Study of Long-Term Efficacy and Safety of LIB003 in CVD or High Risk for CVD Patients Needing Further LDL-C Reduction (LIBerate-HR)

• ClinicalTrials.gov Identifier: NCT04806893
• Recruitment Status: Active, not recruiting
• First Posted: March 19, 2021
• Last Update Posted: December 11, 2023
• Sponsor: LIB Therapeutics LLC
• Collaborator: Medpace, Inc.
• Information provided by (Responsible Party): LIB Therapeutics LLC

Study Description

Brief Summary:

This study is to assess LDL-C reductions at Week 52 with monthly (Q4W [≤31 days]) dosing of LIB003 (lerodalcibep) 300 mg administered subcutaneously (SC) compared to placebo in patients with CVD, or at high risk for CVD, on a stable diet and oral LDL-C lowering drug therapy

Condition or disease	Intervention/treatment	Phase
Cardiovascular Risk Factor; Cardiovascular Diseases; Cardiovascular Stroke; Hypercholesterolemia	Drug: lerodalcibep; Other: Placebo	Phase 3

Detailed Description:

Randomized, double-blind, placebo-controlled, Phase 3 study of 52 weeks duration.

Patients who fulfill the inclusion and exclusion criteria will be enrolled at up to 65 sites in the United States, Canada, Europe, South Africa, Asia, Australasia, and the Middle East. Patients will be randomized in a 2:1 ratio to LIB003 or placebo. The total study duration will be up to 63 weeks which includes up to a Screening Period and 52 weeks of study drug treatment. Following randomization patients will be dosed and seen in the clinic Q4W (≤31 days).

Study Design

• Study Type: Interventional (Clinical Trial)
• Estimated Enrollment: 900 participants
• Allocation: Randomized
• Intervention Model: Parallel Assignment
• Intervention Model Description: Placebo-controlled, randomized 2:1 to Active or placebo
• Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
• Masking Description: participants, study staff, investigator and sponsor blinded to treatment and lipid levels
• Primary Purpose: Treatment
• Official Title: Study to Evaluate the Long-Term Efficacy and Safety of LIB003 in Patients With Cardiovascular Disease, or at High Risk for Cardiovascular Disease, on Stable Lipid-Lowering Therapy Requiring Additional LDL-C Reduction
• Actual Study Start Date: April 22, 2021
• Actual Primary Completion Date: November 15, 2023
• Estimated Study Completion Date: February 28, 2024

Arms and Interventions

Arm	Intervention/treatment
Experimental: LIB003 (lerodalcibep); 300 mg subcutaneously monthly (Q4W)	Drug: lerodalcibep; 300 mg subcutaneous injection every month (Q4W); Other Name: LIB003
Placebo Comparator: Placebo; matching placebo subcutaneously monthly (Q4W)	Other: Placebo; matching subcutaneous injection every month (Q4W)

Outcome Measures

Primary Outcome Measures :

1. LDL-C change compared to placebo [ Time Frame: 52 weeks ]
   Percent change in LS mean from baseline compared to placebo in LDL-C level
2. mean LDL-C change at week 50 and 52 [ Time Frame: 50 and 52 weeks ]
   Percent change in LS mean from baseline compared to placebo in LDL-C level at Weeks 50 and 52

Secondary Outcome Measures :

1. Incidence of Treatment-Emergent Adverse Events as assessed by Medical Dictionary for Regulatory Activities as severe, moderate or mild after 52 weeks [ Time Frame: 52 weeks ]
   Evaluation of Adverse Events based on MedRA based on ITT population
2. Change in Free PCSK9 [ Time Frame: 52 weeks ]
   Percent change in LS mean from baseline compared to placebo in free PCSK9
3. Percentage of patients achieving 2019 ESC/EAS LDL-C goals [ Time Frame: 52 weeks ]
   To assess the effects of LIB003 on the percentage of patients achieving an LDL-C <40 mg/dL, 55 mg/dL, <70 mg/dL, and 100 mg/dL

Eligibility Criteria

• Ages Eligible for Study: 18 Years and older (Adult, Older Adult)
• Sexes Eligible for Study: All
• Accepts Healthy Volunteers: No

Criteria

Inclusion Criteria:

