Prevention & lipidsRandomised controlled trial

Efficacy and Safety of Lerodalcibep in Patients With or at High Risk of Cardiovascular Disease

JAMA CardiolPublished

  • Randomised controlled trial
  • double-blind
  • placebo-controlled
  • phase 3
  • 66 clinics in 11 countries
  • April 23, 2021, to November 15, 2023

Authors' conclusion

In this trial, lerodalcibep, a novel anti-PCSK9 small binding protein, dosed monthly and stable at ambient temperatures significantly reduced LDL-C in patients with CVD or at high risk of atherosclerotic cardiovascular disease with a safety profile similar to placebo.

Study context

Population
Adults on maximally tolerated statin with low-density lipoprotein cholesterol (LDL-C) ≥70 mg/dL with cardiovascular disease (CVD) or ≥100 mg/dL at high risk of CVD811 (88%) completed
Participants
922 adults
Comparison
Lerodalcibep vs placebo
Primary endpoint
Percent change from baseline in LDL-C at week 52 and the mean of weeks 50 and 52 (co-primary)
Follow-up
Week 52; mean of weeks 50 and 52

Primary result

As reported in the abstract

Placebo-adjusted reduction in LDL-C
week 52, modified intention-to-treat (mITT); SE 2.2%
mean placebo-adjusted reduction 56.2 %; P < 0.001
mean of weeks 50 and 52, mITT; SE 1.9%
mean placebo-adjusted reduction 62.7 %; P < 0.001
week 52, ITT with washout imputation; SE 2.4%
mean placebo-adjusted reduction 49.7 %; P < 0.001
mean of weeks 50 and 52, ITT with washout imputation; SE 2.2%
mean placebo-adjusted reduction 55.3 %; P < 0.001
week 52, per-protocol; SE 2.3%
mean placebo-adjusted reduction 60.3 %; P < 0.001
mean of weeks 50 and 52, per-protocol; SE 1.9%
mean placebo-adjusted reduction 65.9 %; P < 0.001

Secondary outcomes

OutcomeLerodalcibepPlacebo
LDL-C reduction ≥50% and recommended LDL-C targets achieved · during the study90%Not reported in the abstract
  • LDL-C reduction ≥50% and recommended LDL-C targets achieved: 555 of 615

Safety

Injection site reactions

Treatment discontinuation

  • Injection site reactions: 42 of 613 vs 1 of 307; graded mild or moderate
  • Treatment discontinuation: 26 of 613 vs 14 of 307

Treatment-emergent adverse events

Similar between lerodalcibep and placebo, except injection site reactions

Original publication

Efficacy and Safety of Lerodalcibep in Patients With or at High Risk of Cardiovascular Disease. JAMA Cardiol. Published 1 September 2024. doi:10.1001/jamacardio.2024.1659

Summarised from the published abstract; every number is checked against it