A Randomized Trial Assessing the Effects of Inclisiran on Clinical Outcomes Among People With Cardiovascular Disease

NCT ID: NCT03705234

Last Updated: 2025-12-11

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

ACTIVE_NOT_RECRUITING

Clinical Phase

PHASE3

Total Enrollment

16124 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-10-30

Study Completion Date

2049-12-31

Brief Summary

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ORION-4 is a research study coordinated by the University of Oxford and co-sponsored by The University of Oxford and Novartis (Protocol: CTSU\_MDCO-PCS-17-01 (CKJX839B12301)). The study aims to find out if a new cholesterol-lowering injection (inclisiran) safely lowers the risk of heart attacks and strokes in people who have already had one of these conditions, or who have had an operation or procedure to treat blocked arteries.

Detailed Description

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The ORION-4 study aims to provide evidence about both the efficacy and safety of inclisiran. Inclisiran is a PCKS9 synthesis inhibitor which has been found to reduce LDL-cholesterol by about 50-60%. ORION-4 will investigate the effects of inclisiran on major adverse cardiovascular events.

The study is intended to be conducted at approximately 180 clinical sites in the UK and the USA. Approximately 15,000 participants aged 40 years or older for men, and 55 years or older for women, with pre-existing atherosclerotic cardiovascular disease will be randomized between inclisiran sodium 300 mg and matching placebo (given by subcutaneous injection on the day of randomization, at 3 months and then every 6-months) in a 1:1 ratio for a planned median duration of about 5 years.

Conditions

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Atherosclerotic Cardiovascular Disease

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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Inclisiran

Inclisiran sodium 300 milligrams (mg) will be administered as a SC injection at randomization, 3 months and then every 6 months.

Group Type EXPERIMENTAL

Inclisiran

Intervention Type DRUG

Inclisiran is a small interfering ribonucleic acid (RNA) that inhibits PCSK9 synthesis.

Placebo

Placebo will be administered as SC injections of saline solution at randomization, 3 months and then every 6 months.

Group Type PLACEBO_COMPARATOR

Placebo

Intervention Type DRUG

Placebo will be supplied as sterile normal saline (0.9% sodium chloride in water for injection).

Interventions

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Inclisiran

Inclisiran is a small interfering ribonucleic acid (RNA) that inhibits PCSK9 synthesis.

Intervention Type DRUG

Placebo

Placebo will be supplied as sterile normal saline (0.9% sodium chloride in water for injection).

Intervention Type DRUG

Other Intervention Names

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Saline solution

Eligibility Criteria

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Inclusion Criteria

History or evidence of at least one of the following:

* Prior MI; or
* Prior ischemic stroke; or
* Peripheral artery disease as evident by prior lower extremity artery revascularization or aortic aneurysm repair.

Minimum age is 40 years for men and 55 years for women

Exclusion Criteria

None of the following must be satisfied (based on self-reported medical history):

* Acute coronary syndrome or stroke less than 4 weeks before the Screening visit or during the Run-in period;
* Coronary revascularization procedure planned within the next 6 months;
* Known chronic liver disease;
* Current or planned renal dialysis or transplantation;
* Previous exposure to inclisiran or participation in a randomized trial of inclisiran;
* Previous (within about 3 months), current or planned treatment with a monoclonal antibody targeting PCSK9, or with a drug known to be contra-indicated with inclisiran (none currently known);
* Known to be poorly compliant with clinic visits or prescribed medication;
* Medical history that might limit the individual's ability to take trial treatments for the duration of the study (e.g. severe respiratory disease; cancer or evidence of spread within approximately the last 5 years, other than non-melanoma skin cancer; or history of alcohol or substance misuse) or may put the individual at significant risk in the opinion of the investigator (or their authorised deputy) if he/she were to participate in the trial;
* Women of child-bearing potential, current pregnancy, or lactation;
* Current participation in a clinical trial with an unlicensed drug or device; or
* Staff personnel directly involved with the study and any family member of the investigational study staff.
Minimum Eligible Age

40 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Oxford

OTHER

Sponsor Role lead

The TIMI Study Group

OTHER

Sponsor Role collaborator

Novartis Pharmaceuticals

INDUSTRY

Sponsor Role collaborator

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Louise Bowman

Role: PRINCIPAL_INVESTIGATOR

University of Oxford

Marion Mafham

Role: PRINCIPAL_INVESTIGATOR

University of Oxford

David Preiss

Role: PRINCIPAL_INVESTIGATOR

University of Oxford

Martin Landray

Role: PRINCIPAL_INVESTIGATOR

University of Oxford

Locations

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TIMI Study Group

Boston, Massachusetts, United States

Site Status

CTSU, University of Oxford

Oxford, Oxfordshire, United Kingdom

Site Status

Countries

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United States United Kingdom

References

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Warden BA, Duell PB. Inclisiran: A Novel Agent for Lowering Apolipoprotein B-containing Lipoproteins. J Cardiovasc Pharmacol. 2021 Aug 1;78(2):e157-e174. doi: 10.1097/FJC.0000000000001053.

Reference Type DERIVED
PMID: 33990512 (View on PubMed)

Related Links

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Other Identifiers

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CTSU_MDCO_PCS-17-01

Identifier Type: -

Identifier Source: org_study_id

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