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Trial to Evaluate the Effect of ALN-PCSSC Treatment on Low Density Lipoprotein Cholesterol (LDL-C)

A Placebo-controlled, Double-blind, Randomized Trial to Compare the Effect of Different Doses of ALN-PCSSC Given as Single or Multiple Subcutaneous Injections in Subjects With High Cardiovascular Risk and Elevated LDL-C

Status
Completed
Phases
Phase 2
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT02597127
Acronym
ORION-1
Enrollment
501
Registered
2015-11-05
Start date
2016-01-31
Completion date
2017-06-07
Last updated
2019-05-17

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

Conditions

Atherosclerotic Cardiovascular Disease, Diabetes, Familial Hypercholesterolemia

Brief summary

This study is a Phase II, placebo-controlled, double-blind, randomized trial in 480 participants with atherosclerotic cardiovascular disease (ASCVD) or ASCVD-risk equivalents (for example, diabetes and familial hypercholesterolemia) and elevated LDL-C despite maximum tolerated dose of LDL-C lowering therapies to evaluate the efficacy, safety, and tolerability of ALN-PCSSC injection(s).

Detailed description

Participants will be screened and 480 eligible participants will be randomized: 60 participants per each of six ALN-PCSSC dose groups plus 120 participants total across the placebo groups (20 participants each to match each of the six drug dose groups). Treatment allocation will be stratified by country and by current use of statins or other lipid-modifying therapies. Each participant will receive either one or two injections on Day 1 or a single injection on Day 1 and on Day 90 of blinded ALN-PCSSC or placebo. Formation of anti-drug antibodies (ADA) will be assessed on Day 1 (prior to and 4 hours after the injection) and on Days 30, 60, 90, 120, 150, 180 (Days 150 and 180 only in participants who receive a second dose of study drug), and 210 or until any ADA response becomes negative within the study duration. The independent Data Monitoring Committee (DMC) will review safety data beginning after the first 40 participants receive the first injection of ALN-PCSSC or placebo and complete the Day 14 follow-up visit. Thereafter, the DMC will review safety data every 2 months until the end of the trial. A recommendation may be taken to stop or amend the study at any of these reviews. On Day 1, all eligible participants will be randomized and receive the first subcutaneous (SC) administration of ALN-PCSSC or placebo. After the first study drug administration, the participant will be observed in the clinic for at least 4 hours post injection before being discharged. Participants will return at Day 14 and then at monthly intervals for 6 months. Participants randomized to receive a second dose of study drug will receive the second injection of ALN-PCSSC or placebo at the Day 90 visit. Efficacy assessments will include the measurement of the effects of ALN-PCSSC on levels of LDL-C lipids and lipoproteins including total cholesterol (TC), triglycerides, high-density lipoprotein cholesterol (HDL-C), non-HDL-C, very low-density lipoprotein (VLDL), apolipoprotein A1 (Apo-AI), apolipoprotein B (Apo-B), lipoprotein (a) \[Lp(a)\], C-reactive protein (CRP), and proprotein convertase subtilisin/kexin type 9 (PCSK9). End of study (EOS) evaluations will be conducted at the EOS visit (Day 210). The expected duration of the participants' involvement in the study will be approximately 374 days, which includes screening, study drug administration, the course of single or multiple injections, and the follow-up period to Day 360. Participants completing the study to Day 210 will be given the opportunity to enroll in a separate long-term extension study. Any participants in whom LDL-C levels have not returned to \>80% of baseline values will continue to be followed as part of this study until either this level has been reached or until a maximum of Day 360, at which point they will be given the opportunity to enroll in the long-term extension study. At each visit, LDL-C levels, adverse events, serious adverse events, concomitant medications, and safety laboratory assessments will be collected. Objectives: Primary: To evaluate the effect of ALN-PCSSC treatment on LDL-C levels at Day 180. Secondary: To evaluate the effect of ALN-PCSSC on the following: * LDL-C at Day 90 * LDL-C levels at other time points * PCSK9 levels over time * Other lipids, lipoproteins, apolipoproteins * Proportion of participants achieving pre-specified global lipid guidelines * Individual responsiveness to different doses * Duration of lipid-lowering effect of different doses * Safety and tolerability profile of ALN-PCSSC Exploratory: To collect/evaluate the effect of ALN-PCSSC on the following: * Cardiovascular (CV) events such as CV death, non-fatal myocardial infarction, resuscitated cardiac arrest and non-fatal stroke (ischemic and hemorrhagic) * Evaluation of ADA for the investigational product

Interventions

ALN-PCSSC is a small interfering ribonucleic acid (RNA) that inhibits PCSK9 synthesis and is given as SC injections

DRUGNormal Saline

Saline (sterile, normal, 0.9%) solution given as SC injections

Sponsors

The Medicines Company
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Investigator)

Eligibility

Sex/Gender
ALL
Age
18 Years to 99 Years
Healthy volunteers
No

Inclusion criteria

1. Male or female participants ≥18 years of age. 2. History of ASCVD or ASCVD-risk equivalents (symptomatic atherosclerosis, Type 2 diabetes, familial hypercholesterolemia, including participants whose 10-year risk of a CV event assessed by Framingham Risk Score (Framingham Risk Score \>20%) or equivalent has a target LDL-C of \<100 mg/deciliter \[dL\]). 3. Serum LDL-C ≥1.8 millimole (mmol)/liter (L) (≥70 mg/dL) for ASCVD participants or ≥2.6 mmol/L (≥100 mg/dL) for ASCVD-risk equivalent participants at screening. 4. Fasting triglyceride \<4.52 mmol/L (\<400 mg/dL) at screening. 5. Calculated glomerular filtration rate 30 mL/min or higher by estimated glomerular filtration rate (eGFR) using standardized local clinical methodology. 6. Participants on statins should be receiving a maximally tolerated dose (investigator's discretion). 7. Participants on lipid-lower therapies (such as statin and/or ezetimibe) should be on a stable dose for ≥30 days before screening with no planned medication or dose change during study participation. 8. Willing and able to give informed consent before initiation of any study-related procedures and willing to comply with all required study procedures.

