HypercholesterolaemiaPhase 3NCT02585778
Efficacy and Safety of Alirocumab Versus Placebo on Top of Maximally Tolerated Lipid Lowering Therapy in Patients With Hypercholesterolemia Who Have Type 1 or Type 2 Diabetes and Are Treated With Insulin (ODYSSEY DM - Insulin)
A Phase 3 study testing Alirocumab, Lipid-Modifying Therapy (LMT) and Antihyperglycemic Drug in people with Hypercholesterolaemia, run by Sanofi at 110 sites in 10 countries.
Trial summary
Primary Objectives: To demonstrate the superiority of alirocumab in comparison with placebo in the reduction of calculated low-density lipoprotein cholesterol (LDL-C) in participants with diabetes treated with insulin and with hypercholesterolemia at high cardiovascular risk not adequately controlled on maximally… Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Hypercholesterolaemia
- What is being tested?
- Alirocumab, Lipid-Modifying Therapy (LMT) and Antihyperglycemic Drug
- Type of treatment
- Injection or infusion
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 517 participants
- Where
- 110 sitesin 10 countries
- Study dates
- 23 Oct 2015to 3 Apr 2017
- Phase
- Phase 3
- Are there results?
- Yes, posted in the registrySummary in the doctors' view
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Participants diagnosed with Type 1 or Type 2 diabetes at least one year prior to the screening visit (Week -3).
- Signed written informed consent
- Participants with type 1 or type 2 diabetes treated with insulin whose LDL-C levels were not adequately controlled with maximally tolerated lipid-modifying therapy
- LDL-C of 70 mg/dL or greater
- 18 years of age or more
- Glycosylated hemoglobin (HbA1c) less than 10%
- History of cardiovascular disease (including coronary heart disease [CHD] and/or CHD risk equivalents) and/or at least one additional cardiovascular risk factor
Who cannot join
- Not on a stable dose of statin or other lipid modifying therapy for at least 4 weeks prior to screening or from screening to randomization, unless statin intolerant
- Triglycerides >400 mg/dL
- Estimated glomerular filtration rate (eGFR) <15 mL/min/1.73 m² according to the Modification of Diet in Renal Disease (MDRD) equation
- Currently received or planned to receive renal replacement therapy (for example, hemodialysis)
- Change in weight of more than 5 kilograms within the prior 2 months
- Not on a stable dose/regimen of insulin or other antidiabetic drugs for the past 3 months or planned to intensify insulin regimen during the study
Show all 11Show fewer
- Not treated with insulin for at least 6 months
- Planned to start new lipid modifying therapy or change dose of current lipid modifying therapy during the study
- Body mass index (BMI) >45 kg/m² or planned to undergo bariatric surgery, weight loss program, or initiate weight loss drugs during the study
- History of recent decompensation of diabetes within the prior 2 months (for example, diabetic ketoacidosis)
- The above information was not intended to contain all considerations relevant to a participant's potential participation in a clinical trial.
Trial locations and contacts
110 sites in 10 countries.
110 sites in 10 countries
United States29 sites
Investigational Site Number 840026
Atlantis, Florida, 33462
Investigational Site Number 840018
Auburn, Maine, 04210
Investigational Site Number 840001
Austin, Texas, 78756
Investigational Site Number 840006
Bradenton, Florida, 33180
Investigational Site Number 840024
Chattanooga, Tennessee, 37404
Investigational Site Number 840003
Dallas, Texas, 75230
Investigational Site Number 840019
Dallas, Texas, 75246
Investigational Site Number 840010
Des Moines, Iowa, 50314
Investigational Site Number 840020
Encino, California, 91436
Investigational Site Number 840002
Fresno, California, 93720
Investigational Site Number 840009
Greer, South Carolina, 29651
Investigational Site Number 840025
Houston, Texas, 77090
Investigational Site Number 840013
Hyattsville, Maryland, 20782
Investigational Site Number 840011
Indianapolis, Indiana, 46260
Investigational Site Number 840023
Jacksonville, Florida, 32205
Investigational Site Number 840012
Jamaica, New York, 11432
Investigational Site Number 840005
Louisville, Kentucky
Investigational Site Number 840027
Loveland, Colorado, 80538
Investigational Site Number 840014
Maumee, Ohio, 43537
Investigational Site Number 840004
Minneapolis, Minnesota, 55416
Investigational Site Number 840029
Oakland, California, 94612
Investigational Site Number 840017
Ogden, Utah, 84405
Investigational Site Number 840028
Palm Harbor, Florida, 34684
Investigational Site Number 840022
Ponte Vedra Beach, Florida
Investigational Site Number 840016
Rockville, Maryland, 20852
Investigational Site Number 840021
Roswell, Georgia, 30076
Investigational Site Number 840008
Salt Lake City, Utah, 84102
Investigational Site Number 840007
Springfield, Illinois, 62704
Investigational Site Number 840015
Valparaiso, Indiana, 46383
