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Safety and Efficacy of Evolocumab in Addition to Optimal Stable Background Statin Therapy in Chinese Participants With Primary Hypercholesterolemia and Mixed Dyslipidemia

A Double-blind, Randomized, Placebo-controlled, Multicenter Study to Evaluate Safety and Efficacy of Evolocumab (AMG 145) in Addition to Optimal Stable Background Statin Therapy in Chinese Subjects With Primary Hypercholesterolemia and Mixed Dyslipidemia

Status
Terminated
Phases
Phase 3
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT03433755
Enrollment
259
Registered
2018-02-15
Start date
2019-05-09
Completion date
2020-05-09
Last updated
2023-03-27

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

Conditions

Mixed Dyslipidemia, Primary Hypercholesterolemia

Keywords

Evolocumab, Repatha, Statin, Chinese, China, Hypercholesterolemia, Mixed Dyslipidemia, High Cholesterol, Lowering cholesterol

Brief summary

This study is being done to learn more about evolocumab in Chinese people with primary hypercholesterolemia or mixed dyslipidemia. This study will see if evolocumab will reduce low density lipoprotein cholesterol (LDL-C) in Chinese people who are also taking a certain type of lipid-lowering medication (statins with or without ezetimibe) and whether it causes any side effects.

Detailed description

This is a phase 3, multicenter, double-blind, randomized, placebo-controlled study of evolocumab in Chinese participants with hypercholesterolemia and mixed dyslipidemia. Participants who have signed the informed consent form (ICF) will have fasting lipids measured and all inclusion and exclusion criteria assessed. All eligible participants must be taking a maximum appropriate dose of an approved statin, not requiring up titration. Participants should maintain their current diet and exercise regimen. Treatment and follow-up period will be 12 weeks with an additional phone call or other participant contact at week 14 for those receiving investigational product every 2 weeks (Q2W). The end of study (EOS) for participants on once monthly (QM) investigational product is at the week 12 visit, which must be at least 30 days post last dose of investigational product. Evolocumab or placebo will be administered by self-injection under the skin at the study site or in an appropriate non-clinic setting (e.g., at home) by spring based prefilled auto injector/pen (AI/Pen). Participants must tolerate an injection of placebo with a prefilled auto injector/pen device to be used during the study prior to randomization. Participants will be randomly added to 1 of 4 groups using a 2:2:1:1 ratio: evolocumab 140 mg Q2W (86 participants total) evolocumab 420 mg QM (86 participants total) placebo Q2W (44 participants total) placebo QM (43 participants total). The dose frequencies of Q2W and QM will not be blinded but the identity of investigational product evolocumab or placebo will be blinded.

Interventions

DRUGevolocumab

Evolocumab will be administered per pre-filled auto-injector pen (AI/Pen). Participants will receive evolocumab (AMG 145) every 2 weeks or monthly subcutaneously.

DRUGplacebo

Placebo will be administered per pre-filled auto-injector pen (AI/Pen). Participants will receive placebo every 2 weeks or monthly subcutaneously.

Sponsors

Amgen
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)

Masking description

The dose frequencies of Q2W and QM will not be blinded but the identity of investigational product (evolocumab or matching SC placebo) will be blinded. In order to protect the blinding of the double-blind treatment period the following labs will be blinded post-investigational product treatment until unblinding of the clinical database and not reported to sites as noted below: • Blinded to the Amgen study team and site staff: lipid panel, Apolipoprotein A1 (ApoA1), Apolipoprotein B (ApoB), lipoprotein(a), high-sensitivity C-reactive protein (hs-CRP), and Proprotein convertase subtilisin/kexin type 9 (PCSK9).

Intervention model description

Participants will be screened for this study and if found eligible as described by the study protocol may be randomized into 1 of 4 groups. Randomized means that you are put into a group by chance. It is like drawing numbers out of a hat. Randomization will be done using a 2:2:1:1 ratio. This means for every 6 participants randomized: * 2 participants will be randomized to evolocumab 140 mg every 2 weeks * 2 participants will be randomized to evolocumab 420 mg once a month * 1 participant will be randomized to placebo every 2 weeks * 1 participant will be randomized to placebo once a month.

Eligibility

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

Inclusion criteria

* Male or female ≥ 18 years of age at signing of informed consent form * On an approved statin, with or without ezetimibe, at optimal stable daily dose(s) for at least 4 weeks before LDL-C screening and, in the opinion of the investigator, not requiring uptitration * Fasting LDL-C as determined by central laboratory at screening ≥ 80 mg/dL * Subject meets at least 1 of the following criteria for high/very high cardiovascular (CV) risk: * history of coronary artery disease * history of ischemic stroke * diagnosis of peripheral artery disease * an estimated glomerular filtration rate (eGFR) as determined by central laboratory at screening of ≥ 30 but \< 60 ml/min/1.73m\^2 * diagnosis of diabetes mellitus type 2 * presence of ≥ 3 of the following risk factors: ≥ 45 years of age if male; ≥ 55 years of age if female; hypertension; smoking; family history of premature cardiovascular disease (CVD; 1st degree of relative: male \< 55 yr, female \< 65 yr); high-density lipoprotein (HDL) cholesterol \< 40 mg/dL; obesity (body mass index ≥ 28 kg/m\^2) OR Subject does not meet high/very high CV risk criteria but fasting LDL-C as determined by central laboratory at screening ≥ 130 mg/dl * Fasting triglycerides ≤ 400 mg/dL (4.5 mmol/L) by determined by central laboratory at screening * Subject tolerates a screening placebo injection.

