Table 3.
Change From Baseline to Primary Endpoint, % | |||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Trial | BG Therapy | Treatment | Comparator | Lp(a) (Median) | TC (LSM) | HDL‐C (LSM) | Non‐HDL‐C (LSM) | Apo B (LSM) | Apo A1 (LSM) | TG (Median) | VLDL‐C (LSM) | TC/HDL‐C Ratio (LSM) | Apo B/apo A1 Ratio (LSM) |
Heterozygous familial hypercholesterolemia | |||||||||||||
Stein 201268 N = 77 | Statin ± EZE | Aliroc | Placebo | −23.38 to −7.45 vs −3.91 | −43.55 to −18.10 vs −8.48 | +6.49 to +12.34 vs +2.20 | −57.90 to −26.84 vs −11.34 | −50.19 to −20.91 vs −6.39 | +1.69 to +8.82 vs −5.32 | −16.73 to −4.92 vs −10.55 | NR | NR | NR |
Stein 201467 N = 58 | LMT | Aliroc | OLE | −24.5 | NR | +4.5 | NR | −45.5 | +7.6 | NR | NR | NR | NR |
ODYSSEY FH I54 N = 486 | Max tolerated statin ± other LMT | Aliroc | Placebo | −25.2 vs −7.5a | NR | +8.8 vs +0.8 | −42.8 vs +9.6 | −41.1 vs +4.7 | +5.0 vs +0.3 | −9.6 vs +6.3a | NR | NR | NR |
ODYSSEY FH II54 N = 249 | Max tolerated statin ± other LMT | Aliroc | Placebo | −30.3 vs −10.0a | NR | +6.0 vs −0.8 | −42.6 vs +3.1 | −42.8 vs −3.5 | +2.8 vs −1.6 | −10.4 vs +0.5a | NR | NR | NR |
RUTHERFORD60 N = 168 | Statin ± EZE | Evo | Placebo | −27.4 to −19.1 vs +4.1a | −37.4 to −28.1 vs +2.9 | +9.1 to +10.1 vs +2.3 | −51.0 to −39.3 vs +2.5 | −43.3 to −31.9 vs +2.9 | +10.3 to +10.6 vs +8.6 | −10.5 to −5.6 vs +9.4a | −18.6 to −7.8 vs +17.0 | −42.0 to −33.7 vs +3.0 | −48.7 to −38.0 vs −4.1 |
RUTHERFORD‐262 N = 331 | Statin ± LMT | Evo | Placebo | −22.9 to −21.6 vs +6.7 to +8.7 | NR | +5.4 to +8.1 vs −3.7 to −1.2 | −56.2 to −49.7 vs −1.4 to +5.3 | −49.8 to −44.8 vs −0.7 to +4.6 | +5.7 to +7.3 vs −1.4 to +1.8 | −16.1 to −5.1 vs +3.5 to +6.4 | NR | −46.0 to −38.3 vs +0.1 to +7.1 | −52.7 to −45.3 vs +1.5 to +4.2 |
Hypercholesterolemia and high cardiovascular risk | |||||||||||||
ODYSSEY COMBO I74 N = 316 | Max tolerated statin ± LMT | Aliroc | Placebo | −20.5 vs −5.9 | −27.9 vs −2.9 | +3.5 vs −3.8 | −39.1 vs −1.6 | −36.7 vs −0.9 | NR | −6.0 vs −5.4 | NR | NR | NR |
ODYSSEY COMBO II73 N = 720 | Max‐ tolerated statin | Aliroc | Placebo + EZE | −27.8 vs −6.1 | −29.3 vs −14.6 | +8.6 vs +0.5 | −42.1 vs −19.2 | −40.7 vs −18.3 | +5.0 vs −1.3 | −13.0 vs −12.8 | NR | NR | NR |
Additional patient populations | |||||||||||||
TESLA69 N = 8 HoFH | Diet + LMT | Evo | Open label | −18.6 to −11.7 | NR | −1.4 to +4.7a | NR | −14.9 to −12.5a | +1.3 to +5.2a | −5.7 to +5.8a | NR | NR | NR |
TESLA Part B61 N = 50 HoFH | Diet + LMT | Evo | Placebo | −9.4 vs +2.4a, b | −18.9 vs +7.8 | +4.0 vs +4.1 | −22.0 vs +8.1 | −19.2 vs +4.0 | NR | −1.4 vs −1.7 | +18.7 vs +62.6 | −21.6 vs +4.4 | −22.5 vs +5.3 |
Additional patient populations (continued) | |||||||||||||