Exclusion criteria

1. Any uncontrolled or serious disease, or any medical or surgical condition, that may either interfere with participation in the clinical study, and/or put the participant at significant risk (according to investigator's \[or delegate\] judgment) if he/she participates in the clinical study. 2. An underlying known disease, or surgical, physical, or medical condition that, in the opinion of the investigator (or delegate), might interfere with interpretation of the clinical study results. 3. New York Heart Association (NYHA) class II, III, or IV heart failure or last known left ventricular ejection fraction \<30%. 4. Cardiac arrhythmia within 3 months prior to randomization that is not controlled by medication or via ablation. 5. Any history of hemorrhagic stroke. 6. Major adverse cardiac event within 6 months prior to randomization. 7. Uncontrolled severe hypertension: systolic blood pressure \>180 millimeters of mercury (mmHg) or diastolic blood pressure \>110 mmHg prior to randomization despite anti-hypertensive therapy. 8. Poorly controlled Type 2 diabetes, such as, glycated hemoglobin A1c (HbA1c)\>10.0% prior to randomization. 9. Active liver disease defined as any known current infectious, neoplastic, or metabolic pathology of the liver or unexplained alanine aminotransferase (ALT) or aspartate aminotransferase (AST) elevation \>2x the upper limit of normal (ULN), or total bilirubin elevation \>1.5x ULN at screening confirmed by a repeat measurement at least 1 week apart. 10. Serious comorbid disease in which the life expectancy of the participant is shorter than the duration of the trial (for example, acute systemic infection, cancer, or other serious illnesses). This includes all cancers with the exception of treated basal-cell carcinoma occurring \>5 years before screening. 11. Females who are pregnant or nursing, or who are of childbearing potential and unwilling to use at least two methods of contraception (oral contraceptives, barrier methods, approved contraceptive implant, long-term injectable contraception, intrauterine device or tubal litigation) for the entire duration of the study. Women who are \>2 years postmenopausal defined as ≥1 year since last menstrual period and if less than 55 years old with a negative pregnancy test within 24 hours of randomization or surgically sterile are exempt from this exclusion. 12. Males who are unwilling to use an acceptable method of birth control during the entire study period (such as, condom with spermicide). 13. Known history of alcohol and/or drug abuse within the last 5 years. 14. Treatment with other investigational medicinal products or devices within 30 days or five half˗lives, whichever is longer. 15. Use of other investigational medicinal products or devices during the course of the study. 16. Any condition that according to the investigator could interfere with the conduct of the study, such as but not limited to the following: * Inappropriate for this study, including participants who are unable to communicate or to cooperate with the investigator. * Unable to understand the protocol requirements, instructions and study-related restrictions, the nature, scope, and possible consequences of the study (including participants whose cooperation is doubtful due to drug abuse or alcohol dependency). * Unlikely to comply with the protocol requirements, instructions, and study-related restrictions (for example, uncooperative attitude, inability to return for follow-up visits, and improbability of completing the study). * Have any medical or surgical condition, which in the opinion of the investigator would put the participants at increased risk from participating in the study. * Involved with, or a relative of, someone directly involved in the conduct of the study. * Any known cognitive impairment (for example, Alzheimer's disease) 17. Previous or current treatment (within 90 days of screening) with monoclonal antibodies directed at PCSK9.

Design outcomes

Primary

MeasureTime frameDescription
Percentage Change in LDL-C From Baseline to Day 180Baseline to 180 daysPercent Change in LDL-C (beta-quantification) from Baseline to Day 180 in MITT Population

Secondary

MeasureTime frameDescription
Percent Change From Baseline In LDL-C Levels At Day 60, Day 120, and Day 210Baseline, Day 60, Day 120, and Day 210This outcome measure evaluated the effects of both single- and double-dose inclisiran on LDL-C levels in the mITT population from baseline to Day 60, Day 120, and Day 210.
Number of Participants With an LDL-C Greater Than 80% of the Baseline Value at Day 180 and Day 210Baseline, Day 180, Day 210This outcome measure evaluated the number of participants (single and double dose) in the mITT population with an LDL-C greater than 80% of the baseline value at Day 180 and Day 210.
Number of Participants With Individual Responsiveness as Measured By LDL-C Levels at Day 90 and Day 180Day 90, Day 180This outcome measure evaluated the individual responsiveness of participants to inclisiran (single and double dose) in the mITT population as defined by an LDL-C level of \<25 mg/deciliter \[dL\] at Day 90 and Day 180.
Number of Participants With Greater Or Equal To 50% LDL-C Reduction From Baseline At Day 180Baseline, Day 180This outcome measure evaluated the number of participants (single and double dose) in the mITT population with an LDL-C reduction greater than 50% of the baseline value at Day 180.
Percentage Change in LDL-C From Baseline to Day 90Baseline to 90 daysPercent Change in LDL-C (beta-quantification) from Baseline to Day 90 in MITT Population
Percentage Change in Other Lipids and Apolipoproteins From Baseline to Day 180Baseline, Day 180This outcome measure evaluated the percent change from baseline to Day 180 in cholesterol (total, high-density lipoprotein \[HDL\], non-HDL) and apolipoproteins (B, A1) in participants (single and double dose) in the mITT population.
Number of Participants Who Attained Global Lipid Modification Targets for Level of Atherosclerotic Cardiovascular Disease RiskBaseline, Day 180This outcome measure evaluated the proportion of participants (single and double dose) in the mITT population who attained a global lipid modification target by baseline cardiovascular risk group, looking specifically at LDL-C levels (mg/dL) in the category of cardiovascular disease (CVD). CVD was defined as a participant who had at least 1 of the following: prior myocardial infarction, prior percutaneous coronary intervention, prior coronary artery bypass graft, prior stroke, prior transient ischemic attack, peripheral artery disease.
Percentage Change in Other Lipids and Inflammatory Markers From Baseline to Day 180Baseline, Day 180This outcome measure evaluated the percent change from baseline to Day 180 in triglycerides, very-low-density lipoprotein (VLDL) cholesterol, lipoprotein(a), and high sensitivity C-reactive protein (hsCRP) in participants (single and double dose) in the mITT population.
Percentage Change in PCSK9 Levels From Baseline at Day 180Baseline, Day 180This outcome measure evaluated the percent change in proprotein convertase subtilisin/kexin type 9 (PCSK9) from baseline to Day 180 in participants (single and double dose) in the mITT population.