Exclusion criteria

* Myocardial infarction, unstable angina, percutaneous coronary intervention (PCI), coronary artery bypass graft (CABG) or stroke within 3 months prior to randomization * Planned coronary or other revascularization within 20 weeks of screening * New York Heart Association (NYHA) III or IV heart failure, or last known left ventricular ejection fraction \< 30 * Uncontrolled serious cardiac arrhythmia defined as recurrent and highly symptomatic ventricular tachycardia, atrial fibrillation with rapid ventricular response, or supraventricular tachycardia that are not controlled by medications, in the past 3 months prior to randomization * Type 1 diabetes, new-onset (hemoglobin \[Hb\]A1c ≥ 6.5% or fasting plasma glucose (FPG) ≥ 126 mg/dL at screening without known diagnosis) or poorly controlled (HbA1c ≥ 8.5%) type 2 diabetes, as determined by central laboratory at screening * Uncontrolled hypertension defined as sitting systolic blood pressure (SBP) \> 180 mmHg or diastolic blood pressure (DBP) \> 110 mmHg * Subject has taken a cholesterylester transfer protein (CETP) inhibitor in the 12 months prior to randomization * Subject has taken in the 6 weeks prior to LDL-C screening: red yeast rice, \> 200 mg/day niacin, \> 1000 mg/day omega-3 fatty acids (eg, dihydroxyacetone docosahexaenoic acid and eicosapentaenoic acid), stanols or prescription lipid-regulating drugs (eg, bile-acid sequestering resins, fibrates and derivatives) or other cholesterol lowering drugs or lipid-lowering dietary supplements or food additives other than statins and ezetimibe * Treatment 3 months prior to LDL-C screening with any of the following drugs: systemic cyclosporine, systemic steroids, (intravenous \[IV\], intramuscular \[IM\], or by-mouth \[PO\]) (Note: hormone replacement therapy is permitted), vitamin A derivatives and retinol derivatives for the treatment of dermatologic conditions (eg, Accutane) (Note: vitamin A in a multivitamin preparation is permitted) * Uncontrolled hypothyroidism or hyperthyroidism as defined by thyroid stimulating hormone (TSH) \< 1.0 time the lower limit of normal (LLN) or \> 1.5 times the upper limit of normal (ULN), respectively, at screening * Severe renal dysfunction, defined as an eGFR \< 30 ml/min/1.73m\^2 at screening as estimated by Cockcroft-Gault method * Active liver disease or hepatic dysfunction, defined as aspartate aminotransferase (AST) or alanine aminotransferase (ALT) \> 3 times the ULN as determined by central laboratory analysis at screening * Creatinine kinase (CK) \> 5 times the ULN at screening * Malignancy (except non-melanoma skin cancers, cervical in-situ carcinoma, breast ductal carcinoma in situ, or stage 1 prostate carcinoma) within the last 5 years prior to randomization * Subject has previously received evolocumab or any other therapy to inhibit PCSK9 * Subject has known sensitivity to any of the active substances or their excipients to be administered during dosing, eg, carboxymethylcellulose * Subject likely to not be available to complete all protocol-required study visits or procedures, and/or to comply with all required study procedures to the best of the subject and investigator's knowledge. * History or evidence of any other clinically significant disorder, condition or disease (with the exception of those outlined above) that, in the opinion of the investigator or Amgen physician, if consulted, would pose a risk to subject safety or interfere with the study evaluation, procedures or completion. * Currently receiving treatment in another investigational device or drug study, or less than 30 days before randomization since ending treatment on another investigational device or drug study(s) or planning to receive other investigational procedures while participating in this study * Female subject of childbearing potential not willing to use an acceptable method(s) of effective birth control during treatment with investigational product and for an additional 15 weeks after the end of treatment with investigational product. Female subjects of non-childbearing potential who are not required to use contraception during the study and include those who have had a: * hysterectomy * bilateral salpingectomy * bilateral oophorectomy or * who are postmenopausal i. A postmenopausal state is defined as no menses for 12 months without an alternative medical cause. \[A high follicle stimulating hormone (FSH) level in the postmenopausal range may be used to confirm a postmenopausal state in women not using hormonal contraception or hormonal replacement therapy (HRT). However, in the absence of 12 months of amenorrhea, a single FSH measurement is insufficient. ii. Females on HRT and whose menopausal status is in doubt will be required to use one of the non-hormonal highly effective contraception methods if they wish to continue their HRT during the study. Otherwise, they must discontinue HRT to allow confirmation of postmenopausal status before study enrollment. Acceptable methods of effective birth control include: * sexual abstinence (defined as refraining from heterosexual intercourse during the entire period of risk associated with the study treatments; the reliability of sexual abstinence must be evaluated in relation to the duration of the trial and the preferred and usual lifestyle of the subject. \[Periodic abstinence (eg., calendar, ovulation, symptothermal, postovulation methods), declaration of abstinence for the duration of a study, and withdrawal are not acceptable methods of contraception\]) * bilateral tubal ligation/occlusion * vasectomized partner (provided that partner is the sole sexual partner of the female subject of childbearing potential and that the vasectomized partner has received medical assessment of the surgical success) * use of hormonal birth control methods (oral, intravaginal (eg. vaginal ring(s), transdermal, injectable, or implantable) * intrauterine devices (IUDs) * intrauterine hormonal releasing system (IUS) * 2 barrier methods (each partner must use 1 barrier method) the male uses a condom and the female must choose either a diaphragm, OR cervical cap, OR contraceptive sponge with spermicide. If spermicide is not commercially available in the country or region, the 2 barrier method without spermicide is acceptable. (A female condom is not an option due to the risk of tearing when both partners use a condom.) * Female subject is pregnant or breast feeding (nursing), planning to become pregnant or planning to breastfeed (nurse) during treatment with investigational product and/or within 15 weeks after the end of treatment with investigational product.

Design outcomes

Primary

MeasureTime frameDescription
Co-Primary Endpoint: Percent Change From Baseline in LDL-C: Mean of Weeks 10 and 12Baseline, Weeks 10 and 12Least squares mean is from the repeated measures linear effects model which includes treatment group, stratification factors, scheduled visit and the interaction of treatment with scheduled visit as covariates.
Co-Primary Endpoint: Percent Change From Baseline in LDL-C at Week 12Baseline, Week 12Least squares mean is from the repeated measures linear effects model which includes treatment group, stratification factors, scheduled visit and the interaction of treatment with scheduled visit as covariates.

