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Alirocumab in patients with heterozygous familial hypercholesterolaemia undergoing lipoprotein apheresis: the ODYSSEY ESCAPE trial

Open access
Moriarty, Patrick M., Parhofer, Klaus G., Babirak, Stephan P., Cornier, Marc-Andre, Duell, P. Barton, Hohenstein, Bernd, Leebmann, Josef, Ramlow, Wolfgang, Schettler, Volker, Simha, Vinaya, Steinhagen-Thiessen, Elisabeth, Thompson, Paul D., Vogt, Anja, von Stritzky, Berndt, Du, Yunling, Manvelian, Garen·2016·European Heart Journal

Abstract

AIM: To evaluate the effect of alirocumab on frequency of standard apheresis treatments [weekly or every 2 weeks (Q2W)] in heterozygous familial hypercholesterolaemia (HeFH). METHODS AND RESULTS: ODYSSEY ESCAPE (NCT02326220) was a double-blind study in 62 HeFH patients undergoing regular weekly or Q2W lipoprotein apheresis. Patients were randomly assigned (2:1, respectively) to receive alirocumab 150 mg (n = 41) or placebo (n = 21) Q2W subcutaneously for 18 weeks. From day 1 to week 6, apheresis rate was fixed according to the patient's established schedule; from weeks 7 to 18, apheresis rate was adjusted based on the patient's low-density lipoprotein cholesterol (LDL-C) response in a blinded fashion. Apheresis was not performed when the LDL-C value was ≥30% lower than the baseline (pre-apheresis) value. The primary efficacy endpoint was the rate of apheresis treatments over 12 weeks (weeks 7-18), standardized to number of planned treatments. In the alirocumab group the least square (LS) mean ± SE (95% confidence interval [CI]) per cent change in pre-apheresis LDL-C from baseline at week 6 was -53.7 ± 2.3 (-58.2 to - 49.2) compared with 1.6 ± 3.1 (-4.7 to 7.9) in the placebo group. The primary efficacy endpoint showed statistically significant benefit in favour of alirocumab (Hodges-Lehmann median estimate of treatment difference: 0.75; 95% CI 0.67-0.83; P < 0.0001). Therefore, alirocumab-treated patients had a 0.75 (75%) additional reduction in the standardized rate of apheresis treatments vs. placebo-treated patients. During this period, 63.4% of patients on alirocumab avoided all and 92.7% avoided at least half of the apheresis treatments. Adverse event rates were similar (75.6% of patients on alirocumab vs. 76.2% on placebo). CONCLUSIONS: Lipoprotein apheresis was discontinued in 63.4% of patients on alirocumab who were previously undergoing regular apheresis, and the rate was at least halved in 92.7% of patients. Alirocumab was generally safe and well tolerated.

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Metadata

Authors
Moriarty, P. M., Parhofer, K. G., Babirak, S. P., Cornier, M.-A., Duell, P. B., Hohenstein, B., Leebmann, J., Ramlow, W., Schettler, V., Simha, V., Steinhagen-Thiessen, E., Thompson, P. D., Vogt, A., von Stritzky, B., Du, Y., & Manvelian, G.
Venue
European Heart Journal
Published
2016-08-29
Volume
37
Issue
48
Pages
3588-3595
ISSN
  • 0195-668X (ISSN-L)
  • 1522-9645
OpenAlex
W2512572393
Cited by
197
References
5
FWCI
36.51
Type
journal article
Language
en
Open access
hybrid

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Moriarty, P. M., Parhofer, K. G., Babirak, S. P., Cornier, M.-A., Duell, P. B., Hohenstein, B., Leebmann, J., Ramlow, W., Schettler, V., Simha, V., Steinhagen-Thiessen, E., Thompson, P. D., Vogt, A., von Stritzky, B., Du, Y., & Manvelian, G. (2016). Alirocumab in patients with heterozygous familial hypercholesterolaemia undergoing lipoprotein apheresis: the ODYSSEY ESCAPE trial. European Heart Journal. https://doi.org/10.1093/eurheartj/ehw388

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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).

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