This is a Phase II clinical study to evaluate the effectiveness and safety of different doses of DNV001 injection in patients with primary hypercholesterolemia or mixed dyslipidemia who have not achieved adequate control of low-density lipoprotein cholesterol (LDL-C) despite statin therapy. The study will enroll approximately 120 participants and will be conducted at 10-15 centers in China. Participants will be randomly assigned to one of four dose groups (50 mg, 150 mg, 300 mg-1, or 300 mg-2) or placebo, administered as subcutaneous injections. The study includes a 2-week screening period, a 4-week run-in period, a 36-week double-blind treatment period, and a 12-week follow-up period, for a total of up to 54 weeks. The main goal is to see how much DNV001 lowers LDL-C levels after 24 weeks of treatment. The study will also look at long-term effectiveness, safety, how the body processes the drug, and whether it causes an immune response. All participants will continue taking their stable dose of statin medication throughout the study.
Study Title: A Multicenter, Randomized, Double-Blind, Placebo-Controlled Phase II Clinical Study to Evaluate the Efficacy and Safety of Different Doses of DNV001 Injection in Patients with Primary Hypercholesterolemia or Mixed Dyslipidemia with Elevated LDL-C Despite Statin Therapy. Sponsor: Hangzhou Dinovate Biotech Co., Ltd. Protocol Number: DNV001-201 Phase: Phase II Study Design: This is a randomized, double-blind, multicenter, placebo-controlled study. Eligible participants will be assigned in a 1:1:1:1 ratio to one of four dose groups: 50 mg, 150 mg, 300 mg-1, or 300 mg-2. Within each dose group, participants will be further randomized 4:1 to receive either DNV001 or placebo. Each dose group will include 24 participants receiving active drug and 6 receiving placebo, for a total of approximately 96 active and 24 placebo participants. Study Duration: Each participant will be involved for up to 54 weeks, including: * Screening: 2 weeks * Run-in: 4 weeks * Double-blind treatment: 36 weeks * Follow-up: 12 weeks Key Eligibility Criteria: Inclusion: * Adults ≥18 years with primary hypercholesterolemia or mixed dyslipidemia * Inadequate LDL-C control despite stable statin therapy * Fasting LDL-C ≥70 mg/dL (with ASCVD history) or ≥100 mg/dL (without ASCVD history) * Fasting triglycerides ≤400 mg/dL * Willing to comply with study visits and lifestyle/dietary guidelines Exclusion: * Homozygous familial hypercholesterolemia * Recent major cardiovascular event or procedure * Uncontrolled hypertension, diabetes, or thyroid disease * Significant liver, kidney, or heart disease * Use of other lipid-lowering therapies (except stable statins) * Recent participation in another clinical trial Endpoints: Primary: · Percent change in LDL-C from baseline at Week 24. Secondary: * Percent change in LDL-C at other timepoints up to Week 48 * Proportion of participants achieving LDL-C reduction ≥50%, LDL-C \<70 mg/dL, etc. * Safety (adverse events, lab abnormalities, ECG, vital signs) * Pharmacodynamics (PCSK9, lipids, lipoproteins) * Pharmacokinetics (Cmax, Tmax, AUC) * Immunogenicity (anti-drug antibodies) Intervention: DNV001 or matching placebo will be administered subcutaneously in the abdomen, upper arm, or thigh. Dosing schedules vary by group (e.g., 50 mg group: doses at Day 1, Week 12, Week 36; 300 mg-2 group: Day 1 and Week 24). Statistical Methods: Analyses will be performed on the Full Analysis Set, Per Protocol Set, and Safety Set. The primary endpoint will be analyzed using a mixed model for repeated measures. Safety and other endpoints will be summarized descriptively.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
120
DNV001 is a human monoclonal antibody targeting PCSK9 (proprotein convertase subtilisin/kexin type 9), administered as a sterile solution for subcutaneous injection. It is supplied in a 1.5 mL type I borosilicate glass vial with a concentration of 200 mg/mL (300 mg per vial). The product should be stored at or below 25°C and must not be frozen
Matching placebo for DNV001 injection. It is identical in appearance, packaging, and administration route to the active drug, but does not contain the active pharmaceutical ingredient. Supplied in a 1.5 mL vial for subcutaneous injection and stored under the same conditions (≤25°C, do not freeze).
To evaluate the efficacy of DNV001 in subjects with primary hypercholesterolaemia or mixed hyperlipidaemia with elevated LDL-C levels
Percent change from baseline in LDL-C levels at Week 24 (W24).