ODYSSEY ALTERNATIVE59 N = 361 SI | LMT | Aliroc | EZE | −25.9 vs −7.3c | −31.8 vs −10.9c | +7.7 vs +6.8c, d | −40.2 vs −14.6c | −36.3 vs −11.2c | +4.8 vs +2.9c, d | −9.3 vs −3.6c, d | NR | NR | NR |
GAUSS71 N = 160 SI | Low‐dose statin or LMT | Evo | Placebo + EZE | −25.9 to −20.3 vs −7.9a | −37.7 to −29.8 vs −10.7 | +5.5 to +7.4 vs −1.1 | −48.6 to −39.8 vs −15.0 | −42.1 to −33.6 vs −12.2 | +6.0 to +7.5 vs −1.4 | −19.3 to −14.2 vs −5.5 | −28.8 to −15.0 vs −13.2 | −40.6 to −32.0 vs −9.6 | −45.4 to −36.5 vs −11.4 |
Evo + EZE | Placebo + EZE | −29.1 vs −7.9a | −44.3 vs −10.7 | +12.0 vs −1.1 | −59.8 vs −15.0 | −49.1 vs −12.2 | +8.3 vs −1.4 | −9.5 vs −5.5 | −37.8 vs −13.2 | −49.4 vs −9.6 | −52.0 vs −11.4 | ||
GAUSS‐270 N = 307 SI | Low‐dose statin or LMT | Evo | Placebo + EZE | −27.0 to −22.1 vs −1.7 to +5.8a | NR | +5.3 to +6.5 vs +1.6 to +1.8 | −48.6 to −46.2 vs −16.5 to −13.2 | −45.8 to −43.1 vs −13.0 to −10.0 | +5.2 to +5.5 vs +1.1 to +3.3 | −3.9 to −2.5 vs −5.5 to +2.16 | −6.2 to −2.2 vs −5.5 to −2.3 | −40.4 to −38.6 vs −14.1 to −9.92 | −47.7 to −45.5 vs −13.1 to −11.4 |
ODYSSEY OPTIONS I76 N = 355 Patients with subtherapeutic response to statins | ATV 20 mg or 40 mg ± LMT | Aliroc + ATV 20 mg | EZE double statin | −23.6 vs −10.6 (EZE) and −20.2 (ATV 40 mg) | NR | +4.8 vs −0.1 (EZE) and +1.9 (ATV 40 mg) | −36.7 vs −15.1 (EZE) and −6.3 (ATV 40 mg) | −33.7 vs −10.1 (EZE) and −4.4 (ATV 40 mg) | NR | −12.0 vs −3.3 (EZE) and −6.7 (ATV 40 mg)a | NR | NR | NR |
Aliroc + ATV 40 mg | EZE double statin | −30.8 vs +0.2 (EZE) and −9.7 (ATV 80 mg) and −4.9 (ROS 40 mg) | NR | +7.7 vs +2.0 (EZE) and +4.7 (ATV 80 mg) and +5.7 (ROS 40 mg) | −47.6 vs −21.0 (EZE) and −6.5 (ATV 80 mg) and −17.4 (ROS 40 mg) | −41.9 vs −14.3 (EZE) and −3.5 (ATV 80 mg) and −10.9 (ROS 40 mg) | NR | −19.1 vs −13.9 (EZE) and −7.3 (ATV 80 mg) and −0.5 (ROS 40 mg)a | NR | NR | NR | ||
ODYSSEY OPTIONS II77 N = 305 | ROS 10 mg or 20 mg ± LMT | Aliroc + ROS 10 mg | EZE double statin | −27.9 vs −4.3 (EZE) and −4.0 (ROS 20 mg)a | NR | +9.1 vs +4.0 (EZE) and +1.7 (ROS 20 mg) | −42.7 vs −13.4 (EZE) and −11.3 (ROS 20 mg) | −36.5 vs −9.7 (EZE) and −7.3 (ROS 20 mg) | NR | −11.2 vs −8.3 (EZE) and −1.8 (ROS 20 mg)a | NR | NR | NR |
Aliroc + ROS 20 mg | EZE double statin | −22.7 vs −5.8 (EZE) and −5.2 (ROS 40 mg)a | NR | +7.2 vs −1.8 (EZE) and +1.5 (ROS 40 mg) | −31.4 vs −12.9 (EZE) and −11.2 (ROS 40 mg) | −28.3 vs −11.2 (EZE) and −9.8 (ROS 40 mg) | NR | −8.7 vs −11.1 (EZE) and −9.9 (ROS 40 mg)a | NR | NR | NR | ||
Additional patient populations (continued) | |||||||||||||