Germany18 sites
Investigational Site Number 276015
Aschaffenburg, 63739
Investigational Site Number 276002
Berlin, 10115
Investigational Site Number 276011
Dortmund, 44137
Investigational Site Number 276019
Dresden, 01099
Investigational Site Number 276014
Dresden, 01279
Investigational Site Number 276009
Dresden, 01307
Investigational Site Number 276021
Hamburg, 20246
Investigational Site Number 276018
Hamburg, 22041
Investigational Site Number 276005
Heidelberg, 69115
Investigational Site Number 276013
Lüneburg, 21339
Investigational Site Number 276022
Magdeburg, 39120
Investigational Site Number 276008
Neumünster, 24534
Investigational Site Number 276017
Neuwied, 56564
Investigational Site Number 276004
Oldenburg, 26133
Investigational Site Number 276003
Pirna, 01796
Investigational Site Number 276006
Riesa, 01587
Investigational Site Number 276010
Saarlouis, 66740
Investigational Site Number 276016
Sulzbach-Rosenberg, 92237
Spain14 sites
Investigational Site Number 724007
Badalona, 08915
Investigational Site Number 724001
Barcelona, 08025
Investigational Site Number 724006
Ferrol, 15405
Investigational Site Number 724013
Granada, 18003
Investigational Site Number 724005
Madrid, 28040
Investigational Site Number 724004
Madrid
Investigational Site Number 724011
Majadahonda, 28222
Investigational Site Number 724008
Málaga, 29010
Investigational Site Number 724014
Oviedo, 33006
Investigational Site Number 724009
Palma de Mallorca, 07198
Investigational Site Number 724002
Pamplona, 31008
Investigational Site Number 724010
Sant Joan Despí, 08970
Investigational Site Number 724012
Segovia
Investigational Site Number 724003
Seville, 41071
United Kingdom13 sites
Investigational Site Number 826010
Airdrie, ML60JS
Investigational Site Number 826011
Bath, BA13NG
Investigational Site Number 826009
Bournemouth, BH77DW
Investigational Site Number 826005
Bradford, BD96RJ
Investigational Site Number 826004
Bristol, BS28HW
Investigational Site Number 826001
Burton-on-Trent, DE13 0RB
Investigational Site Number 826015
Durham, DH15TW
Investigational Site Number 826012
High Wycombe, HP112TT
Investigational Site Number 826007
Manchester, M239LT
Investigational Site Number 826006
Peterborough, PE39QZ
Investigational Site Number 826003
Southampton, SO303JB
Investigational Site Number 826008
Truro, TR13LJ
Investigational Site Number 826002
Welwyn Garden City, AL74HQ
Italy12 sites
Investigational Site Number 380004
Catania, 95122
Investigational Site Number 380003
Catanzaro
Investigational Site Number 380011
Como, 22100
Investigational Site Number 380006
Milan, 20132
Investigational Site Number 380007
Milan, 20162
Investigational Site Number 380005
Moncalieri, 10024
Investigational Site Number 380009
Naples, 80138
Investigational Site Number 380008
Padova
Investigational Site Number 380002
Palermo, 90127
Investigational Site Number 380001
Pisa, 56124
Investigational Site Number 380010
Roma, 00133
Investigational Site Number 380012
Verona, 37126
France9 sites
Investigational Site Number 250-008
Besançon, 25030
Investigational Site Number 250-005
Corbeil-Essonnes, 91100
Investigational Site Number 250-004
La Rochelle, 17019
Investigational Site Number 250-003
Le Creusot, 71200
Investigational Site Number 250-009
Mulhouse
Investigational Site Number 250-002
Nantes, 44093
Investigational Site Number 250-007
Paris, 75018
Investigational Site Number 250-006
Strasbourg, 67098
Investigational Site Number 250-001
Toulouse, 31059
Austria5 sites
Investigational Site Number 040002
Innsbruck, 6020
Investigational Site Number 040005
Linz, 4021
Investigational Site Number 040003
Salzburg, 5020
Investigational Site Number 040004
Salzburg, 5026
Investigational Site Number 040001
Vienna, 1160
Netherlands5 sites
Investigational Site Number 528002
Apeldoorn, 7334 DZ
Investigational Site Number 528005
Groningen
Investigational Site Number 528003
Hoogeveen, 7909AA
Investigational Site Number 528001
Rotterdam, 3045PM
Investigational Site Number 528004
Utrecht
Belgium3 sites
Investigational Site Number 056002
Edegem, 2650
Investigational Site Number 056003
Haine-Saint-Paul, 7100
Investigational Site Number 056001
Leuven, 3000
Switzerland2 sites
Investigational Site Number 756001
Olten, 4600
Investigational Site Number 756003
Sankt Gallen, 9016
About this study
Official title: A Randomized, Double-Blind, Placebo-Controlled, Parallel Group Study to Evaluate the Efficacy and Safety of Alirocumab in Insulin Treated Patients With Type 1 or Type 2 Diabetes and With Hypercholesterolemia at High Cardiovascular Risk Not Adequately Controlled on Maximally Tolerated LDL-C Lowering Therapy
Primary Objectives:
- To demonstrate the superiority of alirocumab in comparison with placebo in the reduction of calculated low-density lipoprotein cholesterol (LDL-C) in participants with diabetes treated with insulin and with hypercholesterolemia at high cardiovascular risk not adequately controlled on maximally tolerated LDL-C lowering therapy.