Secondary

MeasureTime frameDescription
Change From Baseline in LDL-C: Mean of Weeks 10 and 12Baseline, Weeks 10 and 12Least squares mean is from the repeated measures linear effects model which includes treatment group, stratification factors, scheduled visit and the interaction of treatment with scheduled visit as covariates.
Percent Change From Baseline in Non-HDL-C at Week 12Baseline, Week 12Least squares mean is from the repeated measures linear effects model which includes treatment group, stratification factors, scheduled visit and the interaction of treatment with scheduled visit as covariates.
Percent Change From Baseline in Apolipoprotein B (ApoB): Mean of Weeks 10 and 12Baseline, Weeks 10 and 12Least squares mean is from the repeated measures linear effects model which includes treatment group, stratification factors, scheduled visit and the interaction of treatment with scheduled visit as covariates.
Percent Change From Baseline in ApoB at Week 12Baseline and Week 12Least squares mean is from the repeated measures linear effects model which includes treatment group, stratification factors, scheduled visit and the interaction of treatment with scheduled visit as covariates.
Percent Change From Baseline in Total Cholesterol: Mean of Weeks 10 and 12Baseline, Weeks 10 and 12Least squares mean is from the repeated measures linear effects model which includes treatment group, stratification factors, scheduled visit and the interaction of treatment with scheduled visit as covariates.
Percent Change From Baseline in Total Cholesterol at Week 12Baseline and Week 12Least squares mean is from the repeated measures linear effects model which includes treatment group, stratification factors, scheduled visit and the interaction of treatment with scheduled visit as covariates.
Percentage of Participants With Target LDL-C < 70 mg/dL (1.8 mmol/L): Mean of Weeks 10 and 12Weeks 10 and 12Percentage of participants who were below the target LDL-C of 70 mg/dL (1.8 mmol/L) based on the mean LDL-C data collected at weeks 10 and 12.
Percentage of Participants With Target LDL-C < 70 mg/dL (1.8 mmol/L) at Week 12Week 12
Percentage of Participants With LDL-C Response: Mean of Weeks 10 and 12Baseline, Weeks 10 and 12Percentage of participants who had LDL-C response (50% reduction of LDL-C from baseline) based on the mean LDL-C using the data collected at weeks 10 and 12.
Change From Baseline in LDL-C at Week 12Baseline, Week 12Least squares mean is from the repeated measures linear effects model which includes treatment group, stratification factors, scheduled visit and the interaction of treatment with scheduled visit as covariates.
Percent Change From Baseline in Lipoprotein(a) [Lp(a)]: Mean of Weeks 10 and 12Baseline, Weeks 10 and 12Least squares mean is from the repeated measures linear effects model which includes treatment group, stratification factors, scheduled visit and the interaction of treatment with scheduled visit as covariates.
Percent Change From Baseline in Lp(a) at Week 12Baseline and Week 12Least squares mean is from the repeated measures linear effects model which includes treatment group, stratification factors, scheduled visit and the interaction of treatment with scheduled visit as covariates.
Percent Change From Baseline in Triglycerides: Mean of Weeks 10 and 12Baseline, Weeks 10 and 12Least squares mean is from the repeated measures linear effects model which includes treatment group, stratification factors, scheduled visit and the interaction of treatment with scheduled visit as covariates.
Percent Change From Baseline in Triglycerides at Week 12Baseline and Week 12Least squares mean is from the repeated measures linear effects model which includes treatment group, stratification factors, scheduled visit and the interaction of treatment with scheduled visit as covariates.
Percent Change From Baseline in High-Density Lipoprotein Cholesterol (HDL-C): Mean of Weeks 10 and 12Baseline, Weeks 10 and 12Least squares mean is from the repeated measures linear effects model which includes treatment group, stratification factors, scheduled visit and the interaction of treatment with scheduled visit as covariates.
Percent Change From Baseline in HDL-C at Week 12Baseline and Week 12Least squares mean is from the repeated measures linear effects model which includes treatment group, stratification factors, scheduled visit and the interaction of treatment with scheduled visit as covariates.
Percent Change From Baseline in Very Low-Density Lipoprotein Cholesterol (VLDL-C): Mean of Weeks 10 and 12Baseline, Weeks 10 and 12Least squares mean is from the repeated measures linear effects model which includes treatment group, stratification factors, scheduled visit and the interaction of treatment with scheduled visit as covariates.
Percent Change From Baseline in VLDL-C at Week 12Baseline and Week 12Least squares mean is from the repeated measures linear effects model which includes treatment group, stratification factors, scheduled visit and the interaction of treatment with scheduled visit as covariates.
Percentage of Participants With LDL-C Response (50% Reduction of LDL-C From Baseline) at Week 12Baseline and Week 12LDL-C Response is defined as a 50% reduction of LDL-C from Baseline.
Percent Change From Baseline in Non-High-Density Lipoprotein Cholesterol (Non-HDL-C): Mean of Weeks 10 and 12Baseline, Weeks 10 and 12Least squares mean is from the repeated measures linear effects model which includes treatment group, stratification factors, scheduled visit and the interaction of treatment with scheduled visit as covariates.

Countries

China

Participant flow

Recruitment details

Participants were enrolled at 31 research centers in China from 09 May 2019 to 20 January 2020.

Pre-assignment details

Participants were randomized 2:2:1:1 into the following treatment arms: evolocumab140 mg subcutaneously (SC) every 2 weeks (Q2W); evolocumab 420 mg SC once monthly (QM); placebo SC Q2W, or placebo SC QM. Randomization was stratified by entry cardiovascular (CV) risk (high/very high vs. not high/very high). Due to Human Genetic Resource Administration office of China (HGRAC) regulations/restrictions, 17 participants were not included in any analysis.