Roth 201265 N = 92 Hypercholesterolemia | None | Aliroc + ATV 10 mg | Placebo + ATV 80 mg | −34.7 vs −2.7 | −40.5 vs −16.6e | +2.6 vs −3.6 | −58.3 vs −22.3e | −54.4 vs −12.0e | +0.4 vs −5.2 | −4.0 vs −11.9 | NR | NR | NR |
Aliroc + ATV 80 mg | Placebo + ATV 80 mg | −31.0 vs −2.7 | −47.2 vs ‐16.6e | +5.8 vs −3.6 | −63.9 vs −22.3e | −58.0 vs −12.0e | −2.2 vs −5.2 | −24.7 vs −11.9 | NR | NR | NR | ||
McKenney 201258 N = 183 Hypercholesterolemia | ATV 10, 20, or 40 mg | Aliroc | Placebo | −28.6 to −7.9 vs 0.0 | −45.2 to −23.0 vs −1.6 | +4.1 to +8.5 vs −1.0 | −62.5 to −33.6 vs −2.2 | −56.1 to −27.3 vs +2.2 | +0.3 to +4.2 vs 0.0e | −18.9 to −5.5 vs +9.7 | NR | NR | NR |
ODYSSEY MONO66 N = 103 Hypercholesterolemia; no background LMT | None | Aliroc | Placebo + EZE | −16.7 vs −12.3a , f | −29.6 vs −10.9 | +6.0 vs +1.6 | −40.6 vs −15.1 | −36.7 vs −11.0 | +4.7 vs −0.6 | −11.9 vs −10.8f | NR | NR | NR |
MENDEL57 N = 411 Hypercholesterolemia | None | Evo | Placebo | −27.3 to −9.1 vs +2.0 to +9.2a | −34.0 to −26.7 vs −2.2 to +1.4 | +5.3 to +11.5 vs +1.1 to +5.7 | −48.0 to −37.9 vs −2.9 to −0.3 | −44.5 to −32.7 vs −0.3 to +0.2 | +1.2 to +9.0 vs −1.6 to +0.7 | −10.6 to −5.9 vs −4.2 to +1.4 | −26.0 to −10.3 vs −0.1 to +9.8 | −40.0 to −30.1 vs −3.4 to −1.2 | −48.1 to −32.8 vs +0.1 to +2.0 |
LAPLACE‐TIMI 5785 N = 631 Hypercholesterolemia | Statin ± EZE | Evo | Placebo | NR | −42.5 to −26.2g | +1.6 to +8.1g | −61.4 to −37.8g | −56.4 to −34.4g | +0.31 to +4.8g | −33.7 to −13.4g | −44.3 to −21.1g | −47.7 to −27.7g | −53.4 to −33.8g |
OSLER‐155 N = 1104 Hypercholesterolemia | ± Statin | Evo + SOC | Open label | −32.8 for no Evo/Evo vs −11.1 for no Evo/SOC and −8.7 for Evo/ SOC | −32.5 for no Evo/Evo vs −0.5 for no Evo/SOC and −1.5 Evo/SOCc | +8.5 for no Evo/Evo vs +3.5 for no Evo/SOC and +3.7 for Evo/SOCc | −45.9 for no Evo/Evo vs −1.2 no Evo/ SOC and −2.8 Evo/ SOCc | −42.1 for no Evo/Evo vs −4.2 for no Evo/ SOC and −3.6 for Evo/SOCc | +3.6 for no Evo/Evo vs +0.9 for no Evo/ SOC and +0.1 for Evo/ SOCc | −8.3 for no Evo/Evo vs +3.7 for no Evo/SOC and −1.4 for Evo/SOCe | −14.7 no Evo/Evo vs +11.6 no Evo/ SOC and −4.2 Evo/SOCe | −36.9 no Evo/Evo vs −2.3 no Evo/ SOC and −3.1 Evo/ SOCc | −43.7 no Evo/Evo vs −4.2 no Evo/SOC and −2.5 Evo/SOCc |
SOC | Open label | −29.9 for Evo/Evo vs −11.1 for no Evo/SOC and −8.7 for Evo/ SOC | −33.0 for Evo/Evo vs −0.5 for no Evo/ SOC and −1.5 for Evo/ SOCc | +9.1 for Evo/Evo vs +3.5 for no Evo/SOC and +3.7 for Evo/SOCc | −46.5 vs −1.2 and −2.8c | −42.6 for Evo/Evo vs −4.2 for no Evo/SOC and −3.6 for Evo/SOCc | +4.9 for Evo/Evo vs +0.9 for no Evo/SOC and +0.1 for Evo/SOCc | −9.0 for Evo/Evo vs +3.7 for no Evo/SOC and −1.4 for Evo/SOCe | −18.8 for Evo/Evo vs +11.6 for no Evo/SOC and −4.2 for Evo/ SOCe | −37.5 for Evo/Evo vs −2.3 for no Evo/SOC and −3.1 for Evo/SOCc | −44.7 for Evo/Evo vs −4.2 for no Evo/SOC and −2.5 for Evo/SOCc | ||