- To evaluate the safety and tolerability of alirocumab in participants with diabetes treated with insulin.
Read more
Secondary Objective:
To demonstrate that alirocumab was superior in comparison to placebo in its effects on other lipid parameters (i.e., measured LDL-C, non-high-density lipoprotein cholesterol [non-HDL-C], apolipoprotein B [Apo B], total cholesterol [TC], lipoprotein a [Lp(a)], high density lipoprotein cholesterol [HDL-C], triglyceride [TG] levels, triglyceride rich lipoproteins [TGRL], apolipoprotein A-1 [Apo A-1], apolipoprotein C-III [Apo C-III], and LDL particle number and size).
Read the detailed description
The maximum study duration was approximately 9 months per participant, including a 6 month treatment period, a screening period of up to 3 weeks, and an 8 week safety observation period.
- Conditions
- Hypercholesterolaemia
- Being tested
- Alirocumab, Placebo, Lipid-Modifying Therapy (LMT), Antihyperglycemic Drug
- Medical subject headings
- Hypercholesterolemia
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
AlirocumabDrug
Also called Praluent, SAR236553, REGN727
Solution for injection, one subcutaneous injection in the abdomen, thigh, or outer area of upper arm with a disposable auto-injector.
PlaceboDrug
Solution for injection, one subcutaneous injection in the abdomen, thigh, or outer area of upper arm with a disposable auto-injector.
Lipid-Modifying Therapy (LMT)Drug
Statins at stable, maximally tolerated dose with or without other LMT as clinically indicated.
Antihyperglycemic DrugDrug
Insulin (injectable or inhaled) alone or with other antihyperglycemic drugs as clinically indicated.
| Study group | Role | What they receive |
|---|---|---|
| Alirocumab 75 mg Q2W/Up to 150 mg Q2W | Experimental | Alirocumab 75 mg subcutaneous (SC) injection every 2 weeks (Q2W) added to stable, maximally tolerated dose of statin therapy with or without other lipid-modifying therapy (LMT), insulin alone or with other antihyperglycemic drugs for 24 weeks. Alirocumab dose up-titrated to 150 mg Q2W from Week 12 when LDL-C levels ≥70 mg/dL (1.81 mmol/L) at Week 8. Receives: Drug: Alirocumab; Drug: Lipid-Modifying Therapy (LMT); Drug: Antihyperglycemic Drug |
| Placebo Q2W | Placebo comparator | Placebo (for alirocumab) SC injection Q2W added to stable, maximally tolerated dose of statin therapy with or without other LMT, insulin alone or with other antihyperglycemic drugs for 24 weeks. Receives: Drug: Placebo; Drug: Lipid-Modifying Therapy (LMT); Drug: Antihyperglycemic Drug |
What is being measured
The primary outcome is the main question the study is designed to answer.
Percent Change From Baseline in Calculated LDL-C at Week 24 - Intent-to-treat (ITT) Analysis
Adjusted Least-squares (LS) means and standard errors at Week 24 were obtained from a mixed-effect model with repeated measures (MMRM) to account for missing data. All available post-baseline data from Week 4 to Week 24 regardless of status on- or off-treatment were used in the model (ITT analysis).
Measured: From Baseline to Week 24
Percentage of Participants Who Experienced Treatment-Emergent Adverse Events (AEs)
Reported adverse events are treatment-emergent adverse events that is AEs that developed/worsened during the 'treatment-emergent period' (the time from the first dose of study drug up to the last dose of study drug +70 days).