Countries

Canada, Germany, Netherlands, United Kingdom, United States

Participant flow

Participants by arm

ArmCount
Placebo (Single-dose)
Saline subcutaneous administration once at Day 1
65
Inclisiran 200 mg (Single-dose)
200 mg subcutaneous administration once at Day 1
60
Inclisiran 300 mg (Single-dose)
300 mg subcutaneous administration once at Day 1
62
Inclisiran 500 mg (Single-dose)
500 mg subcutaneous administration once at Day 1
66
Placebo (Double-dose)
Saline subcutaneous administration at Day 1 and Day 90
62
Inclisiran 100 mg (Double-dose)
100 mg subcutaneous administration at Day 1 and Day 90
62
Inclisiran 200 mg (Double-dose)
200 mg subcutaneous administration at Day 1 and Day 90
63
Inclisiran 300 mg (Double-dose)
300 mg subcutaneous administration at Day 1 and Day 90
61
Total501

Baseline characteristics

CharacteristicPlacebo (Single-dose)Inclisiran 200 mg (Single-dose)Inclisiran 300 mg (Single-dose)Inclisiran 500 mg (Single-dose)Placebo (Double-dose)Inclisiran 100 mg (Double-dose)Inclisiran 200 mg (Double-dose)Inclisiran 300 mg (Double-dose)Total
Age, Categorical
<=18 years
0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants
Age, Categorical
>=65 years
25 Participants30 Participants35 Participants34 Participants30 Participants38 Participants26 Participants30 Participants248 Participants
Age, Categorical
Between 18 and 65 years
40 Participants30 Participants27 Participants32 Participants32 Participants24 Participants37 Participants31 Participants253 Participants
Age, Continuous62.0 years
STANDARD_DEVIATION 11.4
63.9 years
STANDARD_DEVIATION 10.8
64.1 years
STANDARD_DEVIATION 12.8
62.1 years
STANDARD_DEVIATION 12.4
62.8 years
STANDARD_DEVIATION 10.3
65.2 years
STANDARD_DEVIATION 9.4
62.3 years
STANDARD_DEVIATION 10.8
64.1 years
STANDARD_DEVIATION 9.4
63.6 years
STANDARD_DEVIATION 10
Ethnicity (NIH/OMB)
Hispanic or Latino
7 Participants4 Participants3 Participants1 Participants2 Participants2 Participants6 Participants4 Participants29 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
58 Participants56 Participants59 Participants65 Participants60 Participants60 Participants57 Participants57 Participants472 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
American Indian or Alaska Native
1 Participants0 Participants1 Participants1 Participants0 Participants2 Participants0 Participants1 Participants6 Participants
Race (NIH/OMB)
Asian
0 Participants2 Participants2 Participants2 Participants1 Participants1 Participants0 Participants1 Participants9 Participants
Race (NIH/OMB)
Black or African American
4 Participants4 Participants2 Participants0 Participants3 Participants2 Participants2 Participants1 Participants18 Participants
Race (NIH/OMB)
More than one race
0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants0 Participants1 Participants0 Participants0 Participants0 Participants0 Participants0 Participants1 Participants
Race (NIH/OMB)
Unknown or Not Reported
1 Participants1 Participants0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants2 Participants
Race (NIH/OMB)
White
59 Participants53 Participants56 Participants63 Participants58 Participants57 Participants61 Participants58 Participants465 Participants
Region of Enrollment
Canada
8 Participants8 Participants7 Participants12 Participants10 Participants10 Participants7 Participants9 Participants71 Participants
Region of Enrollment
Germany
12 Participants10 Participants13 Participants10 Participants14 Participants13 Participants10 Participants9 Participants91 Participants
Region of Enrollment
Netherlands
22 Participants21 Participants21 Participants21 Participants20 Participants20 Participants23 Participants21 Participants169 Participants
Region of Enrollment
United Kingdom
11 Participants11 Participants11 Participants11 Participants10 Participants9 Participants11 Participants12 Participants86 Participants
Region of Enrollment
United States
12 Participants10 Participants10 Participants12 Participants8 Participants10 Participants12 Participants10 Participants84 Participants
Sex: Female, Male
Female
23 Participants21 Participants20 Participants19 Participants29 Participants23 Participants24 Participants16 Participants175 Participants
Sex: Female, Male
Male
42 Participants39 Participants42 Participants47 Participants33 Participants39 Participants39 Participants45 Participants326 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
EG002
affected / at risk
EG003
affected / at risk
EG004
affected / at risk
EG005
affected / at risk
EG006
affected / at risk
EG007
affected / at risk
deaths
Total, all-cause mortality
0 / 650 / 600 / 611 / 650 / 620 / 611 / 620 / 61
other
Total, other adverse events
50 / 6549 / 6049 / 6154 / 6551 / 6247 / 6149 / 6251 / 61
serious
Total, serious adverse events
3 / 6511 / 6011 / 618 / 657 / 6213 / 618 / 629 / 61

Outcome results

Primary

Percentage Change in LDL-C From Baseline to Day 180

Percent Change in LDL-C (beta-quantification) from Baseline to Day 180 in MITT Population

Time frame: Baseline to 180 days

Population: Modified intent-to-treat (MITT) population

ArmMeasureValue (LEAST_SQUARES_MEAN)
Placebo (Single Dose)Percentage Change in LDL-C From Baseline to Day 1802.1 Percent change
200 mg (Single Dose)Percentage Change in LDL-C From Baseline to Day 180-27.9 Percent change
300 mg (Single Dose)Percentage Change in LDL-C From Baseline to Day 180-38.4 Percent change
500 mg (Single Dose)Percentage Change in LDL-C From Baseline to Day 180-41.9 Percent change
Placebo (Double Dose)Percentage Change in LDL-C From Baseline to Day 1801.8 Percent change
100 mg (Double Dose)Percentage Change in LDL-C From Baseline to Day 180-35.5 Percent change
200 mg (Double Dose)Percentage Change in LDL-C From Baseline to Day 180-44.9 Percent change
300 mg (Double Dose)Percentage Change in LDL-C From Baseline to Day 180-52.6 Percent change
p-value: <0.0001t-test, 1 sided
p-value: <0.0001t-test, 1 sided
p-value: <0.0001t-test, 1 sided
p-value: <0.0001t-test, 1 sided
p-value: <0.0001t-test, 1 sided
p-value: <0.0001t-test, 1 sided
Secondary

