The goal of this trial is to study the effects of AEGR-733 on LDL cholesterol, other lipids as well as measures of safety over the long-term.
Homozygous familial hypercholesterolemia (FH) is a serious life-threatening genetic disease. Total plasma cholesterol levels are generally over 500 mg/dl and markedly premature cardiovascular disease is the major consequence. Untreated, most patients develop atherosclerosis before age 20 and generally do not survive past age 30. The primary goal of therapy involves reducing cholesterol (specifically, LDL cholesterol) and preventing coronary artery disease. Unfortunately, patients with homozygous FH are minimally responsive or unresponsive to available drug therapy and thus there are limited treatment options. The current standard of care is LDL apheresis, a physical method of removing the plasma of LDL cholesterol which can transiently reduce cholesterol by more than 50%. However, there is rapid re-accumulation of LDL cholesterol in plasma, and therefore apheresis has to be repeated frequently (every 1-2 weeks) and requires 2 separate sites for IV access. Although anecdotally this procedure may delay the onset of atherosclerosis, it is laborious, expensive, and not readily available. Furthermore, although it is a procedure that is generally well tolerated, the fact that it needs frequent repetition and IV access can be challenging for many of these young patients. Therefore, there is a tremendous unmet medical need for new medical therapies for this orphan disease. AEGR-733 is a novel oral therapeutic agent for hypercholesterolemia. Its mechanism involves inhibition of microsomal triglyceride transfer protein, resulting in a reduction of LDL cholesterol. Earlier studies in patients with homozygous FH reveal AEGR-733 is highly effective in lowering LDL cholesterol, yet long term safety and efficacy need to be established.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
29
5-80 mg daily by mouth for 1.5 yrs
Cedars-Sinai Medical Center
Los Angeles, California, United States
University of Pennsylvania
Philadelphia, Pennsylvania, United States
Robarts Research Institute
London, Ontario, Canada
Percent Change From Baseline in Low-density Lipoprotein Cholesterol (LDL-C)
Percent change from Baseline in LDL-C
Time frame: Baseline and Week 26
Percent Change From Baseline in Total Cholesterol (TC)
Percent change from Baseline in TC
Time frame: Baseline and Week 26
Percent Change From Baseline for Apolipoprotein B (Apo B)
Percent change from Baseline for Apo B
Time frame: Baseline and Week 26
Percent Change From Baseline in Triglycerides
Percent change from Baseline in triglycerides
Time frame: Baseline and Week 26
Percent Change From Baseline in High Density Lipoprotein Cholesterol (HDL-C)
Percent change from Baseline in HDL-C
Time frame: Baseline and Week 26
Percent Change From Baseline in Non-HDL-C
Percent change from Baseline in non-HDL-C
Time frame: Baseline and Week 26
Percent Change From Baseline in Apolipoprotein AI (Apo AI)
Percent change from Baseline in Apo AI
Time frame: Baseline and Week 26
Absolute Change From Baseline in Hepatic Fat Percent
Absolute change from Baseline in hepatic fat percent
Time frame: Baseline and Week 78
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Lipid Clinic and University of Montreal Community Genomic Medicine Center
Chicoutimi, Quebec, Canada
Dipartimento di Medicina Clinica e Della Patalogie Emergenti
Palermo, Sicily, Italy
Medicina Interna Universitaria
Ferrara, Italy
Centro Universitario Dislipidemie
Milan, Italy
Dipartimento di Clinica e Terapia Medica
Roma, Italy
Cardiology Research
Bloemfontein, South Africa
University of Capetown
Cape Town, South Africa
Absolute Change From Baseline in Alanine Aminotransferase (ALT)
Absolute change from Baseline in ALT
Time frame: Baseline and Week 78
Absolute Change From Baseline in Aspartate Aminotransferase (AST)
Absolute change from Baseline in AST
Time frame: Baseline and Week 78
Absolute Change From Baseline in Total Bilirubin
Absolute change from Baseline in total bilirubin
Time frame: Baseline and Week 78
Absolute Change From Baseline in Weight
Absolute change from Baseline in weight
Time frame: Baseline and Week 78