Measured: From Baseline up to 10 weeks after last study drug administration (maximum of 32 weeks)
Secondary outcomes (26)
Percent Change From Baseline in Calculated LDL-C at Week 24 - On-Treatment Analysis
Adjusted LS means and standard errors at Week 24 were obtained from MMRM model including available post-baseline on-treatment data from Week 4 to Week 24 (i.e. up to 21 days after last injection).
Measured: From Baseline to Week 24
Percent Change From Baseline in Measured LDL-C at Week 24 - ITT Analysis
Measured LDL-C values via beta quantification method. Adjusted LS means and standard errors at Week 24 from MMRM model including available post-baseline data from Week 4 to Week 24 regardless of status on- or off-treatment.
Measured: From Baseline to Week 24
Percent Change From Baseline in Calculated LDL-C at Week 12 - ITT Analysis
Adjusted LS means and standard errors at Week 12 from MMRM model including available post-baseline data from Week 4 to Week 24 regardless of status on- or off-treatment.
Measured: From Baseline to Week 24
Percent Change From Baseline in Measured LDL-C at Week 12 - ITT Analysis
Measured LDL-C values via beta quantification method. Adjusted LS means and standard errors at Week 12 from MMRM model including available post-baseline data from Week 4 to Week 24 regardless of status on- or off-treatment.
Measured: From Baseline to Week 24
Percent Change From Baseline in Non-High Density Lipoprotein Cholesterol (Non-HDL-C) at Week 24 - ITT Analysis
Adjusted LS means and standard errors at Week 24 from MMRM model including all available post-baseline data from Week 4 to Week 24 regardless of status on- or off-treatment.
Measured: From Baseline to Week 24
Percent Change From Baseline in Apolipoprotein B (Apo-B) at Week 24 - ITT Analysis
Adjusted LS means and standard errors at Week 24 from MMRM model including all available post-baseline data from Week 4 to Week 24 regardless of status on- or off-treatment.
Measured: From Baseline to Week 24
Percent Change From Baseline in Total Cholesterol (Total-C) at Week 24 - ITT Analysis
Adjusted LS means and standard errors at Week 24 from MMRM model including all available post-baseline data from Week 4 to Week 24 regardless of status on- or off-treatment.
Measured: From Baseline to Week 24
Percentage of Participants Reaching Calculated LDL-C <70 mg/dL (1.81 mmol/L) at Week 24 - On-Treatment Analysis
Adjusted percentages at Week 24 from multiple imputation approach model including available post-baseline data from Week 4 to Week 24 (i.e. up to 21 days after last injection).
Measured: Up to Week 24
Percentage of Participants Reaching Calculated LDL-C <50 mg/dL (1.3 mmol/L) at Week 24 - On-Treatment Analysis
Adjusted percentages at Week 24 from last observation carried forward (LOCF) approach (for T1DM participants) and multiple imputation approach model (for T2DM participants) including available post-baseline data from Week 4 to Week 24 (i.e. up to 21 days after last injection). The maximum likelihood estimate did not exist as response rate was zero in a treatment group of T1DM participants.
Measured: Up to Week 24
Percentage of Participants Reaching Calculated Non-HDL-C <100 mg/dL at Week 24 - On-Treatment Analysis
Adjusted percentages at Week 24 from multiple imputation approach model including available post-baseline data from Week 4 to Week 24 (i.e. up to 21 days after last injection).
Measured: Up to Week 24
Percentage of Participants Reaching Calculated Non-HDL-C <80 mg/dL at Week 24 - On-Treatment Analysis
Adjusted percentages at Week 24 from multiple imputation approach including available post-baseline on-treatment data from Week 4 to Week 24 (i.e. up to 21 days after last injection).
Measured: Up to Week 24
Percent Change From Baseline in Lipoprotein(a) at Week 24 - ITT Analysis
Adjusted means and standard errors at Week 24 were obtained from multiple imputation approach for handling of missing data followed by robust regression model. All available post-baseline data from Week 4 to Week 24 regardless of status on- or off-treatment were included in the imputation model.
Measured: From Baseline to Week 24
Percent Change From Baseline in HDL-C at Week 24 - ITT Analysis
Adjusted LS means and standard errors at Week 24 from MMRM model including all available post-baseline data from Week 4 to Week 24 regardless of status on- or off-treatment.
Measured: From Baseline to Week 24
Percent Change From Baseline in Fasting Triglycerides at Week 24 - ITT Analysis
Adjusted means and standard errors at Week 24 from multiple imputation approach for handling of missing data followed by robust regression model including all available post-baseline data from Week 4 to Week 24 regardless of status on- or off-treatment.
