Approval Probability
TA Base Rate
Adjusted LOA
ML Risk
Also known as Bempedoic acid
Bempedoic acid+ Ezetimibe · 10 trials · 9 indications
Blood samples were drawn after a minimum 10-hour fast (water was allowed) at pre-specified intervals. Samples were collected and analyzed for LDL-C. Baseline was defined as the mean of the LDL-C values from Week -2 and predose Day 1/Week 0. Percent change from baseline in LDL-C was analyzed using analysis of covariance (ANCOVA) with treatment group and randomization stratification as a factors and baseline LDL-C as a covariate. Percent change from baseline was calculated as: (\[LDL-C value at Week 12 minus Baseline value\] divided by \[Baseline Value\]) multiplied by 100. For LDL-C, if measured LDL-C value was available, measured LDL-C was used.
TEAEs are defined as adverse events that began or worsened in severity after the first dose of investigational medicinal product (IMP) until 30 days after the last dose in the Open-Label Extension (OLE) Study.
The primary efficacy end point was a four-component composite of adjudicated MACE, defined as death from cardiovascular causes, nonfatal myocardial infarction, nonfatal stroke, or coronary revascularization, as assessed in a time-to first-event analysis.
PCFB was calculated as the (\[post-Baseline (BL) value minus the BL value\] divided by the BL value ) x 100. BL was defined as the mean of the last two non-missing values on or prior to Day 1. If only one value was available, that single value was used as BL. PCFB in LDL-C was analyzed using analysis of covariance (ANCOVA), with treatment group and stratification factor (primary prevention; secondary prevention) as fixed effects and BL as a covariate. For participants with missing lipid data at Week 12 who were no longer taking study treatment, missing values were imputed using multiple imputation via a regression-based model including stratification and BL data from placebo participants only. In this imputation model, treatment group was not included. For participants with missing lipid data at Week 12 who were still taking study treatment, missing values were imputed using multiple imputation via a regression-based model including treatment, stratification and BL value.
Blood plasma samples were collected and analyzed to determine the plasma trough concentration of ETC-1002 following 8 weeks of steady-state dosing of bempedoic acid. The data presented here is for participants who received tablet formulation only.
Blood plasma samples were collected and analyzed to determine the AUC,24ss of ETC-1002 over 24 hours. The data presented here is for participants who received tablet formulation only.
Blood plasma samples were collected and analyzed to determine the Cavg,ss of ETC-1002. Cavg was calculated by empirical Bayesian estimated pediatric exposure over 24 hours divided by 24 (AUC24hr.ss / 24). The data presented here is for participants who received tablet formulation only.
Blood plasma samples were collected and analyzed to determine the Cmax,ss of ETC-1002. The data presented here is for participants who received tablet formulation only.
Blood samples were drawn after a minimum 10-hour fast at pre-specified intervals. Samples were collected and analyzed for LDL-C. Baseline was defined as the average of LDL-C values at the Screening Visit 3 (Visit S3) and the Treatment Visit 1 (Visit T1) (last 2 non-missing values on or prior to Day 1). If only 1 value was available, the single value was used as Baseline. Percent change from Baseline for LDL-C was analyzed using analysis of covariance (ANCOVA), with treatment as factor and Baseline lipid parameter as a covariate. Missing data for LDL-C was imputed using the last observation carried forward (LOCF) method. Percent change from Baseline was calculated as: (\[LDL-C value at Week 12 minus Baseline value\] divided by \[Baseline value\]) multiplied by 100. For LDL-C, if a measured LDL-C value was available, measured LDL-C was used.
Percent change from Baseline is calculated as the (\[post-Baseline value minus the Baseline value\] divided by the Baseline value ) x 100. Baseline is defined as the average of the last two non-missing values within Month -1 (Screening Visit 4) and Day 1 (Treatment Visit 1) values (including unscheduled assessments). If only one value was available, then that single value was used at Baseline. Percent change from Baseline was analyzed using analysis of covariance (ANCOVA), with treatment group as a factor and Baseline as a covariate. Missing data were imputed using last observation carried forward (LOCF) (only post-Baseline values were carried forward).