Participants by arm

ArmCount
Placebo Q2W
Placebo SC Q2W for 12 weeks
41
Placebo QM
Placebo SC QM for 12 weeks
41
Evolocumab 140 mg Q2W
Evolocumab 140 mg SC Q2W for 12 weeks
79
Evolocumab 420 mg QM
Evolocumab 420 mg SC QM for 12 weeks
80
Total241

Withdrawals & dropouts

PeriodReasonFG000FG001FG002FG003
Overall StudyDecision by Sponsor1000
Overall StudyLost to Follow-up1000

Baseline characteristics

CharacteristicEvolocumab 140 mg Q2WEvolocumab 420 mg QMTotalPlacebo Q2WPlacebo QM
Age, Continuous61.2 years
STANDARD_DEVIATION 10.6
60.9 years
STANDARD_DEVIATION 9.8
60.2 years
STANDARD_DEVIATION 10.3
57.8 years
STANDARD_DEVIATION 9.8
59.4 years
STANDARD_DEVIATION 10.9
Ethnicity (NIH/OMB)
Hispanic or Latino
0 Participants0 Participants0 Participants0 Participants0 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
79 Participants80 Participants241 Participants41 Participants41 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants0 Participants0 Participants0 Participants0 Participants
Low-Density Lipoprotein Cholesterol (LDL-C)113.7 mg/dL
STANDARD_DEVIATION 37.7
115.5 mg/dL
STANDARD_DEVIATION 30.1
116.1 mg/dL
STANDARD_DEVIATION 34.6
120.9 mg/dL
STANDARD_DEVIATION 42.2
117.1 mg/dL
STANDARD_DEVIATION 28.2
Race/Ethnicity, Customized
Asian
79 Participants80 Participants241 Participants41 Participants41 Participants
Sex: Female, Male
Female
28 Participants29 Participants78 Participants11 Participants10 Participants
Sex: Female, Male
Male
51 Participants51 Participants163 Participants30 Participants31 Participants
Stratification Factor: Cardiovascular (CV) Risk
High/Very High CV Risk
73 Participants74 Participants222 Participants37 Participants38 Participants
Stratification Factor: Cardiovascular (CV) Risk
Not High/Very High CV Risk
6 Participants6 Participants19 Participants4 Participants3 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
EG002
affected / at risk
EG003
affected / at risk
deaths
Total, all-cause mortality
0 / 420 / 410 / 790 / 80
other
Total, other adverse events
22 / 4122 / 4145 / 7942 / 80
serious
Total, serious adverse events
2 / 414 / 416 / 791 / 80

Outcome results

Primary

Co-Primary Endpoint: Percent Change From Baseline in LDL-C at Week 12

Least squares mean is from the repeated measures linear effects model which includes treatment group, stratification factors, scheduled visit and the interaction of treatment with scheduled visit as covariates.

Time frame: Baseline, Week 12

Population: Full Analysis Set: participants who were randomized and received at least 1 dose of study drug. Participants with baseline and post-baseline assessments.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
Placebo Q2WCo-Primary Endpoint: Percent Change From Baseline in LDL-C at Week 122.48 percent changeStandard Error 4.18
Evolocumab 140 mg Q2WCo-Primary Endpoint: Percent Change From Baseline in LDL-C at Week 12-68.39 percent changeStandard Error 3.55
Placebo QMCo-Primary Endpoint: Percent Change From Baseline in LDL-C at Week 122.72 percent changeStandard Error 4.25
Evolocumab 420 mg QMCo-Primary Endpoint: Percent Change From Baseline in LDL-C at Week 12-63.09 percent changeStandard Error 3.42
p-value: <0.000195% CI: [-79.47, -62.27]Repeated measures linear effects model
p-value: <0.000195% CI: [-73.97, -57.66]Repeated measures linear effects model
Primary

Co-Primary Endpoint: Percent Change From Baseline in LDL-C: Mean of Weeks 10 and 12

Least squares mean is from the repeated measures linear effects model which includes treatment group, stratification factors, scheduled visit and the interaction of treatment with scheduled visit as covariates.

Time frame: Baseline, Weeks 10 and 12

Population: Full Analysis Set: participants who were randomized and received at least 1 dose of study drug. Participants with baseline and post-baseline assessments.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
Placebo Q2WCo-Primary Endpoint: Percent Change From Baseline in LDL-C: Mean of Weeks 10 and 121.88 percent changeStandard Error 3.72
Evolocumab 140 mg Q2WCo-Primary Endpoint: Percent Change From Baseline in LDL-C: Mean of Weeks 10 and 12-68.86 percent changeStandard Error 3.27
Placebo QMCo-Primary Endpoint: Percent Change From Baseline in LDL-C: Mean of Weeks 10 and 12-0.36 percent changeStandard Error 3.78
Evolocumab 420 mg QMCo-Primary Endpoint: Percent Change From Baseline in LDL-C: Mean of Weeks 10 and 12-70.10 percent changeStandard Error 3.21
p-value: <0.000195% CI: [-77.98, -63.48]Repeated measures linear effects model
p-value: <0.000195% CI: [-76.51, -62.97]Repeated measures linear effects model
Secondary

Change From Baseline in LDL-C at Week 12

Least squares mean is from the repeated measures linear effects model which includes treatment group, stratification factors, scheduled visit and the interaction of treatment with scheduled visit as covariates.