Measured: From Baseline to Week 24
Percent Change From Baseline in LDL-C Particle Number at Week 24 - ITT Analysis
LDL-C particle number was calculated from lipid subfractions by nuclear magnetic resonance (NMR) spectroscopy. Adjusted LS means and standard errors at Week 24 from MMRM model including all available post-baseline data from Week 4 to Week 24 regardless of status on- or off-treatment.
Measured: From Baseline to Week 24
Percent Change From Baseline in LDL-C Particle Size at Week 24 - ITT Analysis
LDL-C particle size was calculated from lipid subfractions by NMR spectroscopy. Adjusted LS means and standard errors at Week 24 from MMRM model including available post-baseline data from Week 4 to Week 24 regardless of status on- or off-treatment.
Measured: From Baseline to Week 24
Absolute Change From Baseline in Glycosylated Hemoglobin (HbA1c) at Weeks 12 and 24 - ITT Analysis
Absolute change = HbA1c value at specified weeks minus HbA1c value at baseline.
Measured: Baseline, Weeks 12 and 24
Absolute Change From Baseline in HbA1c at Weeks 12 and 24 - On-Treatment Analysis
Absolute change = HbA1c value at specified weeks minus HbA1c value at baseline.
Measured: Baseline, Weeks 12 and 24
Absolute Change From Baseline in Fasting Plasma Glucose (FPG) at Weeks 12 and 24 - ITT Analysis
Absolute change = FPG value at specified weeks minus FPG value at baseline.
Measured: Baseline, Weeks 12 and 24
Absolute Change From Baseline in FPG at Weeks 12 and 24 - On-Treatment Analysis
Absolute change = FPG value at specified weeks minus FPG value at baseline.
Measured: Baseline, Weeks 12 and 24
Absolute Change From Baseline in Total Daily Insulin Dose at Weeks 12 and 24 - ITT Analysis
Absolute change = total daily insulin dose at specified weeks minus baseline value.
Measured: Baseline, Weeks 12 and 24
Absolute Change From Baseline in Total Daily Insulin Dose at Weeks 12 and 24 - On-Treatment Analysis
Absolute change = total daily insulin dose at specified weeks minus baseline value.
Measured: Baseline, Weeks 12 and 24
Absolute Change From Baseline in Insulin Daily Dose/Kg at Weeks 12 and 24 - ITT Analysis
Absolute change = daily insulin dose/kg at specified weeks minus baseline value.
Measured: Baseline, Weeks 12 and 24
Absolute Change From Baseline in Insulin Daily Dose/Kg at Weeks 12 and 24 - On-Treatment Analysis
Absolute change = daily insulin dose/kg at specified weeks minus baseline value.
Measured: Baseline, Weeks 12 and 24
Absolute Change From Baseline in Number of Glucose-Lowering Treatments at Weeks 12 and 24 - ITT Analysis
Glucose lowering treatment was calculated for non-insulin treatments as one for each unique treatment received and for insulin treatment as one in total for all participants who have taken one or more treatments. Absolute change = number of glucose-lowering treatments at specified weeks minus baseline value.
Measured: Baseline, Weeks 12 and 24
Absolute Change From Baseline in Number of Glucose-Lowering Treatments at Weeks 12 and 24 - On-Treatment Analysis
Glucose lowering treatment was calculated for non-insulin treatments as one for each unique treatment received and for insulin treatment as one in total for all participants who have taken one or more treatments. Absolute change = number of glucose-lowering treatments at specified weeks minus baseline value.
Measured: Baseline, Weeks 12 and 24
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted23 Oct 2015 (estimated)
- Study start23 Oct 2015
- Primary completion3 Apr 2017
- Study completion3 Apr 2017
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Publications (3)Papers the sponsor has linked to this study.
- Other trials for HypercholesterolaemiaStudies of the same condition, open and under way.
- More trials run by SanofiThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 3
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind
- Who is masked
- Participant, Investigator
- Enrolment
- 517 participants (actual)
Sponsor and investigators
- Lead sponsor
- Sanofi
- Sponsor type
- Industry (pharma, biotech, devices)
- Collaborators
- Regeneron Pharmaceuticals
- Responsible party
- Sponsor
- Investigators
- Clinical Sciences & Operations, Study director, Sanofi
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT02585778
- Sponsor's protocol ID
- LPS14355
- Other IDs
- 2015-000799-92, U1111-1172-4772, 2015
- Status last verified
- Apr 2018
- First submitted
- 22 Oct 2015
- Last updated
- 17 May 2018
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- No
Publications
Schmidt AF, Carter JL, Pearce LS, Wilkins JT, Overington JP, Hingorani AD, Casas JP. PCSK9 monoclonal antibodies for the primary and secondary prevention of cardiovascular disease. Cochrane Database Syst Rev. 2020 Oct 20;10(10):CD011748. doi: 10.1002/14651858.CD011748.pub3.
