News | Pharmaceuticals | September 12, 2017

ORION 1 Trial Shows Inclisiran Lowers Bad Cholesterol Up to One Year

September 12, 2017 — Inclisiran lowers low-density lipoprotein (LDL, or “bad”) cholesterol for up to one year in patients with high cardiovascular risk and elevated LDL cholesterol, according to late-breaking results from the ORION 1 trial presented at the 2017 European Society of Cardiology (ESC) Congress.

“The ease of dosing – small volume subcutaneous injections twice a year most likely given by healthcare professionals – promises to improve patient adherence to lipid therapy, which has been a real problem with all other approaches,” said principal investigator Prof. Kausik K. Ray, professor of public health, Imperial College London, U.K., and honorary consultant cardiologist, Imperial College NHS Trust.

ORION 1 is a multicentre, placebo-controlled, double-blind, randomised phase II study on the impact of single or multiple subcutaneous injections of inclisiran on LDL cholesterol reductions over one year. Inclisiran is a first-in-class investigational drug that acts by turning off PCSK9 synthesis in the liver. The objective was to identify the dose and dosing frequency required for the phase III trials.

The trial included 501 patients with atherosclerotic cardiovascular disease (ASCVD) and elevated LDL cholesterol (>70 mg/ml) despite maximum tolerated statin therapy and patients without ASCVD but with high cardiovascular risk conditions such as diabetes and familial hypercholesterolaemia in whom LDL cholesterol was >100 mg/dl despite maximally tolerated statin therapy.

Patients were randomised into eight treatment groups: a single dose regimen of 200, 300 or 500 mg inclisiran, or placebo; or a two dose regimen of 100, 200 or 300 mg inclisiran, or placebo, at days one and 90.

The primary endpoint was the percentage change in LDL cholesterol at six months for each dose of inclisiran versus placebo. As previously reported, the two dose 300 mg inclisiran regimen gave the greatest reduction in LDL cholesterol at six months. (2)

Today researchers report results of one of the secondary endpoints, which was the change in LDL cholesterol at one year with one or two doses of inclisiran. Against a background therapy of statins (73%), alone or with ezetimibe (31%), the time averaged reductions in LDL cholesterol at one year with a single dose of 200, 300 or 500 mg inclisiran were -31.6, -38.1 and -39.8 percent, respectively. The time averaged reductions in LDL cholesterol at one year with a two dose regimen of 100, 200 or 300 mg inclisiran were -31, -41.1 and -46.8 percent, respectively.

As expected based on predictive modelling, patients began to return to their baseline LDL cholesterol values by an average of 2–3% per month, meaning they will be back to their starting levels by about 18–21 months for the two dose groups. Every patient on the two dose regimen had a significant response and the mean LDL cholesterol reductions over time were practically constant. Safety was generally similar between inclisiran and placebo apart from a small numerical excess of injection site reactions with the study drug.

“These one year data affirm and extend the six month results,” Ray explained. “The two dose 300 mg regimen produced the greatest reductions in LDL cholesterol, with an average time-adjusted fall of almost 50 percent at one year. The sustained LDL cholesterol lowering effects of inclisiran were achieved without side effects and were accompanied by predictable and gradual reversal. The data support dosing twice a year after initial injections on days one and 90.”

The study was sponsored by The Medicines Company.

Disclosures: Prof Ray reports acting as Consultant to The Medicines Company.

For more information: http://congress365.escardio.org

 

Links to all the late-breaking ESC 2017 trial presentations.

Reference: 

1, Ray KK, et al. Inclisiran in patients at high cardiovascular risk with elevated LDL cholesterol. N Engl J Med. 2017;376(15):1430–1440. doi: 10.1056/NEJMoa1615758. Epub 2017 Mar 17.
https://www.ncbi.nlm.nih.gov/pubmed/28306389


Related Content

News | Cardiovascular Clinical Studies

November 29, 2023 — Inari Medical, Inc., a medical device company with a mission to treat and transform the lives of ...

Home November 29, 2023
Home
News | Cardiovascular Clinical Studies

November 29, 2023 — Foldax, Inc., a leader in the development of innovative, polymer heart valves, today announced ...

Home November 29, 2023
Home
News | Cardiovascular Clinical Studies

November 28, 2023 — Abiomed, part of Johnson & Johnson MedTech[1], announces the first patient in the world has been ...

Home November 28, 2023
Home
News | Cardiovascular Clinical Studies

November 27, 2023 — Esperion announced the presentation of results from a pre-specified, exploratory analysis of CLEAR ...

Home November 27, 2023
Home
News | Cardiovascular Clinical Studies

November 22, 2023 — The first clinical trial to challenge the routine implantation of a defibrillator in myocardial ...

Home November 22, 2023
Home
News | Cardiovascular Clinical Studies

November 15, 2023 — Researchers at the University of Leicester have discovered the mechanism by which cholesterol in our ...

Home November 15, 2023
Home
News | Cardiovascular Clinical Studies

November 6, 2023 — Bristol Myers Squibb announced that research across the company’s cardiovascular franchise will be ...

Home November 06, 2023
Home
News | Cardiovascular Clinical Studies

October 20, 2023 — JenaValve Technology, Inc., developer and manufacturer of the Trilogy Transcatheter Heart Valve (THV) ...

Home October 20, 2023
Home
News | Cardiovascular Clinical Studies

October 12, 2023 — BioCardia, Inc., a developer of cellular and cell-derived therapeutics for the treatment of ...

Home October 12, 2023
Home
Subscribe Now