Time frame: Baseline to Week 24
To evaluate other efficacy measures of DNV001 in subjects with primary hypercholesterolaemia or mixed hyperlipidaemia with elevated LDL-C levels
● Key secondary endpoints: Percent change from baseline in LDL-C levels at Week 48 (W48);
Time frame: Baseline to Week 48
To evaluate other efficacy measures of DNV001 in subjects with primary hypercholesterolaemia or mixed hyperlipidaemia with elevated LDL-C levels
● Percent change from baseline in LDL-C levels at W2, W4, W8, W12, W14, W16, W20, W28, W32, W36, W40, W44;
Time frame: Baseline to Week 48
To evaluate other efficacy measures of DNV001 in subjects with primary hypercholesterolaemia or mixed hyperlipidaemia with elevated LDL-C levels
● Proportion of subjects whose LDL-C levels are restored to 80% or more of baseline levels at W24, W36, and W48;
Time frame: Baseline to Week 48
To evaluate other efficacy measures of DNV001 in subjects with primary hypercholesterolaemia or mixed hyperlipidaemia with elevated LDL-C levels
● Proportion of subjects whose LDL-C levels have decreased by ≥ 50% from baseline at W24, W36, and W48;
Time frame: Baseline to Week 48
To evaluate other efficacy measures of DNV001 in subjects with primary hypercholesterolaemia or mixed hyperlipidaemia with elevated LDL-C levels
● Proportions of subjects with LDL-C \< 0.65 mmol/L (25 mg/dL), \< 1.3 mmol/L (50 mg/dL), \< 1.8 mmol/L (70 mg/dL), and \< 2.6 mmol/L (100 mg/dL) at W24, W36, and W48;
Time frame: Baseline to Week 48
To evaluate other efficacy measures of DNV001 in subjects with primary hypercholesterolaemia or mixed hyperlipidaemia with elevated LDL-C levels
● Proportion of subjects achieving the LDL-C target according to atherosclerotic cardiovascular disease (ASCVD) risks categories at W24, W28, W32, W36, W40, W44, and W48.
Time frame: Baseline to Week 48
To evaluate the safety of DNV001 in subjects with primary hypercholesterolaemia or mixed hyperlipidaemia with elevated LDL-C levels
● The incidence and severity of adverse events (AEs) and serious adverse events (SAEs) during the study;
Time frame: Baseline to Week 48
To evaluate the safety of DNV001 in subjects with primary hypercholesterolaemia or mixed hyperlipidaemia with elevated LDL-C levels
● Abnormal changes in laboratory tests, electrocardiograms (ECGs), vital signs, physical examinations, etc. during the study.
Time frame: Baseline to Week 48
To characterize the pharmacodynamics (PD) of DNV001 in subjects with primary hypercholesterolaemia or mixed hyperlipidaemia with elevated LDL-C levels
● Changes from baseline in the levels of PCSK9 and other lipid levels, lipoprotein, and apolipoprotein (including triglycerides \[TG\], total cholesterol \[TC\], high density lipoprotein cholesterol \[HDL-C\], apolipoprotein A1 \[ApoA1\], apolipoprotein B \[ApoB\], small dense low density lipoprotein \[sdLDL-C\], and lipoprotein(a) \[Lp(a)\]) at each assessment time point.
Time frame: Baseline to Week 48
To characterize the pharmacokinetics (PK) of DNV001 in subjects with primary hypercholesterolaemia or mixed hyperlipidaemia with elevated LDL-C levels
● Analysis of blood concentrations and PK parameters of DNV001 (including peak concentration \[Cmax\] at specific treatment time points in individuals and groups.
Time frame: Baseline to Week 48
To characterize the pharmacokinetics (PK) of DNV001 in subjects with primary hypercholesterolaemia or mixed hyperlipidaemia with elevated LDL-C levels
● Analysis of blood concentrations and PK parameters of DNV001 including time to peak concentration \[Tmax\] at specific treatment time points in individuals and groups.
Time frame: Baseline to Week 48
To characterize the pharmacokinetics (PK) of DNV001 in subjects with primary hypercholesterolaemia or mixed hyperlipidaemia with elevated LDL-C levels
● Analysis of blood concentrations and PK parameters of DNV001 including area under the time-concentration curve \[AUC\], etc.) at specific treatment time points in individuals and groups.
Time frame: Baseline to Week 48
To evaluate the immunogenicity of DNV001.
● Incidence of anti-drug antibodies (ADA) (including the positive rate and antibody titers of ADA).
Time frame: Baseline to Week 48
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