PubMed 33078867Ray KK, Del Prato S, Muller-Wieland D, Cariou B, Colhoun HM, Tinahones FJ, Domenger C, Letierce A, Mandel J, Samuel R, Bujas-Bobanovic M, Leiter LA. Alirocumab therapy in individuals with type 2 diabetes mellitus and atherosclerotic cardiovascular disease: analysis of the ODYSSEY DM-DYSLIPIDEMIA and DM-INSULIN studies. Cardiovasc Diabetol. 2019 Nov 9;18(1):149. doi: 10.1186/s12933-019-0951-9.
PubMed 31706300Leiter LA, Cariou B, Muller-Wieland D, Colhoun HM, Del Prato S, Tinahones FJ, Ray KK, Bujas-Bobanovic M, Domenger C, Mandel J, Samuel R, Henry RR. Efficacy and safety of alirocumab in insulin-treated individuals with type 1 or type 2 diabetes and high cardiovascular risk: The ODYSSEY DM-INSULIN randomized trial. Diabetes Obes Metab. 2017 Dec;19(12):1781-1792. doi: 10.1111/dom.13114. Epub 2017 Oct 10.
PubMed 28905478
Study at a glance
From the registry record, last updated by the sponsor on 17 May 2018. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Randomized, Double-Blind, Placebo-Controlled, Parallel Group Study to Evaluate the Efficacy and Safety of Alirocumab in Insulin Treated Patients With Type 1 or Type 2 Diabetes and With Hypercholesterolemia at High Cardiovascular Risk Not Adequately Controlled on Maximally Tolerated LDL-C Lowering Therapy
- ClinicalTrials.gov ID
- NCT02585778
- Acronym / sponsor ID
- LPS14355
- Conditions
- Hypercholesterolaemia
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 517 participants (actual)
- Lead sponsor
- SanofiIndustry (pharma, biotech, devices)
- Collaborators
- Regeneron Pharmaceuticals
- Study start
- 23 Oct 2015 (actual)
- Primary completion
- 3 Apr 2017 (actual)
- Study completion
- 3 Apr 2017 (actual)
- First posted
- 23 Oct 2015 (estimated)
- Results
- Posted 17 May 2018
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Primary Objectives:
- To demonstrate the superiority of alirocumab in comparison with placebo in the reduction of calculated low-density lipoprotein cholesterol (LDL-C) in participants with diabetes treated with insulin and with hypercholesterolemia at high cardiovascular risk not adequately controlled on maximally tolerated LDL-C lowering therapy.
- To evaluate the safety and tolerability of alirocumab in participants with diabetes treated with insulin.
Secondary Objective:
To demonstrate that alirocumab was superior in comparison to placebo in its effects on other lipid parameters (i.e., measured LDL-C, non-high-density lipoprotein cholesterol [non-HDL-C], apolipoprotein B [Apo B], total cholesterol [TC], lipoprotein a [Lp(a)], high density lipoprotein cholesterol [HDL-C], triglyceride [TG] levels, triglyceride rich lipoproteins [TGRL], apolipoprotein A-1 [Apo A-1], apolipoprotein C-III [Apo C-III], and LDL particle number and size).
Detailed description
The maximum study duration was approximately 9 months per participant, including a 6 month treatment period, a screening period of up to 3 weeks, and an 8 week safety observation period.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind (participant, investigator)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Alirocumab 75 mg Q2W/Up to 150 mg Q2W | Experimental | Drug: Alirocumab, Drug: Lipid-Modifying Therapy (LMT), Drug: Antihyperglycemic DrugAlirocumab 75 mg subcutaneous (SC) injection every 2 weeks (Q2W) added to stable, maximally tolerated dose of statin therapy with or without other lipid-modifying therapy (LMT), insulin alone or with other antihyperglycemic drugs for 24 weeks. Alirocumab dose up-titrated to 150 mg Q2W from Week 12 when LDL-C levels ≥70 mg/dL (1.81 mmol/L) at Week 8. |
| Placebo Q2W | Placebo comparator | Drug: Placebo, Drug: Lipid-Modifying Therapy (LMT), Drug: Antihyperglycemic DrugPlacebo (for alirocumab) SC injection Q2W added to stable, maximally tolerated dose of statin therapy with or without other LMT, insulin alone or with other antihyperglycemic drugs for 24 weeks. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (7 listed)
- Participants diagnosed with Type 1 or Type 2 diabetes at least one year prior to the screening visit (Week -3).
