle Symptoms	up to 12 weeks	Participants had CK levels assessed throughout the 12 week treatment period. Participants who had any CK level that was ≥10 x ULN and had associated muscle symptoms present within +/- 7 days that were reported as at least possibly-related to study drug were recorded. The CK ULNs for males and females were 287 IU/L and 163 IU/L, respectively.

Participant flow

Pre-assignment details

Study consisted of screening, a 2-week placebo run-in and a 12-week treatment period.

Participants by arm

Arm	Count
Ezetimibe 10 mg 1 ezetimide 10 mg tablet, 2 atorvastatin 10 mg placebo capsules orally once daily for 12 weeks.	35
Atorvastatin 10 mg 1 atorvastatin 10 mg capsule, 1 ezetimide 10 mg placebo tablet, and 1 atorvastatin 10 mg placebo capsule orally once daily for 12 weeks.	68
Atorvastatin 20 mg 2 atorvastatin 10 mg capsules and 1 ezetimide 10 mg placebo tablet orally, once daily for 12 weeks.	69
Ezetimibe 10 mg + Atorvastatin 10 mg 1 Ezetimibe 10 mg tablet, 1 atorvastatin 10 mg capsule and 1 atorvastatin 10 mg placebo capsule orally, once daily for 12 weeks	68
Ezetimibe 10 mg + Atorvastatin 20 mg 1 Ezetimibe 10 mg tablet and 2 atorvastatin 10 mg capsules orally, once daily for 12 weeks	69
Total	309

Withdrawals & dropouts

Period	Reason	FG000	FG001	FG002	FG003	FG004
Overall Study	Adverse Event	0	1	0	0	0
Overall Study	Participant moved	0	0	0	1	0
Overall Study	Physician Decision	0	0	0	1	0
Overall Study	Protocol Violation	2	2	1	0	3
Overall Study	Withdrawal by Subject	0	0	0	1	0

Baseline characteristics

Characteristic	Ezetimibe 10 mg	Atorvastatin 10 mg	Atorvastatin 20 mg	Ezetimibe 10 mg + Atorvastatin 10 mg	Ezetimibe 10 mg + Atorvastatin 20 mg	Total
Age, Continuous	57.1 years STANDARD_DEVIATION 9.8	58.9 years STANDARD_DEVIATION 8.6	58.3 years STANDARD_DEVIATION 10.3	58.7 years STANDARD_DEVIATION 10.4	57.9 years STANDARD_DEVIATION 11	58.3 years STANDARD_DEVIATION 10
Sex: Female, Male Female	18 Participants	34 Participants	39 Participants	34 Participants	37 Participants	162 Participants
Sex: Female, Male Male	17 Participants	34 Participants	30 Participants	34 Participants	32 Participants	147 Participants

Adverse events

Event type	EG000 affected / at risk	EG001 affected / at risk	EG002 affected / at risk	EG003 affected / at risk	EG004 affected / at risk
deaths Total, all-cause mortality	— / —	— / —	— / —	— / —	— / —
other Total, other adverse events	5 / 35	5 / 68	9 / 69	11 / 68	16 / 69
serious Total, serious adverse events	0 / 35	1 / 68	0 / 69	0 / 68	0 / 69

Outcome results

Primary

Percentage of Participants Who Experience 1 or More Allergic Reaction or Rash AEs

Allergic Reaction or Rash AEs included Allergy to Arthropod Sting, Anaphylactoid Reaction, Anaphylactic Reaction, Anaphylatic Shock, Anaphylactoid Shock, Angioedema, Conjunctivitis Allergic, Contrast Media Reaction, Dermatitis, Dermatitis Allergic, Dermatitis Atopic, Dermatitis Bullous, Dermatitis Contact, Dermatitis Psoriasiform, Drug Hypersensitivity, Eczema, Eosinophila, Erythema, Eye Allergy, Face Oedema, Hypersensitivity, Mechanical Urticaria, Palmar Erythema, Periorbital Oedema, Photodermatosis, Photosensitivity Allergic reaction, Photosensitivity Reaction, Pigmentation Disorder, Pruritus, Pruritus Generalised, Rash, Rash Erythematous, Rash Follicular, Rash Generalised, Rash Maculo-Papular, Rash Papulosquamous, Rash Pruritic, Rash Pustular, Rash Vesicular, Rhinitis, Rhinitis Allergic, Rosacea, Skin Exfoliation, Skin Disorder, Skin Hyperpigmentation, Skin Lesion, Skin Mass, Skin Ulcer, Subcutaneous Nodule, Swelling Face, Systemic Lupus Erythematosus Rash, Urticaria.

Time frame: up to 14 weeks