Time frame: Baseline, Week 12

Population: Full Analysis Set: participants who were randomized and received at least 1 dose of study drug. Participants with baseline and post-baseline assessments.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
Placebo Q2WChange From Baseline in LDL-C at Week 12-0.8 mg/dLStandard Error 5.8
Evolocumab 140 mg Q2WChange From Baseline in LDL-C at Week 12-76.7 mg/dLStandard Error 5.1
Placebo QMChange From Baseline in LDL-C at Week 12-2.1 mg/dLStandard Error 6.1
Evolocumab 420 mg QMChange From Baseline in LDL-C at Week 12-75.1 mg/dLStandard Error 5
p-value: <0.000195% CI: [-87.1, -64.7]Repeated measures linear effects model
p-value: <0.000195% CI: [-84.1, -61.8]Repeated measures linear effects model
Secondary

Change From Baseline in LDL-C: Mean of Weeks 10 and 12

Least squares mean is from the repeated measures linear effects model which includes treatment group, stratification factors, scheduled visit and the interaction of treatment with scheduled visit as covariates.

Time frame: Baseline, Weeks 10 and 12

Population: Full Analysis Set: participants who were randomized and received at least 1 dose of study drug. Participants with baseline and post-baseline assessments.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
Placebo Q2WChange From Baseline in LDL-C: Mean of Weeks 10 and 12-0.6 mg/dLStandard Error 5.4
Evolocumab 140 mg Q2WChange From Baseline in LDL-C: Mean of Weeks 10 and 12-77.1 mg/dLStandard Error 4.8
Placebo QMChange From Baseline in LDL-C: Mean of Weeks 10 and 12-5.8 mg/dLStandard Error 5.8
Evolocumab 420 mg QMChange From Baseline in LDL-C: Mean of Weeks 10 and 12-83.0 mg/dLStandard Error 5
p-value: <0.000195% CI: [-86.6, -66.4]Repeated measures linear effects model
p-value: <0.000195% CI: [-87.7, -66.7]Repeated measures linear effects model
Secondary

Percentage of Participants With LDL-C Response (50% Reduction of LDL-C From Baseline) at Week 12

LDL-C Response is defined as a 50% reduction of LDL-C from Baseline.

Time frame: Baseline and Week 12

Population: Full Analysis Set: participants who were randomized and received at least 1 dose of study drug. Participants with observed data.

ArmMeasureValue (NUMBER)
Placebo Q2WPercentage of Participants With LDL-C Response (50% Reduction of LDL-C From Baseline) at Week 120.0 percentage of participants
Evolocumab 140 mg Q2WPercentage of Participants With LDL-C Response (50% Reduction of LDL-C From Baseline) at Week 1282.8 percentage of participants
Placebo QMPercentage of Participants With LDL-C Response (50% Reduction of LDL-C From Baseline) at Week 123.7 percentage of participants
Evolocumab 420 mg QMPercentage of Participants With LDL-C Response (50% Reduction of LDL-C From Baseline) at Week 1286.4 percentage of participants
p-value: <0.000195% CI: [67.8, 90.1]Cochran-Mantel-Haenszel
p-value: <0.000195% CI: [64.8, 89.7]Cochran-Mantel-Haenszel
Secondary

Percentage of Participants With LDL-C Response: Mean of Weeks 10 and 12

Percentage of participants who had LDL-C response (50% reduction of LDL-C from baseline) based on the mean LDL-C using the data collected at weeks 10 and 12.

Time frame: Baseline, Weeks 10 and 12

Population: Full Analysis Set: participants who were randomized and received at least 1 dose of study drug. Participants with observed data.

ArmMeasureValue (NUMBER)
Placebo Q2WPercentage of Participants With LDL-C Response: Mean of Weeks 10 and 120.0 percentage of participants
Evolocumab 140 mg Q2WPercentage of Participants With LDL-C Response: Mean of Weeks 10 and 1287.0 percentage of participants
Placebo QMPercentage of Participants With LDL-C Response: Mean of Weeks 10 and 125.7 percentage of participants
Evolocumab 420 mg QMPercentage of Participants With LDL-C Response: Mean of Weeks 10 and 1294.4 percentage of participants
p-value: <0.000195% CI: [73.3, 93]Cochran-Mantel-Haenszel
p-value: <0.000195% CI: [73.5, 94]Cochran-Mantel-Haenszel
Secondary

Percentage of Participants With Target LDL-C < 70 mg/dL (1.8 mmol/L) at Week 12

Time frame: Week 12

Population: Full Analysis Set: participants who were randomized and received at least 1 dose of study drug. Participants with observed data.

ArmMeasureValue (NUMBER)
Placebo Q2WPercentage of Participants With Target LDL-C < 70 mg/dL (1.8 mmol/L) at Week 120.0 percentage of participants
Evolocumab 140 mg Q2WPercentage of Participants With Target LDL-C < 70 mg/dL (1.8 mmol/L) at Week 1290.6 percentage of participants
Placebo QMPercentage of Participants With Target LDL-C < 70 mg/dL (1.8 mmol/L) at Week 123.7 percentage of participants
Evolocumab 420 mg QMPercentage of Participants With Target LDL-C < 70 mg/dL (1.8 mmol/L) at Week 1289.4 percentage of participants
p-value: <0.000195% CI: [76.6, 95.6]Cochran-Mantel-Haenszel
p-value: <0.000195% CI: [68.2, 91.9]Cochran-Mantel-Haenszel
Secondary

Percentage of Participants With Target LDL-C < 70 mg/dL (1.8 mmol/L): Mean of Weeks 10 and 12

Percentage of participants who were below the target LDL-C of 70 mg/dL (1.8 mmol/L) based on the mean LDL-C data collected at weeks 10 and 12.

Time frame: Weeks 10 and 12

Population: Full Analysis Set: participants who were randomized and received at least 1 dose of study drug. Participants with observed data.