Number of Participants Who Attained Global Lipid Modification Targets for Level of Atherosclerotic Cardiovascular Disease Risk

This outcome measure evaluated the proportion of participants (single and double dose) in the mITT population who attained a global lipid modification target by baseline cardiovascular risk group, looking specifically at LDL-C levels (mg/dL) in the category of cardiovascular disease (CVD). CVD was defined as a participant who had at least 1 of the following: prior myocardial infarction, prior percutaneous coronary intervention, prior coronary artery bypass graft, prior stroke, prior transient ischemic attack, peripheral artery disease.

Time frame: Baseline, Day 180

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
Placebo (Single Dose)Number of Participants Who Attained Global Lipid Modification Targets for Level of Atherosclerotic Cardiovascular Disease RiskCVD45 Participants
Placebo (Single Dose)Number of Participants Who Attained Global Lipid Modification Targets for Level of Atherosclerotic Cardiovascular Disease Risk<70 mg/dL0 Participants
200 mg (Single Dose)Number of Participants Who Attained Global Lipid Modification Targets for Level of Atherosclerotic Cardiovascular Disease RiskCVD43 Participants
200 mg (Single Dose)Number of Participants Who Attained Global Lipid Modification Targets for Level of Atherosclerotic Cardiovascular Disease Risk<70 mg/dL16 Participants
300 mg (Single Dose)Number of Participants Who Attained Global Lipid Modification Targets for Level of Atherosclerotic Cardiovascular Disease RiskCVD46 Participants
300 mg (Single Dose)Number of Participants Who Attained Global Lipid Modification Targets for Level of Atherosclerotic Cardiovascular Disease Risk<70 mg/dL27 Participants
500 mg (Single Dose)Number of Participants Who Attained Global Lipid Modification Targets for Level of Atherosclerotic Cardiovascular Disease RiskCVD33 Participants
500 mg (Single Dose)Number of Participants Who Attained Global Lipid Modification Targets for Level of Atherosclerotic Cardiovascular Disease Risk<70 mg/dL18 Participants
Placebo (Double Dose)Number of Participants Who Attained Global Lipid Modification Targets for Level of Atherosclerotic Cardiovascular Disease RiskCVD45 Participants
Placebo (Double Dose)Number of Participants Who Attained Global Lipid Modification Targets for Level of Atherosclerotic Cardiovascular Disease Risk<70 mg/dL1 Participants
100 mg (Double Dose)Number of Participants Who Attained Global Lipid Modification Targets for Level of Atherosclerotic Cardiovascular Disease RiskCVD41 Participants
100 mg (Double Dose)Number of Participants Who Attained Global Lipid Modification Targets for Level of Atherosclerotic Cardiovascular Disease Risk<70 mg/dL24 Participants
200 mg (Double Dose)Number of Participants Who Attained Global Lipid Modification Targets for Level of Atherosclerotic Cardiovascular Disease Risk<70 mg/dL27 Participants
200 mg (Double Dose)Number of Participants Who Attained Global Lipid Modification Targets for Level of Atherosclerotic Cardiovascular Disease RiskCVD39 Participants
300 mg (Double Dose)Number of Participants Who Attained Global Lipid Modification Targets for Level of Atherosclerotic Cardiovascular Disease RiskCVD42 Participants
300 mg (Double Dose)Number of Participants Who Attained Global Lipid Modification Targets for Level of Atherosclerotic Cardiovascular Disease Risk<70 mg/dL33 Participants
Secondary

Number of Participants With an LDL-C Greater Than 80% of the Baseline Value at Day 180 and Day 210

This outcome measure evaluated the number of participants (single and double dose) in the mITT population with an LDL-C greater than 80% of the baseline value at Day 180 and Day 210.

Time frame: Baseline, Day 180, Day 210

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
Placebo (Single Dose)Number of Participants With an LDL-C Greater Than 80% of the Baseline Value at Day 180 and Day 210Day 18035 Participants
Placebo (Single Dose)Number of Participants With an LDL-C Greater Than 80% of the Baseline Value at Day 180 and Day 210Day 21034 Participants
200 mg (Single Dose)Number of Participants With an LDL-C Greater Than 80% of the Baseline Value at Day 180 and Day 210Day 1806 Participants
200 mg (Single Dose)Number of Participants With an LDL-C Greater Than 80% of the Baseline Value at Day 180 and Day 210Day 2108 Participants
300 mg (Single Dose)Number of Participants With an LDL-C Greater Than 80% of the Baseline Value at Day 180 and Day 210Day 1805 Participants
300 mg (Single Dose)Number of Participants With an LDL-C Greater Than 80% of the Baseline Value at Day 180 and Day 210Day 2105 Participants
500 mg (Single Dose)Number of Participants With an LDL-C Greater Than 80% of the Baseline Value at Day 180 and Day 210Day 1800 Participants
500 mg (Single Dose)Number of Participants With an LDL-C Greater Than 80% of the Baseline Value at Day 180 and Day 210Day 2102 Participants
Placebo (Double Dose)Number of Participants With an LDL-C Greater Than 80% of the Baseline Value at Day 180 and Day 210Day 18029 Participants
Placebo (Double Dose)Number of Participants With an LDL-C Greater Than 80% of the Baseline Value at Day 180 and Day 210Day 21034 Participants
100 mg (Double Dose)Number of Participants With an LDL-C Greater Than 80% of the Baseline Value at Day 180 and Day 210Day 1802 Participants
100 mg (Double Dose)Number of Participants With an LDL-C Greater Than 80% of the Baseline Value at Day 180 and Day 210Day 2101 Participants
200 mg (Double Dose)Number of Participants With an LDL-C Greater Than 80% of the Baseline Value at Day 180 and Day 210Day 2101 Participants
200 mg (Double Dose)Number of Participants With an LDL-C Greater Than 80% of the Baseline Value at Day 180 and Day 210Day 1801 Participants
300 mg (Double Dose)Number of Participants With an LDL-C Greater Than 80% of the Baseline Value at Day 180 and Day 210Day 1800 Participants
300 mg (Double Dose)Number of Participants With an LDL-C Greater Than 80% of the Baseline Value at Day 180 and Day 210Day 2101 Participants
Secondary

