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Familial Chylomicronemia SyndromePhase 3BALANCENCT04568434

A Study of Olezarsen (Formerly Known as AKCEA-APOCIII-LRx) Administered to Patients With Familial Chylomicronemia Syndrome (FCS)

A Phase 3 study testing Olezarsen in people with Familial Chylomicronemia Syndrome, run by Ionis Pharmaceuticals, Inc. at 47 sites in 11 countries.

Completed

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

Official record
Search all trials

Trial summary

The purpose of the study was to evaluate the efficacy of olezarsen as compared to placebo on the percent change in fasting triglycerides (TG) from baseline. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Familial Chylomicronemia Syndrome
What is being tested?
Olezarsen
Type of treatment
Injection or infusion
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
66 participants
Where
47 sitesin 11 countries
Study dates
18 Nov 2020to 17 Oct 2023
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

  • A diagnosis of genetically confirmed Familial Chylomicronemia Syndrome (type 1 Hyperlipoproteinemia)
  • Fasting TG ≥ 880 mg/dL (10 millimoles per liter (mmol/L) at Screening
  • History of pancreatitis. Patients without a documented history of pancreatitis are also eligible but their enrollment will be capped at 35%
  • Stable doses of statins, omega-3 fatty acids, fibrates, or other lipid-lowering medications are allowed

Who cannot join

  • Acute coronary syndrome within 6 months of Screening
  • Major surgery within 3 months of Screening
  • Have any other conditions, which, in the opinion of the Investigator would make the participant unsuitable for inclusion, or could interfere with participating in or completing the study

Trial locations and contacts

47 sites in 11 countries.

47 sites in 11 countries

United States17 sites
  • University of Michigan- Endocrinology & Metabolism

    Ann Arbor, Michigan, 48105

  • Excel Medical Clinical Trials, LLC

    Boca Raton, Florida, 33434

  • University of Texas Southwestern

    Dallas, Texas, 75390

  • NorthShore University Health System

    Evanston, Illinois, 60201

  • Moses H. Cone Memorial Hospital

    Greensboro, North Carolina, 27401

  • Baylor College of Medicine

    Houston, Texas, 77030

  • Diabetes/Lipid Management & Research Center

    Huntington Beach, California, 92648

  • Ascension St. Vincent Cardiovascular Research Institute

    Indianapolis, Indiana, 46290

  • University of Kansas Medical Center (KUMC)

    Kansas City, Kansas, 66160

  • West Virginia University Heart and Vascular Institute

    Morgantown, West Virginia, 26506

  • Vanderbilt University

    Nashville, Tennessee, 37232

  • New York University (NYU) Langone Medical Center

    New York, New York, 10016

  • Columbia University Medical Center

    New York, New York, 10032

  • York Clinical Research LLC

    Norfolk, Virginia, 23510

  • Advocate Health and Hospitals Corporation - Lutheran General Hospital

    Park Ridge, Illinois, 60068

  • University of Pennsylvania

    Philadelphia, Pennsylvania, 19104

  • University of California, San Francisco (UCSF) - Medical Center

    San Francisco, California, 94143

Other trials in United States

Spain5 sites
  • Hospital Abente y Lago

    A Coruña, 15001

  • Hospital Clinic Barcelona

    Barcelona, 08036

  • Hospital Universitario 12 de Octubre

    Madrid, 28041

  • Hospital Universitario Virgen del Rocio

    Seville, 41013

  • Fundacio Pere Virgili

    Tarragona, 43204

Other trials in Spain

Canada4 sites
  • Ecogene-21

    Chicoutimi, Quebec, G7H 7K9

  • Nathalie Saint-Pierre

    Montreal, Quebec, H2W 1R7

  • Institute de Recherches Cliniques de Montreal

    Montreal, H2W 1R7

  • Clinique des Maladies Lipidiques de Quebec Inc.

