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HypertriglyceridemiaPhase 2NCT03385239

Study of ISIS 678354 (AKCEA-APOCIII-LRx) in Participants With Hypertriglyceridemia and Established Cardiovascular Disease (CVD)

A Phase 2 study testing ISIS 678354 in people with Hypertriglyceridemia and Cardiovascular Diseases, run by Akcea Therapeutics at 31 sites in 2 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

This was a multicenter, randomized, double-blind, placebo-controlled, dose-ranging study to evaluate the safety, including tolerability, of ISIS 678354 and to assess the efficacy of different doses and dosing regimens of ISIS 678354 for reduction of serum triglyceride (TG) levels in participants with… Read more about this study

Who is it for?
Ages 18 to 80 years
Conditions the study is for
Hypertriglyceridemia, Cardiovascular Diseases
What is being tested?
ISIS 678354
Type of treatment
Injection or infusion
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
114 participants
Where
31 sitesin 2 countries
Study dates
30 Jan 2018to 25 Feb 2020
Phase
Phase 2
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 to 80 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Clinical diagnosis of CVD (defined as documented coronary artery disease, stroke, or peripheral artery disease).
  • Fasting serum triglycerides (TG) greater than or equal to (≥) 200 milligrams per deciliter (mg/dL) (≥ 2.3 millimoles per liter (mmol/L)) and less than or equal to (≤) 500 mg/dL (≥ 5.7 mmol/L) at Screening.
  • Fasting TG ≥ 200 mg/dL and ≤ 500 mg/dL at Qualification visit.
  • Must be on standard-of-care preventative therapy for known CVD risk factors.

Who cannot join

  • Within 6 months of Screening: acute coronary syndrome, major cardiac surgery, or stroke/transient ischemic attack (TIA).
  • Within 3 months of Screening: coronary, carotid, or peripheral arterial revascularization, major non-cardiac surgery, or lipoprotein apheresis.
  • Heart failure New York Heart Association (NYHA) class IV.
  • Type 1 diabetes mellitus.
  • Type 2 diabetes mellitus with any of the following:
  • Newly diagnosed within 12 weeks of Screening.
Show all 9Show fewer
  • Glycated hemoglobin (HbA1c) ≥ 9.0% at Screening.
  • Recent change in anti-diabetic pharmacotherapy (change in dosage or addition of new medication within 12 weeks of Screening [with the exception of ± 10 units of insulin].
  • Body Mass Index (BMI) greater than (>) 40 kilograms per square meter (kg/m^2).

Trial locations and contacts

31 sites in 2 countries.

31 sites in 2 countries

United States24 sites
  • Clinical Site

    Ames, Iowa, 50010

  • Clinical Site

    Boca Raton, Florida, 33434

  • Clinical Site

    Carmichael, California, 95608

  • Clinical Site

    Cooperstown, New York, 13326

  • Clinical Site

    Cottonwood, Arizona, 86326

  • Clinical Site

    Fall River, Massachusetts, 02721

  • Clinical Site

    Fresno, California, 93720

  • Clinical Site

    Greer, South Carolina, 29651

  • Clinical Site

    High Point, North Carolina, 27262

  • Clinical Site

    Houston, Texas, 77030

  • Clinical Site

    Jacksonville, Florida, 32216

  • Clinical Site

    Kansas City, Kansas, 66160

  • Clinical Site

    La Jolla, California, 92037-7410

  • Clinical Site

    Lansdale, Pennsylvania, 19446

  • Clinical Site

    Little Rock, Arkansas, 72205

  • Clinical Site

    Long Beach, California, 90807

  • Clinical Site

    Louisville, Kentucky, 40213

  • Clinical Site

    Milwaukee, Wisconsin, 53215

  • Clinical Site

    Montclair, California, 91763

  • Clinical Site

    Munster, Indiana, 46321

  • Clinical Site

    New Port Richey, Florida, 34652

  • Clinical Site

    Portland, Oregon, 97239

  • Clinical Site

    Providence, Rhode Island, 02906

  • Clinical Site

    Wilmington, Delaware, 19803

Other trials in United States

Canada7 sites
  • Clinical Site

    Brossard, Quebec, J4Z 2K9

  • Clinical Site

    Cambridge, Ontario, N1R 6V6

  • Clinical Site

    Chicoutimi, Quebec

  • Clinical Site

    Gatineau, Quebec, J8Y 6S8

  • Clinical Site

    Greater Sudbury, Ontario, P3E 5M4

  • Clinical Site

    Montreal, Quebec, H1T 1C8

  • Clinical Site

    Québec, Quebec, G1V 4W2

Other trials in Canada

About this study

Official title: A Randomized, Double-blind, Placebo-Controlled, Dose-Ranging Phase 2 Study of ISIS 678354 Administered Subcutaneously to Patients With Hypertriglyceridemia and Established Cardiovascular Disease (CVD) or at a High Risk for CVD