Number of Participants With Greater Or Equal To 50% LDL-C Reduction From Baseline At Day 180

This outcome measure evaluated the number of participants (single and double dose) in the mITT population with an LDL-C reduction greater than 50% of the baseline value at Day 180.

Time frame: Baseline, Day 180

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
Placebo (Single Dose)Number of Participants With Greater Or Equal To 50% LDL-C Reduction From Baseline At Day 1800 Participants
200 mg (Single Dose)Number of Participants With Greater Or Equal To 50% LDL-C Reduction From Baseline At Day 1809 Participants
300 mg (Single Dose)Number of Participants With Greater Or Equal To 50% LDL-C Reduction From Baseline At Day 18019 Participants
500 mg (Single Dose)Number of Participants With Greater Or Equal To 50% LDL-C Reduction From Baseline At Day 18016 Participants
Placebo (Double Dose)Number of Participants With Greater Or Equal To 50% LDL-C Reduction From Baseline At Day 1800 Participants
100 mg (Double Dose)Number of Participants With Greater Or Equal To 50% LDL-C Reduction From Baseline At Day 18014 Participants
200 mg (Double Dose)Number of Participants With Greater Or Equal To 50% LDL-C Reduction From Baseline At Day 18027 Participants
300 mg (Double Dose)Number of Participants With Greater Or Equal To 50% LDL-C Reduction From Baseline At Day 18032 Participants
Secondary

Number of Participants With Individual Responsiveness as Measured By LDL-C Levels at Day 90 and Day 180

This outcome measure evaluated the individual responsiveness of participants to inclisiran (single and double dose) in the mITT population as defined by an LDL-C level of \<25 mg/deciliter \[dL\] at Day 90 and Day 180.

Time frame: Day 90, Day 180

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
Placebo (Single Dose)Number of Participants With Individual Responsiveness as Measured By LDL-C Levels at Day 90 and Day 180Day 900 Participants
Placebo (Single Dose)Number of Participants With Individual Responsiveness as Measured By LDL-C Levels at Day 90 and Day 180Day 1800 Participants
200 mg (Single Dose)Number of Participants With Individual Responsiveness as Measured By LDL-C Levels at Day 90 and Day 180Day 900 Participants
200 mg (Single Dose)Number of Participants With Individual Responsiveness as Measured By LDL-C Levels at Day 90 and Day 180Day 1800 Participants
300 mg (Single Dose)Number of Participants With Individual Responsiveness as Measured By LDL-C Levels at Day 90 and Day 180Day 905 Participants
300 mg (Single Dose)Number of Participants With Individual Responsiveness as Measured By LDL-C Levels at Day 90 and Day 180Day 1801 Participants
500 mg (Single Dose)Number of Participants With Individual Responsiveness as Measured By LDL-C Levels at Day 90 and Day 180Day 903 Participants
500 mg (Single Dose)Number of Participants With Individual Responsiveness as Measured By LDL-C Levels at Day 90 and Day 180Day 1802 Participants
Placebo (Double Dose)Number of Participants With Individual Responsiveness as Measured By LDL-C Levels at Day 90 and Day 180Day 900 Participants
Placebo (Double Dose)Number of Participants With Individual Responsiveness as Measured By LDL-C Levels at Day 90 and Day 180Day 1800 Participants
100 mg (Double Dose)Number of Participants With Individual Responsiveness as Measured By LDL-C Levels at Day 90 and Day 180Day 900 Participants
100 mg (Double Dose)Number of Participants With Individual Responsiveness as Measured By LDL-C Levels at Day 90 and Day 180Day 1801 Participants
200 mg (Double Dose)Number of Participants With Individual Responsiveness as Measured By LDL-C Levels at Day 90 and Day 180Day 1802 Participants
200 mg (Double Dose)Number of Participants With Individual Responsiveness as Measured By LDL-C Levels at Day 90 and Day 180Day 901 Participants
300 mg (Double Dose)Number of Participants With Individual Responsiveness as Measured By LDL-C Levels at Day 90 and Day 180Day 900 Participants
300 mg (Double Dose)Number of Participants With Individual Responsiveness as Measured By LDL-C Levels at Day 90 and Day 180Day 1803 Participants
Secondary

Percentage Change in LDL-C From Baseline to Day 90

Percent Change in LDL-C (beta-quantification) from Baseline to Day 90 in MITT Population

Time frame: Baseline to 90 days

Population: In this analysis, the single and double-dose 200mg arms were combined, as were the single and double-dose 300mg arms. The second dose for patients in double-dose arms was given on Day 90. Therefore, up to day 90, those patients in double-dose arms received the same treatment as patients in the single dose arms within the same dose amount.

ArmMeasureValue (LEAST_SQUARES_MEAN)
Placebo (Single Dose)Percentage Change in LDL-C From Baseline to Day 90-49 Percent change
200 mg (Single Dose)Percentage Change in LDL-C From Baseline to Day 90-34.2 Percent change
300 mg (Single Dose)Percentage Change in LDL-C From Baseline to Day 90-0.8 Percent change
500 mg (Single Dose)Percentage Change in LDL-C From Baseline to Day 90-41.8 Percent change
Placebo (Double Dose)Percentage Change in LDL-C From Baseline to Day 90-45.7 Percent change
Secondary

Percentage Change in Other Lipids and Apolipoproteins From Baseline to Day 180

This outcome measure evaluated the percent change from baseline to Day 180 in cholesterol (total, high-density lipoprotein \[HDL\], non-HDL) and apolipoproteins (B, A1) in participants (single and double dose) in the mITT population.