Additional patient populations (continued) | |||||||||||||
OSLER‐1/OSLER‐275 , h N = 4465 Hypercholesterolemia | SOC | Evo | Open label | −25.5 vs 0.0 | −32.3 vs +3.8c | +8.7 vs +1.7c | −46.1 vs +5.9c | −41.7 vs +5.5c | +6.8 vs +2.6c | −9.1 vs +3.5 | NR | NR | NR |
DESCARTES51 N = 905 Hypercholesterolemia | Diet + none; diet + ATV | Evo + diet | Placebo | −22.5 vs −12.8a | −30.9 vs +5.4 | +9.2 vs −2.1 | −44.9 vs +9.5 | −43.3 vs −0.4 | +3.1 vs −1.7 | −7.7 vs +15.4a | −2.1 vs +77.2 | −34.7 vs +9.7 | −44.1 vs +1.9c |
Diet + ATV + EZE | Evo + diet + ATV 10 mg | Placebo | −32.8 vs −3.6a | −30.1 vs +5.3 | +4.8 vs −0.5 | −46.0 vs +8.5 | −44.8 vs +2.9 | +1.5 vs −0.9 | −1.0 vs +10.2a | +8.6 vs +28.7 | −32.1 vs +6.8 | −45.1 vs +4.4c | |
Evo + diet + ATV 80 mg | Placebo | −30.1 vs −10.6a | −25.0 vs +8.1 | +5.4 vs +1.5 | −37.8 vs +11.7 | −39.2 vs +5.4 | +3.4 vs −0.1 | −0.9 vs +11.5a | +4.4 vs +35.5 | −28 vs +8.4 | −40.8 vs +6.1c | ||
Evo + diet + ATV 80 mg + EZE | Placebo | −20.5 vs −1.1a | −27.0 vs +1.7 | +5.0 vs +1.0 | −38.9 vs +2.4 | −37 vs +0.8 | +0.9 vs −1.7 | −2.1 vs +1.6a | −3.9 vs +13.6 | −28.8 vs +2.2 | −36.2 vs +2.9c | ||
MENDEL‐256 N = 614 Hypercholesterolemia | None | Evo | Placebo | −20.4 to −17.8 vs 0.0e | NR | +4.1 to +4.8 vs −5.3 to −1.2e | −50.1 to −49.7 vs −0.3 to +1.5 | −47.2 to −46.6 vs +0.6 to +1.8 | NR | −15.6 to −8.1 vs −1.9 to +2.0 | −16.3 to −9.5 vs −1.6 to 0.0e | NR | −48.5 to −48.3 vs +1.1 to +4.5 |
EZE | −2.1 to 0.0e | NR | −2.8 to −1.5e | −16.5 to −14.9 | −14.0 to −13.2 | NR | −2.4 to 0.0 | −3.6 to −0.9e | NR | −14.3 to −12.7 | |||
LAPLACE‐263 , i N = 1899 Hypercholesterolemia | ATV 10 mg | Evo | Placebo | −25.9 to −20.3 vs −0.4 to +7.3a | −37.2 to −36.5 vs +1.4 to +5.6 | +7.0 to +7.9 vs 0.0 to +0.2 | −53.4 to −52.5 vs +2.4 to +8.3 | −50.9 to −47.15 vs +0.21 to +7.89 | NR | −13.3 to −3.8 vs +8.3 to +14.4a | −11.7 to −6.2 vs +8.3 to +14.7 | NR | NR |
EZE | +3.3 to +7.2a | −14.3 to −11.3 | −1.8 to −0.4 | −18.27 to −14.8 | −15.98 to −10.95 | NR | −0.4 to +4.9a | −4.6 to +3.5 | NR | NR | |||
ATV 80 mg | Evo | Placebo | −24.7 to −24.6 vs −2.2 to +3.4a | −36.3 to −32.6 vs +6.0 to +9.34 | +7.4 to +9.1 vs +0.3 to +5.0 | −54.8 to −50.1 vs +10.0 to +11.8 | −49.77 to −46.47 vs +6.54 to +11.64 | NR | −10.1 to −1.1 vs +6.7 to +8.2a | −9.7 to −1.1 vs +6.7 to +8.5 | NR | NR | |
EZE | +8.0 to +10.2a | −12.3 to −10.0 | +0.2 to +0.6 | −17.3 to −14.3 | −12.31 to −12.16 | NR | −7.4 to −3.1a | −7.9 to −6.0 | NR | NR | |||