This was a multicenter, randomized, double-blind, placebo-controlled, dose-ranging study to evaluate the safety, including tolerability, of ISIS 678354 and to assess the efficacy of different doses and dosing regimens of ISIS 678354 for reduction of serum triglyceride (TG) levels in participants with hypertriglyceridemia and established CVD or at a high risk for CVD.

Being tested
ISIS 678354, Placebo
Keywords
AKCEA-APOCIII-LRx, IONIS-APOCIII-LRx, Dyslipidemia, Metabolic Disease, Hyperlipidemia, Cardiac Disease, Lipid Metabolism Disorders, Triglycerides High, Vascular Diseases
Medical subject headings
Hypertriglyceridemia, Cardiovascular Diseases, Dyslipidemias, Metabolic Diseases, Hyperlipidemias, Heart Diseases, Lipid Metabolism Disorders, Vascular Diseases

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • ISIS 678354Drug

    Also called AKCEA-APOCIII-LRx, IONIS-APOCIII-LRx

    ISIS 678354 solution for SC injection.

  • PlaceboDrug

    Sterile Normal Saline (0.9% NaCl).

Study groups in NCT03385239
Study groupRoleWhat they receive
Pooled PlaceboPlacebo comparatorParticipants in each cohort (A, B, C and D) were randomized to receive placebo at a dose-matched volume of study drug (ISIS 678354).
Receives: Drug: Placebo
Cohort A: ISIS 678354: 10 mg Q4WExperimentalCohort A participants received 10 milligrams (mg) ISIS 678354, subcutaneous (SC) injection, once every 4 weeks (Q4W), for up to 49 weeks and a maximum of 13 doses.
Receives: Drug: ISIS 678354
Cohort C: ISIS 678354: 15 mg Q2WExperimentalCohort C participants received 15 mg ISIS 678354, SC injection, once every 2 weeks (Q2W) for up to 51 weeks and a maximum of 26 doses.
Receives: Drug: ISIS 678354
Cohort D: ISIS 678354: 10 mg QWExperimentalCohort D participants received 10 mg ISIS 678354, SC injection, once weekly (QW) for up to 52 weeks and a maximum of 52 doses.
Receives: Drug: ISIS 678354
Cohort B: ISIS 678354: 50 mg Q4WPlacebo comparatorCohort B participants received 50 mg ISIS 678354, SC injection, once Q4W for up to 49 weeks and a maximum of 13 doses.
Receives: Drug: ISIS 678354

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Percent Change From Baseline in Fasting Triglycerides (TG) at the Primary Analysis Time Point

    An analysis of covariance (ANCOVA) model was performed on the log ratio of TG value at the Primary Analysis Time Point to TG value at Baseline. The estimate of the log ratio was converted back to the original scale and percent change was calculated using formula: (ratio of TG value at the Primary Analysis Time Point to TG value at Baseline - 1) × 100.

    Measured: Baseline and Month 6 (Week 25 for Cohorts A and B and Week 27 for Cohorts C and D)

  2. Number of Participants With Treatment-Emergent Adverse Events (TEAEs)

    An adverse event (AE) was defined as any unfavorable and unintended sign (including a clinically-significant abnormal laboratory finding, for example), symptom, or disease temporally associated with the study or use of investigational drug product, whether or not the AE was considered to be related to the investigational drug product. A TEAE was defined as any AE starting on or after the first dose of the study drug.

    Measured: Up to the 13-week post-treatment follow-up period (Up to approximately 15 months)

Secondary outcomes (6)
  1. Percent Change From Baseline in ApoC-III, TC, LDL-C, HDL-C, Non-HDL-C, VLDL-C, ApoB, and ApoA-I at the Primary Analysis Time Point

    An ANCOVA model was performed on the log ratio of Primary Analysis Time Point value to Baseline value for ApoC-III, TC, LDL-C, HDL-C, Non-HDL-C, VLDL-C, ApoB, and ApoA-I. The estimate of the log ratio was converted back to the original scale and percent change for each lipid parameter was calculated using formula: (ratio of Primary Analysis Time Point value to Baseline value - 1) × 100.