Percent change from Baseline is calculated as the (\[post-Baseline value minus the Baseline value\] divided by the Baseline value ) x 100. Baseline is defined as the mean of the values from Week -1 (Screening Visit 2) and predose Day 1/Week 0 (Treatment Visit 1). Percent change from Baseline in LDL-C was analyzed using analysis of covariance (ANCOVA) with treatment group as a factor and Baseline value as a covariate. Missing LDL-C values were imputed using last observation carried forward (LOCF), with only post-Baseline values carried forward. If LDL-C was measured (i.e., if TG was \>400 mg/dL or LDL-C was \<50 mg/dL), the measured values were used in the analysis.
| Arm | Type | Description |
|---|---|---|
| BA 180 mg + EZE 10 mg FDC | EXPERIMENTAL | Bempedoic acid (BA) + ezetimibe (EZE) fixed-dose combination (FDC) 180 mg/10 mg tablets taken orally once daily for 12 weeks |
| BA 180 mg | EXPERIMENTAL | Bempedoic acid (BA) 180 mg tablets taken orally once daily for 12 weeks |
| EZE 10 mg | ACTIVE_COMPARATOR | Ezetimibe (EZE) 10 mg overencapsulated tablets taken orally once daily for 12 weeks |
| Placebos | PLACEBO_COMPARATOR | Placebos to match identical bempedoic acid + ezetimibe fixed-dose combination (FDC) 180 mg/10 mg tablet, or identical bempedoic acid 180 mg tablet, or identical ezetimibe 10 mg capsule, taken orally, once daily for 12 weeks |
| Open-Label bempedoic acid | EXPERIMENTAL | bempedoic acid 180 mg tablet |
| Bempedoic Acid 180 mg | EXPERIMENTAL | Bempedoic acid 180 mg tablet taken orally, once daily. |
| Placebo Comparator | PLACEBO_COMPARATOR | Matching placebo tablet taken orally, once daily |
| bempedoic acid | EXPERIMENTAL | bempedoic acid 180 mg tablet taken orally, daily. Patients remain on ongoing ezetimibe therapy (study provided) |
| placebo | PLACEBO_COMPARATOR | Matching placebo tablet taken orally, daily. Patients remain on ongoing ezetimibe therapy (study provided) |
| Cohort 1 | EXPERIMENTAL | Participants at 16 to \<30 kilograms (kg) body weight at screening receiving once daily 60 milligrams (mg) bempedoic acid for 8 weeks followed by 90 mg bempedoic acid for 8 weeks. |
| Cohort 2 | EXPERIMENTAL | Participants at 30 to 60 kg body weight at screening receiving once daily120 mg bempedoic acid for 8 weeks followed by 150 mg bempedoic acid for 8 weeks. |
| Cohort 3 | EXPERIMENTAL | Participants at greater than 60 kg body weight at screening receiving once daily 180 mg bempedoic acid for 8 weeks. |
| Bempedoic acid + Ezetimibe FDC | EXPERIMENTAL | Bempedoic acid + Ezetimibe FDC Oral Tablet; Placebo oral capsule |
| Ezetimibe 10 mg | ACTIVE_COMPARATOR | Ezetimibe 10Mg Oral Tablet; Placebo Oral Tablet |
| Triplet Therapy | EXPERIMENTAL | Bempedoic acid 180 mg, ezetimibe 10 mg, and atorvastatin 20 mg taken orally, daily. |
| Name | Type | Description |
|---|---|---|
| Bempedoic Acid + Ezetimibe Fixed-Dose Combination | COMBINATION_PRODUCT | bempedoic acid + ezetimibe FDC 180 mg/10 mg tablet |
| Bempedoic Acid | DRUG | bempedoic acid 180 mg tablet |
| Ezetimibe | DRUG | ezetimibe 10 mg overencapsulated tablet |
| Placebos | DRUG | placebo tablet or capsule to match bempedoic acid + ezetimibe fixed-dose combination (FDC) 180 mg/10 mg tablet, or bempedoic acid 180 mg tablet, or ezetimibe 10 mg capsule |