ArmMeasureValue (NUMBER)
Placebo Q2WPercentage of Participants With Target LDL-C < 70 mg/dL (1.8 mmol/L): Mean of Weeks 10 and 122.7 percentage of participants
Evolocumab 140 mg Q2WPercentage of Participants With Target LDL-C < 70 mg/dL (1.8 mmol/L): Mean of Weeks 10 and 1289.9 percentage of participants
Placebo QMPercentage of Participants With Target LDL-C < 70 mg/dL (1.8 mmol/L): Mean of Weeks 10 and 125.7 percentage of participants
Evolocumab 420 mg QMPercentage of Participants With Target LDL-C < 70 mg/dL (1.8 mmol/L): Mean of Weeks 10 and 1297.2 percentage of participants
p-value: <0.000195% CI: [72.6, 92.8]Cochran-Mantel-Haenszel
p-value: <0.000195% CI: [76.9, 96.1]Cochran-Mantel-Haenszel
Secondary

Percent Change From Baseline in ApoB at Week 12

Least squares mean is from the repeated measures linear effects model which includes treatment group, stratification factors, scheduled visit and the interaction of treatment with scheduled visit as covariates.

Time frame: Baseline and Week 12

Population: Full Analysis Set: participants who were randomized and received at least 1 dose of study drug. Participants with baseline and post-baseline assessments.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
Placebo Q2WPercent Change From Baseline in ApoB at Week 122.53 percent changeStandard Error 3.55
Evolocumab 140 mg Q2WPercent Change From Baseline in ApoB at Week 12-53.16 percent changeStandard Error 3.03
Placebo QMPercent Change From Baseline in ApoB at Week 121.20 percent changeStandard Error 3.51
Evolocumab 420 mg QMPercent Change From Baseline in ApoB at Week 12-50.01 percent changeStandard Error 2.77
p-value: <0.000195% CI: [-62.98, -48.41]Repeated measures linear effects model
p-value: <0.000195% CI: [-58.06, -44.37]Repeated measures linear effects model
Secondary

Percent Change From Baseline in Apolipoprotein B (ApoB): Mean of Weeks 10 and 12

Least squares mean is from the repeated measures linear effects model which includes treatment group, stratification factors, scheduled visit and the interaction of treatment with scheduled visit as covariates.

Time frame: Baseline, Weeks 10 and 12

Population: Full Analysis Set: participants who were randomized and received at least 1 dose of study drug. Participants with baseline and post-baseline assessments.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
Placebo Q2WPercent Change From Baseline in Apolipoprotein B (ApoB): Mean of Weeks 10 and 121.80 percent changeStandard Error 3.17
Evolocumab 140 mg Q2WPercent Change From Baseline in Apolipoprotein B (ApoB): Mean of Weeks 10 and 12-54.45 percent changeStandard Error 2.79
Placebo QMPercent Change From Baseline in Apolipoprotein B (ApoB): Mean of Weeks 10 and 120.07 percent changeStandard Error 3
Evolocumab 420 mg QMPercent Change From Baseline in Apolipoprotein B (ApoB): Mean of Weeks 10 and 12-56.93 percent changeStandard Error 2.54
p-value: <0.000195% CI: [-62.44, -50.07]Repeated measures linear effects model
p-value: <0.000195% CI: [-62.35, -51.65]Repeated measures linear effects model
Secondary

Percent Change From Baseline in HDL-C at Week 12

Least squares mean is from the repeated measures linear effects model which includes treatment group, stratification factors, scheduled visit and the interaction of treatment with scheduled visit as covariates.

Time frame: Baseline and Week 12

Population: Full Analysis Set: participants who were randomized and received at least 1 dose of study drug. Participants with baseline and post-baseline assessments.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
Placebo Q2WPercent Change From Baseline in HDL-C at Week 121.95 percent changeStandard Error 2.88
Evolocumab 140 mg Q2WPercent Change From Baseline in HDL-C at Week 129.89 percent changeStandard Error 2.49
Placebo QMPercent Change From Baseline in HDL-C at Week 120.95 percent changeStandard Error 2.97
Evolocumab 420 mg QMPercent Change From Baseline in HDL-C at Week 127.12 percent changeStandard Error 2.33
p-value: 0.00895% CI: [2.18, 13.71]Repeated measures linear effects model
p-value: 0.01795% CI: [0.42, 11.92]Repeated measures linear effects model
Secondary

Percent Change From Baseline in High-Density Lipoprotein Cholesterol (HDL-C): Mean of Weeks 10 and 12

Least squares mean is from the repeated measures linear effects model which includes treatment group, stratification factors, scheduled visit and the interaction of treatment with scheduled visit as covariates.

Time frame: Baseline, Weeks 10 and 12

Population: Full Analysis Set: participants who were randomized and received at least 1 dose of study drug. Participants with baseline and post-baseline assessments.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
Placebo Q2WPercent Change From Baseline in High-Density Lipoprotein Cholesterol (HDL-C): Mean of Weeks 10 and 121.01 percent changeStandard Error 2.65
Evolocumab 140 mg Q2WPercent Change From Baseline in High-Density Lipoprotein Cholesterol (HDL-C): Mean of Weeks 10 and 129.45 percent changeStandard Error 2.35
Placebo QMPercent Change From Baseline in High-Density Lipoprotein Cholesterol (HDL-C): Mean of Weeks 10 and 121.86 percent changeStandard Error 2.6
Evolocumab 420 mg QMPercent Change From Baseline in High-Density Lipoprotein Cholesterol (HDL-C): Mean of Weeks 10 and 128.66 percent changeStandard Error 2.18
p-value: 0.00895% CI: [3.35, 13.52]Repeated measures linear effects model
p-value: 0.01795% CI: [2.1, 11.5]Repeated measures linear effects model
Secondary

Percent Change From Baseline in Lipoprotein(a) [Lp(a)]: Mean of Weeks 10 and 12

Least squares mean is from the repeated measures linear effects model which includes treatment group, stratification factors, scheduled visit and the interaction of treatment with scheduled visit as covariates.