Time frame: Baseline, Day 180

ArmMeasureGroupValue (MEAN)Dispersion
Placebo (Single Dose)Percentage Change in Other Lipids and Apolipoproteins From Baseline to Day 180HDL Cholesterol3.8 percent changeStandard Deviation 15.6
Placebo (Single Dose)Percentage Change in Other Lipids and Apolipoproteins From Baseline to Day 180Non-HDL Cholesterol1.5 percent changeStandard Deviation 16.7
Placebo (Single Dose)Percentage Change in Other Lipids and Apolipoproteins From Baseline to Day 180Total Cholesterol1.8 percent changeStandard Deviation 12.1
Placebo (Single Dose)Percentage Change in Other Lipids and Apolipoproteins From Baseline to Day 180Apolipoprotein A13.6 percent changeStandard Deviation 10.6
Placebo (Single Dose)Percentage Change in Other Lipids and Apolipoproteins From Baseline to Day 180Apolipoprotein B1.7 percent changeStandard Deviation 14.7
200 mg (Single Dose)Percentage Change in Other Lipids and Apolipoproteins From Baseline to Day 180Apolipoprotein A12.9 percent changeStandard Deviation 9.3
200 mg (Single Dose)Percentage Change in Other Lipids and Apolipoproteins From Baseline to Day 180Total Cholesterol-17.6 percent changeStandard Deviation 19
200 mg (Single Dose)Percentage Change in Other Lipids and Apolipoproteins From Baseline to Day 180Non-HDL Cholesterol-25.1 percent changeStandard Deviation 26.3
200 mg (Single Dose)Percentage Change in Other Lipids and Apolipoproteins From Baseline to Day 180HDL Cholesterol4.4 percent changeStandard Deviation 14.8
200 mg (Single Dose)Percentage Change in Other Lipids and Apolipoproteins From Baseline to Day 180Apolipoprotein B-22.9 percent changeStandard Deviation 21
300 mg (Single Dose)Percentage Change in Other Lipids and Apolipoproteins From Baseline to Day 180Non-HDL Cholesterol-35.2 percent changeStandard Deviation 20.2
300 mg (Single Dose)Percentage Change in Other Lipids and Apolipoproteins From Baseline to Day 180HDL Cholesterol8.8 percent changeStandard Deviation 11.1
300 mg (Single Dose)Percentage Change in Other Lipids and Apolipoproteins From Baseline to Day 180Total Cholesterol-23.7 percent changeStandard Deviation 15.7
300 mg (Single Dose)Percentage Change in Other Lipids and Apolipoproteins From Baseline to Day 180Apolipoprotein B-30.8 percent changeStandard Deviation 18
300 mg (Single Dose)Percentage Change in Other Lipids and Apolipoproteins From Baseline to Day 180Apolipoprotein A13.8 percent changeStandard Deviation 8.9
500 mg (Single Dose)Percentage Change in Other Lipids and Apolipoproteins From Baseline to Day 180Apolipoprotein B-33.1 percent changeStandard Deviation 12.7
500 mg (Single Dose)Percentage Change in Other Lipids and Apolipoproteins From Baseline to Day 180HDL Cholesterol6.9 percent changeStandard Deviation 14
500 mg (Single Dose)Percentage Change in Other Lipids and Apolipoproteins From Baseline to Day 180Total Cholesterol-26.6 percent changeStandard Deviation 10.7
500 mg (Single Dose)Percentage Change in Other Lipids and Apolipoproteins From Baseline to Day 180Apolipoprotein A14.1 percent changeStandard Deviation 10.9
500 mg (Single Dose)Percentage Change in Other Lipids and Apolipoproteins From Baseline to Day 180Non-HDL Cholesterol-36.9 percent changeStandard Deviation 14
Placebo (Double Dose)Percentage Change in Other Lipids and Apolipoproteins From Baseline to Day 180Total Cholesterol0.7 percent changeStandard Deviation 12.3
Placebo (Double Dose)Percentage Change in Other Lipids and Apolipoproteins From Baseline to Day 180Apolipoprotein B0.9 percent changeStandard Deviation 13
Placebo (Double Dose)Percentage Change in Other Lipids and Apolipoproteins From Baseline to Day 180HDL Cholesterol0.5 percent changeStandard Deviation 12.5
Placebo (Double Dose)Percentage Change in Other Lipids and Apolipoproteins From Baseline to Day 180Apolipoprotein A10.8 percent changeStandard Deviation 8.3
Placebo (Double Dose)Percentage Change in Other Lipids and Apolipoproteins From Baseline to Day 180Non-HDL Cholesterol1.3 percent changeStandard Deviation 16.9
100 mg (Double Dose)Percentage Change in Other Lipids and Apolipoproteins From Baseline to Day 180Apolipoprotein B-27.8 percent changeStandard Deviation 13.4
100 mg (Double Dose)Percentage Change in Other Lipids and Apolipoproteins From Baseline to Day 180HDL Cholesterol7.6 percent changeStandard Deviation 12.2
100 mg (Double Dose)Percentage Change in Other Lipids and Apolipoproteins From Baseline to Day 180Total Cholesterol-22.4 percent changeStandard Deviation 12.4
100 mg (Double Dose)Percentage Change in Other Lipids and Apolipoproteins From Baseline to Day 180Non-HDL Cholesterol-31.7 percent changeStandard Deviation 15.1
100 mg (Double Dose)Percentage Change in Other Lipids and Apolipoproteins From Baseline to Day 180Apolipoprotein A15.5 percent changeStandard Deviation 10.6
200 mg (Double Dose)Percentage Change in Other Lipids and Apolipoproteins From Baseline to Day 180Non-HDL Cholesterol-38.9 percent changeStandard Deviation 16.8
200 mg (Double Dose)Percentage Change in Other Lipids and Apolipoproteins From Baseline to Day 180HDL Cholesterol10.3 percent changeStandard Deviation 15.3
200 mg (Double Dose)Percentage Change in Other Lipids and Apolipoproteins From Baseline to Day 180Total Cholesterol-26.8 percent changeStandard Deviation 13
200 mg (Double Dose)Percentage Change in Other Lipids and Apolipoproteins From Baseline to Day 180Apolipoprotein B-35 percent changeStandard Deviation 15.8
200 mg (Double Dose)Percentage Change in Other Lipids and Apolipoproteins From Baseline to Day 180Apolipoprotein A18.6 percent changeStandard Deviation 11.5
300 mg (Double Dose)Percentage Change in Other Lipids and Apolipoproteins From Baseline to Day 180Apolipoprotein B-40.9 percent changeStandard Deviation 14.8
300 mg (Double Dose)Percentage Change in Other Lipids and Apolipoproteins From Baseline to Day 180Total Cholesterol33.2 percent changeStandard Deviation 11.3
300 mg (Double Dose)Percentage Change in Other Lipids and Apolipoproteins From Baseline to Day 180HDL Cholesterol8.6 percent changeStandard Deviation 14.9
300 mg (Double Dose)Percentage Change in Other Lipids and Apolipoproteins From Baseline to Day 180Apolipoprotein A16.2 percent changeStandard Deviation 11.9
300 mg (Double Dose)Percentage Change in Other Lipids and Apolipoproteins From Baseline to Day 180Non-HDL Cholesterol-46 percent changeStandard Deviation 14.6
Secondary