    Measured: Baseline and Month 6 (Week 25 for Cohorts A and B and Week 27 for Cohorts C and D)

  2. Percentage of Participants Who Achieved Fasting Triglycerides (TG) <= 150 mg/dL (<= 1.7 Millimoles Per Liter [mmol/L])

    The percentage of participants who achieved <= 150 mg/dL or <= 1.7 mmol/L of fasting TG levels at the primary analysis time point were compared between each ISIS 678354 treatment group and pooled placebo group using a logistic regression model with log-transformed baseline TG value as a covariate.

    Measured: Baseline and Month 6 (Week 25 for Cohorts A and B and Week 27 for Cohorts C and D)

  3. Percentage of Participants Who Achieved Fasting Triglycerides (TG) <= 100 mg/dL (<= 1.13 mmol/L)

    The percentage of participants who achieved <= 100 mg/dL or <= 1.13 mmol/L of fasting TG levels at the primary analysis time point were compared between each ISIS 678354 treatment group and pooled placebo group using a logistic regression model with log-transformed baseline TG value as a covariate.

    Measured: Baseline and Month 6 (Week 25 for Cohorts A and B and Week 27 for Cohorts C and D)

  4. Maximum Plasma Concentration (Cmax) of ISIS 678354

    Measured: Predose, 1, 2, 4, 8, 24 hours post the first dose (Day 1), Week 21 (for Cohorts A and B) and Week 25 (for Cohorts C and D)

  5. Time to Reach Maximum Plasma Concentration (Tmax) of ISIS 678354

    Measured: Predose, 1, 2, 4, 8, 24 hours post the first dose (Day 1), Week 21 (for Cohorts A and B) and Week 25 (for Cohorts C and D)

  6. Area Under the Plasma Concentration Versus Time Curve From Time Zero to 24 Hours (AUC0-24) of ISIS 678354

    Measured: Predose, 1, 2, 4, 8, 24 hours post the first dose (Day 1), Week 21 (for Cohorts A and B) and Week 25 (for Cohorts C and D)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted28 Dec 2017
  2. Study start30 Jan 2018
  3. Primary completion25 Nov 2019
  4. Study completion25 Feb 2020

Resources

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 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Triple blind
Who is masked
Participant, Investigator, Outcomes assessor
Enrolment
114 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03385239
Sponsor's protocol ID
ISIS 678354-CS2
Status last verified
Dec 2022
First submitted
1 Dec 2017
Last updated
11 Jan 2023
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
No

Publications

  • Lin L, Brush MN, Nelson CB, Alexander VJ, Xia S, Gordts PLSM, Tsimikas S. A Novel Triglyceride- and Cholesterol-Enriched Lipoprotein(a) Phenotype in Moderate Hypertriglyceridemia: Reversal by ApoC-III Inhibition. JACC Basic Transl Sci. 2026 Sep 17;11(10):101699. doi: 10.1016/j.jacbts.2026.101699. Online ahead of print.

    PubMed 42753678
  • Tardif JC, Karwatowska-Prokopczuk E, Amour ES, Ballantyne CM, Shapiro MD, Moriarty PM, Baum SJ, Hurh E, Bartlett VJ, Kingsbury J, Figueroa AL, Alexander VJ, Tami J, Witztum JL, Geary RS, O'Dea LSL, Tsimikas S, Gaudet D. Apolipoprotein C-III reduction in subjects with moderate hypertriglyceridaemia and at high cardiovascular risk. Eur Heart J. 2022 Apr 6;43(14):1401-1412. doi: 10.1093/eurheartj/ehab820.

    PubMed 35025993

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing ISIS 678354 in people with Hypertriglyceridemia and Cardiovascular Diseases, run by Akcea Therapeutics at 31 sites in 2 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 4 inclusion and 9 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 11 Jan 2023. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 31 sites in United States, Canada. 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 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

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 11 Jan 2023). 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 Fasting Triglycerides (TG) at the Primary Analysis Time Point (time frame: Baseline and Month 6 (Week 25 for Cohorts A and B and Week 27 for Cohorts C and D)). 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 NCT03385239, which also lists 2 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 11 Jan 2023.

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