SIM 40 mg | Evo | Placebo | −38.06 to −29.23 vs −6.81 to −1.06a | −41.9 to −36.5 vs +0.4 to +0.7 | +6.4 to +10.9 vs −2.7 to +1.1 | −59.02 to −50.96 vs +1.89 to +5.66 | −55.95 to −49.16 vs +0.35 to +3.57 | NR | −14.7 to −13.7 vs +8.1 to +16.7a | −15.9 to −14.8 vs +7.6 to +21.0 | NR | NR | |
Additional patient populations (continued) | |||||||||||||
ROS 5 mg | Evo | Placebo | −25.09 to −20.85 vs +4.49 to +11.40a | −36.4 to −36.3 vs +3.1 to +6.3 | +6.1 to +7.2 vs −0.2 to +2.9 | −52.04 to −51.57 vs +5.85 to +7.92 | −50.15 to −48.58 vs +4.63 to +6.35 | NR | −6.9 to −4.5 vs +13.0 to +13.6a | −8.2 to −6.3 vs +12.5 to +13.8 | NR | NR | |
ROS 40 mg | Evo | Placebo | −26.11 to −21.97 vs +10.21 to +10.38a | −33.3 to −29.8 vs +1.2 vs +4.3 | +4.7 to +5.6 vs −0.4 to +0.7 | −50.97 to −46.42 vs +3.35 to +8.61 | −45.61 to −43.71 vs +3.24 to +4.91 | NR | −10.5 to +5.6 vs +10.0 to +11.0a | −10.0 to −6.1 vs +8.6 to +10.1 | NR | NR | |
Ballantyne 201572 N = 354 Hypercholesterolemia | Statin | Boco | Placebo | −10.7 to 0.0 vs 0.0 to +3.5 | −31.6 to −10.5 vs −2.4 to +1.2c | +2.7 to +7.1 vs −0.4 to +0.8c | −44.9 to −17.3 vs −2.3 to +2.8c | −37.4 to −13.6 vs −2.1 to +1.5c | +2.9 to +9.9 vs +1.8 to +2.1c | −18.6 to −7.6 vs −14.5 to +3.7 | NR | NR | NR |
ODYSSEY LONG TERM64 N = 2341 HeFH, or high CV risk | Max‐tolerated statin ± other LMT | Aliroc | Placebo | −30.2 vs −3.9 | −38.8 vs −0.4 | +4.2 vs −0.7 | −53.1 vs +0.6 | −54.3 vs +1.2 | +4.2 vs +1.2 | −15.8 vs +1.4 | NR | NR | NR |
Aliroc, alirocumab; apo A1, apolipoprotein A1; apo B, apolipoprotein B; ATV, atorvastatin; BG, background; Boco, bococizumab; CV, cardiovascular; Evo, evolocumab; EZE, ezetimibe; HDL‐C, high‐density lipoprotein cholesterol; HeFH, heterozygous familial hypercholesterolemia; HoFH, homozygous familial hypercholesterolemia; LDL‐C, low‐density lipoprotein cholesterol; LMT, lipid‐modifying therapy; Lp(a), lipoprotein(a); LSM, least squares mean; NR, not reported; OLE, open‐label extension; ROS, rosuvastatin; SI, statin intolerance; SIM, simvastatin; SOC, standard of care; TC, total cholesterol; TG, triglycerides; VLDL‐C, very low‐density lipoprotein cholesterol.
LSM.
Multiplicity adjustments following the Hochberg procedure were used to control for overall significance at the 0.05 level of significance for the primary and secondary endpoints.
Mean change from baseline.
Hierarchical testing terminated at the endpoint of HDL‐C (baseline to week 24, intention‐to‐treat analysis), and this statistical comparison and all subsequent comparisons (TG and apo A1) were not considered statistically significant.
Median.
Combined estimate for adjusted mean (SE) percentage changes are shown.
Mean change vs placebo.
Change at 12 weeks in OSLER program (including OSLER‐1 and OSLER‐2).
Similar results were observed for the mean of weeks 10 and 12.