    Québec, Quebec, G1V 4W2

Other trials in Canada

Italy4 sites
  • ASST Grande Ospedale Metropolitano Niguarda

    Milan, 20162

  • Azienda Ospedaliera Universitaria Federico II

    Naples, 80131

  • Azienda Ospedaliera Universitaria Policlinico Paolo Giaccone

    Palermo, 90127

  • Azienda Ospedaliero Universitaria Policlinico Umberto I

    Roma, 00161

Other trials in Italy

United Kingdom4 sites
  • The Royal Free Hospital

    London, NW3 2QG

  • St. Thomas' Hospital

    London, SE1 7EH

  • Manchester University NHS Foundation Trust (MFT)

    Manchester, MI39WL

  • Sandwell General Hospital

    West Bromwich, B71 4HJ

Other trials in United Kingdom

France3 sites
  • Hôpital Louis Pradel - HCL

    Bron, 69677

  • CHU Dijon - Bocage

    Dijon, 21000

  • Assistance Publique - Hopitaux de Marseille

    Marseille, 13385

Other trials in France

Netherlands3 sites
  • Academic Medical Center - Department of Vascular Medicine

    Amsterdam, 1105 AZ

  • Erasmus MC

    Rotterdam, 3015 GD

  • Universitair Medisch Centrum Utrecht

    Utrecht, 3584 CX

Other trials in Netherlands

Portugal3 sites
  • Centro Hospitalar de Lisboa Ocidental. E.P.E, - Hospital Santa Cruz

    Carnaxide, 2790-134

  • Hospital da Senhora da Oliveira - Guimaraes

    Creixomil, 4835-044

  • Centro Hospitalar de Lisboa Ocidental, EPE - Hospital Egas Moniz

    Lisbon, 1349-019

Other trials in Portugal

Sweden2 sites
  • Sahlgrenska University Hospital

    Gothenburg, 413 45

  • Karolinska University Hospital

    Solna, 171 76

Other trials in Sweden

Norway1 site
  • The Lipid Clinic (Oslo University Hospital)

    Oslo, 0372

Other trials in Norway

Slovakia1 site
  • Metabolicke centrum MUDr Katariny Raslovej s. r. o.

    Bratislava, 83301

Other trials in Slovakia

About this study

Official title: A Randomized, Double-Blind, Placebo-Controlled, Phase 3 Study of AKCEA-APOCIII-LRx Administered Subcutaneously to Patients With Familial Chylomicronemia Syndrome (FCS)

The purpose of the study was to evaluate the efficacy of olezarsen as compared to placebo on the percent change in fasting triglycerides (TG) from baseline.

Read the detailed description

This was a multi-center, double-blind, Phase 3 study in up to 60 patients with FCS. Participants were randomized in a 2:1 ratio to receive Olezarsen or matching placebo in a 53-week treatment period. The length of participation in the study was approximately 74 weeks, which included an up to 8-week screening period, a 53-week treatment period, and a 13-week post-treatment evaluation period. Following the treatment period, eligible patients had the option to enroll in the Open-label Extension (OLE) Study ISIS 678354-CS13 (NCT05130450).

Being tested
Olezarsen, Placebo
Keywords
FCS
Medical subject headings
Familial hyperchylomicronemia syndrome

What participants receive

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

  • OlezarsenDrug

    Also called ISIS 678354, AKCEA-APOCIII-LRx

    Olezarsen was administered by SC injection.

  • PlaceboDrug

    Olezarsen-matching placebo was administered by SC injection.

Study groups in NCT04568434
Study groupRoleWhat they receive
PlaceboPlacebo comparatorParticipants received olezarsen-matching placebo, once every 4 weeks by subcutaneous (SC) injection, during Weeks 1 to 49 of the 53-week treatment period.
Receives: Drug: Placebo
Olezarsen 50 mgExperimentalParticipants received olezarsen, 50 milligrams (mg), once every 4 weeks by SC injection, during Weeks 1 to 49 of the 53-week treatment period.
Receives: Drug: Olezarsen
Olezarsen 80 mgExperimentalParticipants received olezarsen 80 mg, once every 4 weeks by SC injection, during Weeks 1 to 49 of the 53-week treatment period.
Receives: Drug: Olezarsen

What is being measured

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

  1. Percent Change From Baseline in Fasting TG at Month 6

    Measured: Baseline, Month 6

Secondary outcomes (14)
  1. Percent Change From Baseline in Fasting TG at Month 12

    Measured: Baseline, Month 12

  2. Percent Change From Baseline in Fasting Apolipoprotein C-III (apoC-III) at Months 6 and 12

    Measured: Baseline, Months 6 and 12

  3. Percentage of Participants With ≥ 40% Reduction in Fasting TG at Month 6

    Percentages are rounded off to the nearest single decimal place.

