Michel Farnier1, G Kees Hovingh2, Gisle Langslet3, Robert Dufour4, Marie T Baccara-Dinet5, Chantal Din-Bell6, Garen Manvelian7, John R Guyton8. 1. Lipid Clinic, Point Médical and Department of Cardiology, CHU Dijon-Bourgogne, Dijon, France. Electronic address: michelfarnier@nerim.net. 2. Department of Vascular Medicine, Academic Medical Center, Amsterdam, the Netherlands. 3. Lipid Clinic, Oslo University Hospital, Oslo, Norway. 4. Institut de recherches cliniques de Montréal and Université de Montréal, Montréal, QC, Canada. 5. Clinical Development, R&D, Sanofi, Montpellier, France. 6. Biostatistics and Programming, Sanofi, Chilly-Mazarin, France. 7. Regeneron Pharmaceuticals, Tarrytown, NY, USA. 8. Duke University Medical Center, Durham, NC, USA.
Abstract
BACKGROUND AND AIMS: ODYSSEY OLE (open-label extension; NCT01954394) included patients diagnosed with heterozygous familial hypercholesterolemia (HeFH), receiving maximally tolerated statins, who had completed one of four Phase 3 double-blind parent studies (all 18 months' duration), with the aim to assess longer-term safety and efficacy of alirocumab. METHODS: Patients received starting dose alirocumab 75 mg every 2 weeks (Q2W; patients from FH I, FH II, and LONG TERM) or alirocumab 150 mg Q2W (patients from HIGH FH). Low-density lipoprotein cholesterol (LDL-C) levels were blinded to the patient and physician until Week 8; from Week 8, LDL-C levels were communicated to physicians. From Week 12, dose adjustment from 75 to 150 mg Q2W, or vice versa, was possible per physician's clinical judgment according to patient's LDL-C levels. RESULTS: Patients who had received alirocumab (n = 655) compared with placebo (n = 330) in the parent studies exhibited similar rates of treatment-emergent adverse events (TEAEs; 87.3% vs. 83.9%) during OLE (2.5 years median alirocumab exposure). Overall, 33 patients (3.4%) experienced TEAEs leading to permanent treatment discontinuation. At Week 8, alirocumab reduced mean LDL-C by 44.2% (reduction from 151.9 mg/dL at parent study baseline to 84.9 mg/dL); reduction in LDL-C was consistent to Week 96 of OLE. Reductions in lipid parameters were similar regardless of treatment allocation in the parent study. CONCLUSIONS: In patients with HeFH, no unexpected long-term safety concerns were observed with alirocumab compared with previously published data; durability of LDL-C-lowering over 3 years (including 1.5 years of parent trials) was demonstrated.
RCT Entities:
BACKGROUND AND AIMS: ODYSSEY OLE (open-label extension; NCT01954394) included patients diagnosed with heterozygous familial hypercholesterolemia (HeFH), receiving maximally tolerated statins, who had completed one of four Phase 3 double-blind parent studies (all 18 months' duration), with the aim to assess longer-term safety and efficacy of alirocumab. METHODS:Patients received starting dose alirocumab 75 mg every 2 weeks (Q2W; patients from FH I, FH II, and LONG TERM) or alirocumab 150 mg Q2W (patients from HIGH FH). Low-density lipoprotein cholesterol (LDL-C) levels were blinded to the patient and physician until Week 8; from Week 8, LDL-C levels were communicated to physicians. From Week 12, dose adjustment from 75 to 150 mg Q2W, or vice versa, was possible per physician's clinical judgment according to patient's LDL-C levels. RESULTS:Patients who had received alirocumab (n = 655) compared with placebo (n = 330) in the parent studies exhibited similar rates of treatment-emergent adverse events (TEAEs; 87.3% vs. 83.9%) during OLE (2.5 years median alirocumab exposure). Overall, 33 patients (3.4%) experienced TEAEs leading to permanent treatment discontinuation. At Week 8, alirocumab reduced mean LDL-C by 44.2% (reduction from 151.9 mg/dL at parent study baseline to 84.9 mg/dL); reduction in LDL-C was consistent to Week 96 of OLE. Reductions in lipid parameters were similar regardless of treatment allocation in the parent study. CONCLUSIONS: In patients with HeFH, no unexpected long-term safety concerns were observed with alirocumab compared with previously published data; durability of LDL-C-lowering over 3 years (including 1.5 years of parent trials) was demonstrated.
Authors: Mary P McGowan; Seyed Hamed Hosseini Dehkordi; Patrick M Moriarty; P Barton Duell Journal: J Am Heart Assoc Date: 2019-12-16 Impact factor: 5.501
Authors: Tim Hollstein; Ursula Kassner; Thomas Grenkowitz; Friederike Schumann; Thomas Bobbert; Elisabeth Steinhagen-Thiessen Journal: Am J Cardiovasc Drugs Date: 2021-01 Impact factor: 3.571