Time frame: Baseline, Weeks 10 and 12

Population: Full Analysis Set: participants who were randomized and received at least 1 dose of study drug. Participants with baseline and post-baseline assessments.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
Placebo Q2WPercent Change From Baseline in Lipoprotein(a) [Lp(a)]: Mean of Weeks 10 and 124.96 percent changeStandard Error 4.97
Evolocumab 140 mg Q2WPercent Change From Baseline in Lipoprotein(a) [Lp(a)]: Mean of Weeks 10 and 12-43.49 percent changeStandard Error 4.46
Placebo QMPercent Change From Baseline in Lipoprotein(a) [Lp(a)]: Mean of Weeks 10 and 1211.27 percent changeStandard Error 4.37
Evolocumab 420 mg QMPercent Change From Baseline in Lipoprotein(a) [Lp(a)]: Mean of Weeks 10 and 12-29.16 percent changeStandard Error 3.58
p-value: <0.000195% CI: [-57.78, -39.11]Repeated measures linear effects model
p-value: <0.000195% CI: [-48.62, -32.24]Repeated measures linear effects model
Secondary

Percent Change From Baseline in Lp(a) at Week 12

Least squares mean is from the repeated measures linear effects model which includes treatment group, stratification factors, scheduled visit and the interaction of treatment with scheduled visit as covariates.

Time frame: Baseline and Week 12

Population: Full Analysis Set: participants who were randomized and received at least 1 dose of study drug. Participants with baseline and post-baseline assessments.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
Placebo Q2WPercent Change From Baseline in Lp(a) at Week 121.87 percent changeStandard Error 5.21
Evolocumab 140 mg Q2WPercent Change From Baseline in Lp(a) at Week 12-42.83 percent changeStandard Error 4.6
Placebo QMPercent Change From Baseline in Lp(a) at Week 1214.53 percent changeStandard Error 5.64
Evolocumab 420 mg QMPercent Change From Baseline in Lp(a) at Week 12-23.73 percent changeStandard Error 4.18
p-value: <0.000195% CI: [-54.76, -34.65]Repeated measures linear effects model
p-value: <0.000195% CI: [-49.94, -26.59]Repeated measures linear effects model
Secondary

Percent Change From Baseline in Non-HDL-C at Week 12

Least squares mean is from the repeated measures linear effects model which includes treatment group, stratification factors, scheduled visit and the interaction of treatment with scheduled visit as covariates.

Time frame: Baseline, Week 12

Population: Full Analysis Set: participants who were randomized and received at least 1 dose of study drug. Participants with baseline and post-baseline assessments.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
Placebo Q2WPercent Change From Baseline in Non-HDL-C at Week 123.86 percent changeStandard Error 3.85
Evolocumab 140 mg Q2WPercent Change From Baseline in Non-HDL-C at Week 12-57.59 percent changeStandard Error 3.3
Placebo QMPercent Change From Baseline in Non-HDL-C at Week 121.78 percent changeStandard Error 3.7
Evolocumab 420 mg QMPercent Change From Baseline in Non-HDL-C at Week 12-54.86 percent changeStandard Error 2.99
p-value: <0.000195% CI: [-69.25, -53.65]Repeated measures linear effects model
p-value: <0.000195% CI: [-63.66, -49.63]Repeated measures linear effects model
Secondary

Percent Change From Baseline in Non-High-Density Lipoprotein Cholesterol (Non-HDL-C): Mean of Weeks 10 and 12

Least squares mean is from the repeated measures linear effects model which includes treatment group, stratification factors, scheduled visit and the interaction of treatment with scheduled visit as covariates.

Time frame: Baseline, Weeks 10 and 12

Population: Full Analysis Set: participants who were randomized and received at least 1 dose of study drug. Participants with baseline and post-baseline assessments.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
Placebo Q2WPercent Change From Baseline in Non-High-Density Lipoprotein Cholesterol (Non-HDL-C): Mean of Weeks 10 and 122.36 percent changeStandard Error 3.52
Evolocumab 140 mg Q2WPercent Change From Baseline in Non-High-Density Lipoprotein Cholesterol (Non-HDL-C): Mean of Weeks 10 and 12-58.84 percent changeStandard Error 3.1
Placebo QMPercent Change From Baseline in Non-High-Density Lipoprotein Cholesterol (Non-HDL-C): Mean of Weeks 10 and 12-0.06 percent changeStandard Error 3.3
Evolocumab 420 mg QMPercent Change From Baseline in Non-High-Density Lipoprotein Cholesterol (Non-HDL-C): Mean of Weeks 10 and 12-62.20 percent changeStandard Error 2.81
p-value: <0.000195% CI: [-68.04, -54.37]Repeated measures linear effects model
p-value: <0.000195% CI: [-67.97, -56.32]Repeated measures linear effects model
Secondary

Percent Change From Baseline in Total Cholesterol at Week 12

Least squares mean is from the repeated measures linear effects model which includes treatment group, stratification factors, scheduled visit and the interaction of treatment with scheduled visit as covariates.

Time frame: Baseline and Week 12

Population: Full Analysis Set: participants who were randomized and received at least 1 dose of study drug. Participants with baseline and post-baseline assessments.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
Placebo Q2WPercent Change From Baseline in Total Cholesterol at Week 122.69 percent changeStandard Error 2.99
Evolocumab 140 mg Q2WPercent Change From Baseline in Total Cholesterol at Week 12-40.36 percent changeStandard Error 2.57
Placebo QMPercent Change From Baseline in Total Cholesterol at Week 121.17 percent changeStandard Error 2.96
Evolocumab 420 mg QMPercent Change From Baseline in Total Cholesterol at Week 12-39.25 percent changeStandard Error 2.4
p-value: <0.000195% CI: [-49.09, -37]Repeated measures linear effects model
p-value: <0.000195% CI: [-45.98, -34.87]Repeated measures linear effects model
Secondary

Percent Change From Baseline in Total Cholesterol: Mean of Weeks 10 and 12

Least squares mean is from the repeated measures linear effects model which includes treatment group, stratification factors, scheduled visit and the interaction of treatment with scheduled visit as covariates.