    Measured: Month 6

  4. Percent Change From Baseline in Fasting Apolipoprotein B-48 (apoB-48) at Months 6 and 12

    Measured: Baseline, Months 6 and 12

  5. Percent Change From Baseline in Fasting Non-High-Density Lipoprotein Cholesterol (Non-HDL-C) at Months 6 and 12

    Measured: Baseline, Months 6 and 12

  6. Adjudicated Acute Pancreatitis Mean Event Rate Per 100 Participant-Years During the Treatment Period (Week 1 Through Week 53) in Participants With Prior History of Pancreatitis

    All AEs and SAEs that consistently occurred during the study with an event of acute pancreatitis were adjudicated by a blinded, independent committee according to the Atlanta classification of acute pancreatitis as outlined in the Acute Pancreatitis Adjudication Committee (PAC) Charter. These events were categorized as 1) documented pancreatitis, 2) probable pancreatitis, 3) possible pancreatitis, 4) unable to adjudicate and 5) no diagnosis of acute pancreatitis. The adjudicated event rate represents the average number of events per 100 participant-years during the treatment period.

    Measured: During the treatment period Week 1 through Week 53

  7. Adjudicated Acute Pancreatitis Mean Event Rate Per 100 Participant-Years During the Treatment Period (Week 1 Through Week 53)

    All AEs and SAEs that consistently occurred during the study with an event of acute pancreatitis were adjudicated by a blinded, independent committee according to the Atlanta classification of acute pancreatitis as outlined in the PAC Charter. These events were categorized as 1) documented pancreatitis, 2) probable pancreatitis, 3) possible pancreatitis, 4) unable to adjudicate and 5) no diagnosis of acute pancreatitis. The adjudicated event rate represents the average number of events per 100 participant-years during the treatment period.

    Measured: During the treatment period Week 1 through Week 53

  8. Adjudicated Acute Pancreatitis Mean Event Per 100 Participant-Years Rate During Week 13 Through Week 53 in Participants With Prior History of Pancreatitis

    All AEs and SAEs that consistently occurred during the study with an event of acute pancreatitis were adjudicated by a blinded, independent committee according to the Atlanta classification of acute pancreatitis as outlined in the PAC Charter. These events were categorized as 1) documented pancreatitis, 2) probable pancreatitis, 3) possible pancreatitis, 4) unable to adjudicate and 5) no diagnosis of acute pancreatitis. The adjudicated event rate represents the average number of events per 100 participant-years during the specified duration.

    Measured: Week 13 through Week 53

  9. Adjudicated Acute Pancreatitis Mean Event Rate Per 100 Participant-Years During Week 13 to Week 53

    All AEs and SAEs that consistently occurred during the study with an event of acute pancreatitis were adjudicated by a blinded, independent committee according to the Atlanta classification of acute pancreatitis as outlined in the PAC Charter. These events were categorized as 1) documented pancreatitis, 2) probable pancreatitis, 3) possible pancreatitis, 4) unable to adjudicate and 5) no diagnosis of acute pancreatitis. The adjudicated event rate represents the average number of events per 100 participant-years during the specified duration.

    Measured: Week 13 through Week 53

  10. Percentage of Participants With ≥ 70% Reduction in Fasting TG at Month 6

    Percentages are rounded off to the nearest single decimal place.

    Measured: Month 6

  11. Percentage of Participants With Fasting TG ≤ 880 mg/dL at Month 6

    Percentages are rounded off to the nearest single decimal place.