- Signed written informed consent
- Participants with type 1 or type 2 diabetes treated with insulin whose LDL-C levels were not adequately controlled with maximally tolerated lipid-modifying therapy
- LDL-C of 70 mg/dL or greater
- 18 years of age or more
Key exclusion criteria (11 listed)
- Not on a stable dose of statin or other lipid modifying therapy for at least 4 weeks prior to screening or from screening to randomization, unless statin intolerant
- Triglycerides >400 mg/dL
- Estimated glomerular filtration rate (eGFR) <15 mL/min/1.73 m² according to the Modification of Diet in Renal Disease (MDRD) equation
- Currently received or planned to receive renal replacement therapy (for example, hemodialysis)
- Change in weight of more than 5 kilograms within the prior 2 months
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| AlirocumabAlso: Praluent, SAR236553, REGN727Solution for injection, one subcutaneous injection in the abdomen, thigh, or outer area of upper arm with a disposable auto-injector. | Drug | Alirocumab 75 mg Q2W/Up to 150 mg Q2W |
| PlaceboSolution for injection, one subcutaneous injection in the abdomen, thigh, or outer area of upper arm with a disposable auto-injector. | Drug | Placebo Q2W |
| Lipid-Modifying Therapy (LMT)Statins at stable, maximally tolerated dose with or without other LMT as clinically indicated. | Drug | Alirocumab 75 mg Q2W/Up to 150 mg Q2W, Placebo Q2W |
| Antihyperglycemic DrugInsulin (injectable or inhaled) alone or with other antihyperglycemic drugs as clinically indicated. | Drug | Alirocumab 75 mg Q2W/Up to 150 mg Q2W, Placebo Q2W |
Primary outcome
Percent Change From Baseline in Calculated LDL-C at Week 24 - Intent-to-treat (ITT) Analysis
Time frame: From Baseline to Week 24
Adjusted Least-squares (LS) means and standard errors at Week 24 were obtained from a mixed-effect model with repeated measures (MMRM) to account for missing data. All available post-baseline data from Week 4 to Week 24 regardless of status on- or off-treatment were used in the model (ITT analysis).
Percentage of Participants Who Experienced Treatment-Emergent Adverse Events (AEs)
Time frame: From Baseline up to 10 weeks after last study drug administration (maximum of 32 weeks)
Reported adverse events are treatment-emergent adverse events that is AEs that developed/worsened during the 'treatment-emergent period' (the time from the first dose of study drug up to the last dose of study drug +70 days).
26 secondary outcomes
Percent Change From Baseline in Calculated LDL-C at Week 24 - On-Treatment Analysis
Time frame: From Baseline to Week 24
Percent Change From Baseline in Measured LDL-C at Week 24 - ITT Analysis
Time frame: From Baseline to Week 24
Percent Change From Baseline in Calculated LDL-C at Week 12 - ITT Analysis
Time frame: From Baseline to Week 24
Percent Change From Baseline in Measured LDL-C at Week 12 - ITT Analysis
Time frame: From Baseline to Week 24
Percent Change From Baseline in Non-High Density Lipoprotein Cholesterol (Non-HDL-C) at Week 24 - ITT Analysis
Time frame: From Baseline to Week 24
Percent Change From Baseline in Apolipoprotein B (Apo-B) at Week 24 - ITT Analysis
Time frame: From Baseline to Week 24
Percent Change From Baseline in Total Cholesterol (Total-C) at Week 24 - ITT Analysis
Time frame: From Baseline to Week 24
Percentage of Participants Reaching Calculated LDL-C <70 mg/dL (1.81 mmol/L) at Week 24 - On-Treatment Analysis
Time frame: Up to Week 24
Percentage of Participants Reaching Calculated LDL-C <50 mg/dL (1.3 mmol/L) at Week 24 - On-Treatment Analysis
Time frame: Up to Week 24
Percentage of Participants Reaching Calculated Non-HDL-C <100 mg/dL at Week 24 - On-Treatment Analysis
Time frame: Up to Week 24
Percentage of Participants Reaching Calculated Non-HDL-C <80 mg/dL at Week 24 - On-Treatment Analysis
Time frame: Up to Week 24
Percent Change From Baseline in Lipoprotein(a) at Week 24 - ITT Analysis
Time frame: From Baseline to Week 24
Percent Change From Baseline in HDL-C at Week 24 - ITT Analysis
Time frame: From Baseline to Week 24