• Provision of written and signed informed consent prior to any study-specific procedure;
• Weight of ≥40 kg (88 lb) and body mass index (BMI) ≥17 and ≤42 kg/m2;
• History of CVD, (including cerebrovascular or peripheral arterial disease) or very-high risk for CVD as defined in the 2019 ESC/EAS Guidelines or
• High risk for CVD as defined in the 2019 ESC/EAS Guidelines
• At Screening or post Washout/Stabilization, LDL-C ≥70 mg/dL and TG ≤400 mg/dL while on stable lipid-lowering oral drug therapy (i.e., maximally tolerated statin with or without ezetimibe); Patients unable to tolerate approved doses of a statin may take lower than approved doses and dose less frequently than daily as long as the dose and dosing frequency is consistent; Patients with documentation of inability to tolerate any statin at any dose, or history of rhabdomyolysis, may also participate;
• Stable diet and lipid-lowering oral therapies (such as statins, ezetimibe, bile-acid sequestrants, OM-3 compounds, fenofibrate, bezafibrate, nicotinic acid, and bempedoic acid) or combinations thereof for at least 4 weeks
• Patients on a PCSK9 mAb at a dose of 75 mg, 140 mg, or 150 mg Q2W must undergo a washout period of ≥4 weeks after the last dose; for those on 300 mg or 420 mg Q4W (≤31 days) the washout period is ≥8 weeks following last dose;
• Females of childbearing potential must be using a highly effective form of birth control if sexually active and have a negative urine pregnancy test at the last Screening Visit;

Exclusion Criteria:

• Use of prohibited oral lipid-lowering agents mipomersen or lomitapide within 6 months of screening, gemfibrozil within 6 weeks of screening, apheresis within 2 months prior to randomization; received other investigational agent(s) such as PCSK9 or Lp(a) siRNA or locked nucleic acid-reducing agents within 12 months of the Screening Visit;
• Documented history of HoFH defined clinically or genetically
• History of any prior or active clinical condition or acute and/or unstable systemic disease compromising patient inclusion, at the discretion of the Investigator
• Females of childbearing potential who are sexually active, not using or unwilling to use a highly effective form of contraception, pregnant or breastfeeding, or who have a positive urine pregnancy test at the last Screening Visit;
• Moderate to severe renal dysfunction, defined as an eGFR <30 mL/min/1.73m2
• Active liver disease or hepatic dysfunction, history of liver transplant, and/or ALT or AST >2.5 × the ULN as determined by central laboratory analysis at screening
• Uncontrolled thyroid disease: hyperthyroidism or hypothyroidism
• Uncontrolled Type 1 or Type 2 DM, defined as FBS ≥200 mg/dL or HbA1C ≥9%;
• Uncontrolled serious cardiac arrhythmia, MI, unstable angina, PCI, CABG, placement of implantable cardioverter defibrillator or biventricular pacemaker, aortic valve surgery, or stroke within 3 months prior to the Screening Visit;
• Planned cardiac surgery or revascularization;
• New York Heart Association class III-IV heart failure

Contacts and Locations

Locations

United States, Ohio

Sterling Research Group

Cincinnati, Ohio, United States, 45219

The Lindner Research Center

Cincinnati, Ohio, United States, 45219

Metabolic & Atherosclerosis Research Center (MARC)

Cincinnati, Ohio, United States, 45227

India

G.B. Pant Institute of Postgraduate Medical Education & Research

New Delhi, India, 110002

Israel

Department of Medicine, Hadassah University Hospital

Jerusalem, Israel, 12000

Rabin Medical Center, Beilinson Hospital,

Petah Tikva, Israel, 49100

Sponsors and Collaborators

LIB Therapeutics LLC

Medpace, Inc.

Investigators

• Study Director: Evan A Stein, MD PhD; LIB Therapeutics

More Information

• Responsible Party: LIB Therapeutics LLC
• ClinicalTrials.gov Identifier: NCT04806893
• Other Study ID Numbers: LIB003-006
• First Posted: March 19, 2021
• Last Update Posted: December 11, 2023
• Last Verified: December 2023

• Studies a U.S. FDA-regulated Drug Product: Yes
• Studies a U.S. FDA-regulated Device Product: No

Keywords provided by LIB Therapeutics LLC:

lerodalcibep; PCSK9 inhibitor

Additional relevant MeSH terms:

Cardiovascular Diseases; Myocardial Infarction; Hypercholesterolemia; Hyperlipidemias; Dyslipidemias; Lipid Metabolism Disorders; Metabolic Diseases; Myocardial Ischemia; Heart Diseases; Vascular Diseases; Infarction; Ischemia; Pathologic Processes; Necrosis