Time frame: Baseline, Weeks 10 and 12

Population: Full Analysis Set: participants who were randomized and received at least 1 dose of study drug. Participants with baseline and post-baseline assessments.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
Placebo Q2WPercent Change From Baseline in Total Cholesterol: Mean of Weeks 10 and 121.32 percent changeStandard Error 2.74
Evolocumab 140 mg Q2WPercent Change From Baseline in Total Cholesterol: Mean of Weeks 10 and 12-41.42 percent changeStandard Error 2.42
Placebo QMPercent Change From Baseline in Total Cholesterol: Mean of Weeks 10 and 12-0.09 percent changeStandard Error 2.68
Evolocumab 420 mg QMPercent Change From Baseline in Total Cholesterol: Mean of Weeks 10 and 12-44.39 percent changeStandard Error 2.28
p-value: <0.000195% CI: [-48.06, -37.41]Repeated measures linear effects model
p-value: <0.000195% CI: [-49.02, -39.58]Repeated measures linear effects model
Secondary

Percent Change From Baseline in Triglycerides at Week 12

Least squares mean is from the repeated measures linear effects model which includes treatment group, stratification factors, scheduled visit and the interaction of treatment with scheduled visit as covariates.

Time frame: Baseline and Week 12

Population: Full Analysis Set: participants who were randomized and received at least 1 dose of study drug. Participants with baseline and post-baseline assessments.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
Placebo Q2WPercent Change From Baseline in Triglycerides at Week 1210.01 percent changeStandard Error 5.63
Evolocumab 140 mg Q2WPercent Change From Baseline in Triglycerides at Week 12-7.55 percent changeStandard Error 4.73
Placebo QMPercent Change From Baseline in Triglycerides at Week 120.69 percent changeStandard Error 5.56
Evolocumab 420 mg QMPercent Change From Baseline in Triglycerides at Week 12-11.66 percent changeStandard Error 4.37
p-value: 0.00895% CI: [-29.42, -5.69]Repeated measures linear effects model
p-value: <0.000195% CI: [-23.04, -1.67]Repeated measures linear effects model
Secondary

Percent Change From Baseline in Triglycerides: Mean of Weeks 10 and 12

Least squares mean is from the repeated measures linear effects model which includes treatment group, stratification factors, scheduled visit and the interaction of treatment with scheduled visit as covariates.

Time frame: Baseline, Weeks 10 and 12

Population: Full Analysis Set: participants who were randomized and received at least 1 dose of study drug. Participants with baseline and post-baseline assessments.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
Placebo Q2WPercent Change From Baseline in Triglycerides: Mean of Weeks 10 and 125.23 percent changeStandard Error 4.77
Evolocumab 140 mg Q2WPercent Change From Baseline in Triglycerides: Mean of Weeks 10 and 12-9.86 percent changeStandard Error 4.19
Placebo QMPercent Change From Baseline in Triglycerides: Mean of Weeks 10 and 123.03 percent changeStandard Error 4.85
Evolocumab 420 mg QMPercent Change From Baseline in Triglycerides: Mean of Weeks 10 and 12-16.64 percent changeStandard Error 4.09
p-value: 0.00895% CI: [-24.44, -5.75]Repeated measures linear effects model
p-value: <0.000195% CI: [-28.3, -11.05]Repeated measures linear effects model
Secondary

Percent Change From Baseline in Very Low-Density Lipoprotein Cholesterol (VLDL-C): Mean of Weeks 10 and 12

Least squares mean is from the repeated measures linear effects model which includes treatment group, stratification factors, scheduled visit and the interaction of treatment with scheduled visit as covariates.

Time frame: Baseline, Weeks 10 and 12

Population: Full Analysis Set: participants who were randomized and received at least 1 dose of study drug. Participants with baseline and post-baseline assessments.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
Placebo Q2WPercent Change From Baseline in Very Low-Density Lipoprotein Cholesterol (VLDL-C): Mean of Weeks 10 and 127.08 percent changeStandard Error 5.32
Evolocumab 140 mg Q2WPercent Change From Baseline in Very Low-Density Lipoprotein Cholesterol (VLDL-C): Mean of Weeks 10 and 12-15.88 percent changeStandard Error 4.73
Placebo QMPercent Change From Baseline in Very Low-Density Lipoprotein Cholesterol (VLDL-C): Mean of Weeks 10 and 124.95 percent changeStandard Error 4.97
Evolocumab 420 mg QMPercent Change From Baseline in Very Low-Density Lipoprotein Cholesterol (VLDL-C): Mean of Weeks 10 and 12-22.87 percent changeStandard Error 4.21
p-value: 0.000295% CI: [-33.12, -12.81]Repeated measures linear effects model
p-value: <0.000195% CI: [-36.6, -19.02]Repeated measures linear effects model
Secondary

Percent Change From Baseline in VLDL-C at Week 12

Least squares mean is from the repeated measures linear effects model which includes treatment group, stratification factors, scheduled visit and the interaction of treatment with scheduled visit as covariates.

Time frame: Baseline and Week 12

Population: Full Analysis Set: participants who were randomized and received at least 1 dose of study drug. Participants with baseline and post-baseline assessments.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
Placebo Q2WPercent Change From Baseline in VLDL-C at Week 1211.23 percent changeStandard Error 6.12
Evolocumab 140 mg Q2WPercent Change From Baseline in VLDL-C at Week 12-10.55 percent changeStandard Error 5.22
Placebo QMPercent Change From Baseline in VLDL-C at Week 121.72 percent changeStandard Error 5.57
Evolocumab 420 mg QMPercent Change From Baseline in VLDL-C at Week 12-14.02 percent changeStandard Error 4.42
p-value: 0.000295% CI: [-34.31, -9.25]Repeated measures linear effects model
p-value: <0.000195% CI: [-26.31, -5.18]Repeated measures linear effects model

Source: ClinicalTrials.gov · Data processed: Feb 10, 2026