This is a randomized, double-blinded, placebo controlled, two periods phase 3 clinical study. The primary objective of the study is to evaluate the efficacy and safety of VSA001 injection in Chinese adults with familial chylomicronemia syndrome (FCS). A total of approximately 30 participants will be enrolled in the study.
Familial chylomicronemia syndrome (FCS) is a severe and ultrarare genetic disease, with a prevalence of approximately 1 in 1,000,000, often caused by various monogenic mutations. FCS leads to extremely high fasting triglyceride (TG) levels, typically over 900 mg/dL. Such severe elevations lead to various serious signs and symptoms including acute pancreatitis (which can be fatal), chronic daily abdominal pain, type 2 diabetes mellitus, hepatic steatosis, and cognitive issues. APOC3 is an 8.8 kilodalton (kDa) protein component of triglyceride-rich lipoproteins (TRLs) such as very-low-density lipoprotein cholesterol (VLDL-C), intermediate density lipoprotein cholesterol (IDL-C), chylomicrons, high-density lipoprotein cholesterol (HDL-C), and remnant particle lipoproteins. APOC3 is synthesized predominantly in hepatocytes. It inhibits the hydrolysis of TG on TRLs at the muscle and adipose tissue capillary level through inhibition of lipoprotein lipase (LPL), and delays clearance of lipoprotein remnants by the liver by inhibiting hepatocyte receptor-mediated uptake. APOC3 functions as a key regulator of fasting and postprandial plasma TG levels. VSA001 is a synthetic, double-stranded, hepatocyte-targeted RNA interference (RNAi) trigger (also referred to as a small interfering RNA \[siRNA\]) designed to specifically silence messenger RNA (mRNA) transcripts from the APOC3 gene using an RNAi mechanism. Given the important role of APOC3 in serum TG level modulation and its primary source of synthesis in hepatocytes, reduction of APOC3 through a hepatocyte-targeted RNAi strategy is likely to reduce circulating TG, benefiting several patient populations, including patients with FCS.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
37
also referred to as ARO-APOC3
Matching VSA001 injection
Huashan Hospital Affiliated to Fudan University
Shanghai, Shanghai Municipality, China
Change of Fasting Triglyceride (TG) by Month 10
Percent change from baseline at Month 10 in fasting TG
Time frame: Baseline, month 10
Change of Fasting TG at Months 10 and 12 (Averaged)
Percent change from baseline at Months 10 and 12 (averaged) in fasting TG
Time frame: Baseline, Months 10 and 12 (averaged)
Change of Fasting APOC3 by Month 10
Percent change from baseline at Month 10 in fasting APOC3
Time frame: Baseline, month 10
Change of Fasting APOC3 by Month 12
Percent change from baseline at Month 12 in fasting serum APOC3
Time frame: Baseline, month 12
Change of Fasting Serum Non-high Density Lipoprotein Cholesterol (Non-HDL-C) and HDL-C by Month 10
Percent change from baseline at Month 10 in fasting serum non-high density lipoprotein cholesterol (non-HDL-C) and HDL-C
Time frame: Baseline, month 10
Change of Fasting Serum TG, Non-HDL-C, and HDL-C by Month 12
Percent change from baseline at Month 12 in fasting serum TG, non-HDL-C, and HDL-C
Time frame: Baseline, Month 12
Participants Achieving Fasting Serum TG of <500 mg/dL at Month 10
Proportion of participants achieving fasting serum TG of \<500 mg/dL at Month 10
Time frame: Month 10
Participants Achieving Fasting Serum TG of <500 mg/dL at Month 12
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Proportion of participants achieving fasting serum TG of \<500 mg/dL at Month 12
Time frame: Month 12
Change From Baseline at Each Scheduled Assessment in Fasting Serum TG up to Month 12
Change from baseline at each scheduled assessment in fasting serum TG up to Month 12(including month 1,2,3,4,5,6,7,8,9,10,11,12)
Time frame: From baseline up to Month 12
Percent Change From Baseline at Each Scheduled Assessment in Fasting Serum TG up to Month 12
Percent change from baseline at each scheduled assessment in fasting serum TG up to Month 12(including month 1,2,3,4,5,6,7,8,9,10,11,12)
Time frame: From baseline up to Month 12
Incidence of TEAEs in the Participants
Incidence of TEAEs in the participants
Time frame: From treatment with VSA001 to 12 months
Incidence of Positively Adjudicated Events of Acute Pancreatitis
Any AEs and SAEs reported by the investigator during the study that were consistent with acute pancreatitis events were adjudicated by the blinded Data Safety Committee based on the Atlanta Classification for Acute Pancreatitis 2013 for fulfillment of any 2 of the following 3 criteria: 1. Abdominal pain consistent with symptoms of acute pancreatitis (acute episodes of persistent, severe upper abdominal pain often radiating to the back) 2. Serum lipase activity (or amylase activity) ≥3 × upper limit of normal (ULN) 3. Characteristic findings of acute pancreatitis on contrast-enhanced computed tomography (CECT) or magnetic resonance imaging (MRI) or transabdominal ultrasonography
Time frame: From treatment with VSA001 to 12 months