Percent Change From Baseline in Fasting Triglycerides at Week 24 - ITT Analysis
Time frame: From Baseline to Week 24
Percent Change From Baseline in LDL-C Particle Number at Week 24 - ITT Analysis
Time frame: From Baseline to Week 24
Percent Change From Baseline in LDL-C Particle Size at Week 24 - ITT Analysis
Time frame: From Baseline to Week 24
Absolute Change From Baseline in Glycosylated Hemoglobin (HbA1c) at Weeks 12 and 24 - ITT Analysis
Time frame: Baseline, Weeks 12 and 24
Absolute Change From Baseline in HbA1c at Weeks 12 and 24 - On-Treatment Analysis
Time frame: Baseline, Weeks 12 and 24
Absolute Change From Baseline in Fasting Plasma Glucose (FPG) at Weeks 12 and 24 - ITT Analysis
Time frame: Baseline, Weeks 12 and 24
Absolute Change From Baseline in FPG at Weeks 12 and 24 - On-Treatment Analysis
Time frame: Baseline, Weeks 12 and 24
Absolute Change From Baseline in Total Daily Insulin Dose at Weeks 12 and 24 - ITT Analysis
Time frame: Baseline, Weeks 12 and 24
Absolute Change From Baseline in Total Daily Insulin Dose at Weeks 12 and 24 - On-Treatment Analysis
Time frame: Baseline, Weeks 12 and 24
Absolute Change From Baseline in Insulin Daily Dose/Kg at Weeks 12 and 24 - ITT Analysis
Time frame: Baseline, Weeks 12 and 24
Absolute Change From Baseline in Insulin Daily Dose/Kg at Weeks 12 and 24 - On-Treatment Analysis
Time frame: Baseline, Weeks 12 and 24
Absolute Change From Baseline in Number of Glucose-Lowering Treatments at Weeks 12 and 24 - ITT Analysis
Time frame: Baseline, Weeks 12 and 24
Absolute Change From Baseline in Number of Glucose-Lowering Treatments at Weeks 12 and 24 - On-Treatment Analysis
Time frame: Baseline, Weeks 12 and 24
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 17 May 2018.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Derived from this study: PubMed 33078867Schmidt AF, Carter JL, Pearce LS, Wilkins JT, Overington JP, Hingorani AD, Casas JP. PCSK9 monoclonal antibodies for the primary and secondary prevention of cardiovascular disease. Cochrane Database Syst Rev. 2020 Oct 20;10(10):CD011748. doi: 10.1002/14651858.CD011748.pub3.
- Derived from this study: PubMed 31706300Ray KK, Del Prato S, Muller-Wieland D, Cariou B, Colhoun HM, Tinahones FJ, Domenger C, Letierce A, Mandel J, Samuel R, Bujas-Bobanovic M, Leiter LA. Alirocumab therapy in individuals with type 2 diabetes mellitus and atherosclerotic cardiovascular disease: analysis of the ODYSSEY DM-DYSLIPIDEMIA and DM-INSULIN studies. Cardiovasc Diabetol. 2019 Nov 9;18(1):149. doi: 10.1186/s12933-019-0951-9.
- Derived from this study: PubMed 28905478Leiter LA, Cariou B, Muller-Wieland D, Colhoun HM, Del Prato S, Tinahones FJ, Ray KK, Bujas-Bobanovic M, Domenger C, Mandel J, Samuel R, Henry RR. Efficacy and safety of alirocumab in insulin-treated individuals with type 1 or type 2 diabetes and high cardiovascular risk: The ODYSSEY DM-INSULIN randomized trial. Diabetes Obes Metab. 2017 Dec;19(12):1781-1792. doi: 10.1111/dom.13114. Epub 2017 Oct 10.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Clinical Sciences & Operations study director
Sanofi
110 sites in 10 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing Alirocumab, Lipid-Modifying Therapy (LMT) and Antihyperglycemic Drug in people with Hypercholesterolaemia, run by Sanofi at 110 sites in 10 countries.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 7 inclusion and 11 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 17 May 2018. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 110 sites in United States, Germany, Spain, United Kingdom, Italy and 5 more countries. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
Yes. Results are posted in the registry (first posted 17 May 2018). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Percent Change From Baseline in Calculated LDL-C at Week 24 - Intent-to-treat (ITT) Analysis (time frame: From Baseline to Week 24). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT02585778, which also lists 3 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 17 May 2018.