| Bempedoic acid 180 mg tablet | DRUG | Patients take bempedoic acid 180 mg tablet orally once daily |
| Matching placebo tablet | DRUG | Patients take matching placebo tablet orally once daily |
| Placebo | OTHER | matching placebo tablet |
| Bempedoic acid + Ezetimibe FDC Oral Tablet | DRUG | Experimental therapy of bempedoic acid 180 mg + ezetimibe 10 mg FDC tablet |
| Ezetimibe 10 mg Oral Tablet | DRUG | Ezetimibe 10 mg tablet, overencapsulated for blinding purposes |
| Placebo Oral Tablet | DRUG | Placebo tablet, matched for the FDC product for blinding purposes |
| Placebo oral capsule | DRUG | Placebo over-encapsulated for blinding purposes |
| bempedoic acid 180mg | DRUG | Daily bempedoic acid 180mg tablet in addition to monthly PCSK9i (evolocumab) background therapy |
| evolocumab | DRUG | Monthly PCSK9i (evolocumab) background therapy |
| Ezetimibe 10mg | DRUG | ezetimibe 10 mg |
| Atorvastatin 20mg | DRUG | atorvastatin 20 mg |
Inclusion Criteria: * Require lipid-modifying therapy for primary or secondary prevention of cardiovascular disease * Fasting LDL-C ≥ 130 mg/dL for primary prevention or LDL-C ≥ 100 mg/dL for secondary prevention (history of HeFH and/or ASCVD) * Treated with maximally tolerated statin therapy at st...
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Bempedoic acid + ezetimibe is a fixed-dose combination oral tablet being developed for cardiovascular diseases, diabetes, hypercholesterolemia, and hyperlipidemias. It combines bempedoic acid 180 mg with ezetimibe in a single tablet. Esperion Therapeutics, Inc. (ticker: ESPR) is developing the combination, which is in Phase 3 clinical development.
Bempedoic acid + ezetimibe is being studied for cardiovascular diseases, diabetes, hypercholesterolemia, and hyperlipidemias, including elevated LDL-C in patients with type 2 diabetes and in patients on maximally tolerated statin therapy. It is an investigational fixed-dose combination and is in Phase 3 clinical development.
Bempedoic acid, one component of the fixed-dose combination, targets ACLY (ATP citrate lyase) and acts as an inhibitor. Ezetimibe is the second component of the combination. The fixed-dose combination is a small molecule product developed by Esperion Therapeutics, Inc. (ticker: ESPR).
Esperion Therapeutics, Inc., which trades under the ticker ESPR, is developing bempedoic acid + ezetimibe. The company is the developer of the fixed-dose combination oral tablet, which is in Phase 3 clinical development for cardiovascular diseases, diabetes, hypercholesterolemia, and hyperlipidemias.
Bempedoic acid + ezetimibe is in Phase 3 clinical development. Seven trials of the program are listed as completed, with a total enrollment of 13,970 participants across randomized, double-blind, placebo-controlled studies. It is an investigational fixed-dose combination and is not described as approved.
Completed trials include NCT03337308, a Phase 3 study of the bempedoic acid plus ezetimibe fixed-dose combination versus bempedoic acid, ezetimibe, and placebo in patients on maximally tolerated statin therapy, and NCT03531905, a Phase 2 fixed-dose combination study in patients with type 2 diabetes and elevated LDL-C. NCT03193047 evaluated bempedoic acid 180 mg added to PCSK9 inhibitor therapy.