    Measured: Month 6

  12. Adjudicated Acute Pancreatitis Mean Event Rate Per 100 Participant-Years During Treatment Period in Participants With ≥ 2 Events in 5 Years Prior to Enrollment

    All AEs and SAEs that consistently occurred during the study with an event of acute pancreatitis were adjudicated by a blinded, independent committee according to the Atlanta classification of acute pancreatitis as outlined in the PAC Charter. These events were categorized as 1) documented pancreatitis, 2) probable pancreatitis, 3) possible pancreatitis, 4) unable to adjudicate and 5) no diagnosis of acute pancreatitis. The adjudicated event rate represents the average number of events per 100 participant-years during the treatment period.

    Measured: During the treatment period Week 1 through Week 53

  13. Adjudicated Acute Pancreatitis Mean Event Rate Per 100 Participant-Years From Week 13 to Week 53 in Participants With ≥ 2 Events in 5 Years Prior to Enrollment

    All AEs and SAEs that consistently occurred during the study with an event of acute pancreatitis were adjudicated by a blinded, independent committee according to the Atlanta classification of acute pancreatitis as outlined in the PAC Charter. These events were categorized as 1) documented pancreatitis, 2) probable pancreatitis, 3) possible pancreatitis, 4) unable to adjudicate and 5) no diagnosis of acute pancreatitis. The adjudicated event rate represents the average number of events per 100 participant-years during the specified duration.

    Measured: Week 13 to Week 53

  14. Percentage of Participants With Fasting TG ≤ 500 mg/dL at Month 6

    Percentages are rounded off to the nearest single decimal place.

    Measured: Month 6

Timeline

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

  1. First posted29 Sep 2020
  2. Study start18 Nov 2020
  3. Primary completion14 Jul 2023
  4. Study completion17 Oct 2023

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 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Double blind
Who is masked
Participant, Investigator
Enrolment
66 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04568434
Sponsor's protocol ID
ISIS 678354-CS3
Other IDs
2020-002536-67
Acronym
BALANCE
Status last verified
Feb 2025
First submitted
23 Sep 2020
Last updated
6 Mar 2025
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
Yes: Ionis may share anonymized individual participant data, aggregated clinical data, and other types of data that support the results in this study. Data requests from qualified researchers will be considered once all three of the following criteria are met: (1) 12 months from marketing approval of the study drug in both the United States and European Union; (2) 18 months from conclusion of the study; and (3) 6 months from publication of study article. Access would be via a secure environment and is contingent upon approval of a research proposal and entry into an appropriate data use agreement. Requests to access data can be submitted via the website https://vivli.org/ourmember/ionis/.
Expanded access
Available

Publications

  • Stroes ESG, Alexander VJ, Karwatowska-Prokopczuk E, Hegele RA, Arca M, Ballantyne CM, Soran H, Prohaska TA, Xia S, Ginsberg HN, Witztum JL, Tsimikas S; Balance Investigators. Olezarsen, Acute Pancreatitis, and Familial Chylomicronemia Syndrome. N Engl J Med. 2024 May 16;390(19):1781-1792. doi: 10.1056/NEJMoa2400201. Epub 2024 Apr 7.

    PubMed 38587247
  • Sikora Kessler A, Vera-Llonch M, Karwatowska-Prokopczuk E, Alexander VJ, Ann Q, Mejia Herrera C, Paparrodopoulos S, Xia S, Stroes ESG, Baum SJ, Tsimikas S; Balance Investigators. Olezarsen reduces all-cause health services utilization and improves the treatment experience of patients with familial chylomicronemia syndrome. J Clin Lipidol. 2026 Feb;20(2):299-309. doi: 10.1016/j.jacl.2025.12.018. Epub 2025 Dec 19.

    PubMed 41545246

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Olezarsen in people with Familial Chylomicronemia Syndrome, run by Ionis Pharmaceuticals, Inc. at 47 sites in 11 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 3 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 6 Mar 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 47 sites in United States, Spain, Canada, Italy, United Kingdom and 6 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 6 Mar 2025). 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 TG at Month 6 (time frame: Baseline, Month 6). 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 NCT04568434, 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 6 Mar 2025.

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