Percentage Change in Other Lipids and Inflammatory Markers From Baseline to Day 180

This outcome measure evaluated the percent change from baseline to Day 180 in triglycerides, very-low-density lipoprotein (VLDL) cholesterol, lipoprotein(a), and high sensitivity C-reactive protein (hsCRP) in participants (single and double dose) in the mITT population.

Time frame: Baseline, Day 180

ArmMeasureGroupValue (MEDIAN)
Placebo (Single Dose)Percentage Change in Other Lipids and Inflammatory Markers From Baseline to Day 180Triglycerides6.4 percent change
Placebo (Single Dose)Percentage Change in Other Lipids and Inflammatory Markers From Baseline to Day 180VLDL Cholesterol2.4 percent change
Placebo (Single Dose)Percentage Change in Other Lipids and Inflammatory Markers From Baseline to Day 180Lipoprotein(a)0.5 percent change
Placebo (Single Dose)Percentage Change in Other Lipids and Inflammatory Markers From Baseline to Day 180hsCRP-5.3 percent change
200 mg (Single Dose)Percentage Change in Other Lipids and Inflammatory Markers From Baseline to Day 180hsCRP7.1 percent change
200 mg (Single Dose)Percentage Change in Other Lipids and Inflammatory Markers From Baseline to Day 180VLDL Cholesterol-11.6 percent change
200 mg (Single Dose)Percentage Change in Other Lipids and Inflammatory Markers From Baseline to Day 180Triglycerides1.1 percent change
200 mg (Single Dose)Percentage Change in Other Lipids and Inflammatory Markers From Baseline to Day 180Lipoprotein(a)-14.3 percent change
300 mg (Single Dose)Percentage Change in Other Lipids and Inflammatory Markers From Baseline to Day 180Triglycerides-12.8 percent change
300 mg (Single Dose)Percentage Change in Other Lipids and Inflammatory Markers From Baseline to Day 180hsCRP-16.2 percent change
300 mg (Single Dose)Percentage Change in Other Lipids and Inflammatory Markers From Baseline to Day 180VLDL Cholesterol-23.8 percent change
300 mg (Single Dose)Percentage Change in Other Lipids and Inflammatory Markers From Baseline to Day 180Lipoprotein(a)-14.3 percent change
500 mg (Single Dose)Percentage Change in Other Lipids and Inflammatory Markers From Baseline to Day 180Triglycerides-12.2 percent change
500 mg (Single Dose)Percentage Change in Other Lipids and Inflammatory Markers From Baseline to Day 180VLDL Cholesterol-14.6 percent change
500 mg (Single Dose)Percentage Change in Other Lipids and Inflammatory Markers From Baseline to Day 180Lipoprotein(a)-18.2 percent change
500 mg (Single Dose)Percentage Change in Other Lipids and Inflammatory Markers From Baseline to Day 180hsCRP-19.8 percent change
Placebo (Double Dose)Percentage Change in Other Lipids and Inflammatory Markers From Baseline to Day 180hsCRP-20 percent change
Placebo (Double Dose)Percentage Change in Other Lipids and Inflammatory Markers From Baseline to Day 180Lipoprotein(a)0 percent change
Placebo (Double Dose)Percentage Change in Other Lipids and Inflammatory Markers From Baseline to Day 180VLDL Cholesterol2.7 percent change
Placebo (Double Dose)Percentage Change in Other Lipids and Inflammatory Markers From Baseline to Day 180Triglycerides-3 percent change
100 mg (Double Dose)Percentage Change in Other Lipids and Inflammatory Markers From Baseline to Day 180hsCRP-12.5 percent change
100 mg (Double Dose)Percentage Change in Other Lipids and Inflammatory Markers From Baseline to Day 180Lipoprotein(a)-14.9 percent change
100 mg (Double Dose)Percentage Change in Other Lipids and Inflammatory Markers From Baseline to Day 180VLDL Cholesterol-16.4 percent change
100 mg (Double Dose)Percentage Change in Other Lipids and Inflammatory Markers From Baseline to Day 180Triglycerides-6.3 percent change
200 mg (Double Dose)Percentage Change in Other Lipids and Inflammatory Markers From Baseline to Day 180hsCRP-16.3 percent change
200 mg (Double Dose)Percentage Change in Other Lipids and Inflammatory Markers From Baseline to Day 180Triglycerides0.7 percent change
200 mg (Double Dose)Percentage Change in Other Lipids and Inflammatory Markers From Baseline to Day 180Lipoprotein(a)-17.3 percent change
200 mg (Double Dose)Percentage Change in Other Lipids and Inflammatory Markers From Baseline to Day 180VLDL Cholesterol-21.2 percent change
300 mg (Double Dose)Percentage Change in Other Lipids and Inflammatory Markers From Baseline to Day 180VLDL Cholesterol-16 percent change
300 mg (Double Dose)Percentage Change in Other Lipids and Inflammatory Markers From Baseline to Day 180Lipoprotein(a)-25.6 percent change
300 mg (Double Dose)Percentage Change in Other Lipids and Inflammatory Markers From Baseline to Day 180hsCRP-16.7 percent change
300 mg (Double Dose)Percentage Change in Other Lipids and Inflammatory Markers From Baseline to Day 180Triglycerides-14.2 percent change
Secondary

Percentage Change in PCSK9 Levels From Baseline at Day 180

This outcome measure evaluated the percent change in proprotein convertase subtilisin/kexin type 9 (PCSK9) from baseline to Day 180 in participants (single and double dose) in the mITT population.

Time frame: Baseline, Day 180

ArmMeasureValue (MEAN)Dispersion
Placebo (Single Dose)Percentage Change in PCSK9 Levels From Baseline at Day 1802.2 percent changeStandard Deviation 23.4
200 mg (Single Dose)Percentage Change in PCSK9 Levels From Baseline at Day 180-47.9 percent changeStandard Deviation 21
300 mg (Single Dose)Percentage Change in PCSK9 Levels From Baseline at Day 180-56 percent changeStandard Deviation 19.2
500 mg (Single Dose)Percentage Change in PCSK9 Levels From Baseline at Day 180-59.3 percent changeStandard Deviation 18
Placebo (Double Dose)Percentage Change in PCSK9 Levels From Baseline at Day 180-1.2 percent changeStandard Deviation 20.7
100 mg (Double Dose)Percentage Change in PCSK9 Levels From Baseline at Day 180-53.2 percent changeStandard Deviation 20.9
200 mg (Double Dose)Percentage Change in PCSK9 Levels From Baseline at Day 180-66.2 percent changeStandard Deviation 15.6
300 mg (Double Dose)Percentage Change in PCSK9 Levels From Baseline at Day 180-69.1 percent changeStandard Deviation 12.1
Secondary

Percent Change From Baseline In LDL-C Levels At Day 60, Day 120, and Day 210

This outcome measure evaluated the effects of both single- and double-dose inclisiran on LDL-C levels in the mITT population from baseline to Day 60, Day 120, and Day 210.

Time frame: Baseline, Day 60, Day 120, and Day 210

ArmMeasureGroupValue (MEAN)
Placebo (Single Dose)Percent Change From Baseline In LDL-C Levels At Day 60, Day 120, and Day 210Day 60-4.27 Percent change
Placebo (Single Dose)Percent Change From Baseline In LDL-C Levels At Day 60, Day 120, and Day 210Day 2101.45 Percent change
Placebo (Single Dose)Percent Change From Baseline In LDL-C Levels At Day 60, Day 120, and Day 210Day 120-0.91 Percent change
200 mg (Single Dose)Percent Change From Baseline In LDL-C Levels At Day 60, Day 120, and Day 210Day 210-28.98 Percent change
200 mg (Single Dose)Percent Change From Baseline In LDL-C Levels At Day 60, Day 120, and Day 210Day 120-36.94 Percent change
200 mg (Single Dose)Percent Change From Baseline In LDL-C Levels At Day 60, Day 120, and Day 210Day 60-44.32 Percent change
300 mg (Single Dose)Percent Change From Baseline In LDL-C Levels At Day 60, Day 120, and Day 210Day 210-35.39 Percent change
300 mg (Single Dose)Percent Change From Baseline In LDL-C Levels At Day 60, Day 120, and Day 210Day 60-50.87 Percent change
300 mg (Single Dose)Percent Change From Baseline In LDL-C Levels At Day 60, Day 120, and Day 210Day 120-43.32 Percent change
500 mg (Single Dose)Percent Change From Baseline In LDL-C Levels At Day 60, Day 120, and Day 210Day 60-49.58 Percent change
500 mg (Single Dose)Percent Change From Baseline In LDL-C Levels At Day 60, Day 120, and Day 210Day 120-46.42 Percent change
500 mg (Single Dose)Percent Change From Baseline In LDL-C Levels At Day 60, Day 120, and Day 210Day 210-39.2 Percent change
Placebo (Double Dose)Percent Change From Baseline In LDL-C Levels At Day 60, Day 120, and Day 210Day 1200.17 Percent change
Placebo (Double Dose)Percent Change From Baseline In LDL-C Levels At Day 60, Day 120, and Day 210Day 60-1.92 Percent change
Placebo (Double Dose)Percent Change From Baseline In LDL-C Levels At Day 60, Day 120, and Day 210Day 2100.58 Percent change
100 mg (Double Dose)Percent Change From Baseline In LDL-C Levels At Day 60, Day 120, and Day 210Day 120-41.37 Percent change
100 mg (Double Dose)Percent Change From Baseline In LDL-C Levels At Day 60, Day 120, and Day 210Day 60-35.73 Percent change
100 mg (Double Dose)Percent Change From Baseline In LDL-C Levels At Day 60, Day 120, and Day 210Day 210-31.67 Percent change
200 mg (Double Dose)Percent Change From Baseline In LDL-C Levels At Day 60, Day 120, and Day 210Day 120-49.54 Percent change
200 mg (Double Dose)Percent Change From Baseline In LDL-C Levels At Day 60, Day 120, and Day 210Day 60-44.28 Percent change
200 mg (Double Dose)Percent Change From Baseline In LDL-C Levels At Day 60, Day 120, and Day 210Day 210-42.59 Percent change
300 mg (Double Dose)Percent Change From Baseline In LDL-C Levels At Day 60, Day 120, and Day 210Day 60-50.99 Percent change
300 mg (Double Dose)Percent Change From Baseline In LDL-C Levels At Day 60, Day 120, and Day 210Day 120-54.73 Percent change
300 mg (Double Dose)Percent Change From Baseline In LDL-C Levels At Day 60, Day 120, and Day 210Day 210-50.54 Percent change

Source: ClinicalTrials.gov · Data processed: Mar 1, 2026