AZD0780 to reduce major heart and blood vessel events in people with or at high risk for atherosclerotic cardiovascular disease.
A Phase III, Randomised, Double-blind, Placebo-controlled, Parallel-group Study to Assess the Effect of AZD0780 on Major Adverse Cardiovascular Events in Patients With Established Atherosclerotic Cardiovascular Disease (ASCVD) or at High Risk for a First ASCVD Event
This trial tests whether the oral PCSK9 inhibitor AZD0780 can lower the risk of major heart and vascular events in adults with prior ASCVD or who are at high risk for a first ASCVD event.
Quick facts
| Phase | Phase 3 |
|---|---|
| Study type | Interventional |
| Enrollment | 15100 (estimated) |
| Ages | 18 Years and up |
| Sex | All |
| Sponsor | AstraZeneca Industry-sponsored |
| Drugs / interventions | evolocumab, alirocumab |
| Locations | 1264 sites (Birmingham, Alabama and 1263 other locations) |
| Trial ID | NCT07000357 on ClinicalTrials.gov |
What this trial studies
This phase 3, randomized, double-blind, placebo-controlled, event-driven trial compares oral AZD0780 with matching placebo in adults with established atherosclerotic cardiovascular disease or at increased risk for a first ASCVD event. Participants are followed from randomization until a predefined primary analysis censoring date when MACE-PLUS events are counted for the primary endpoint, and a Study Closure Visit occurs after that date. Enrollment requires specific age, LDL-C, and additional risk-factor criteria to enrich for higher event rates. The trial is conducted at a small set of research sites in Alabama and aims to show whether oral AZD0780 reduces major cardiovascular events versus placebo.
Who should consider this trial
Good fit: Adults 18 and older with prior atherosclerotic events (such as MI, ischemic stroke due to atherosclerosis, or peripheral artery revascularization) or men ≥50 or women ≥55 at increased risk for a first ASCVD event who meet the trial's LDL-C and additional risk-factor requirements.
Not a fit: People without atherosclerotic disease or who do not meet the age, LDL-C, or specified risk-factor thresholds—including those with presumed lacunar or cardioembolic strokes—are unlikely to be eligible or to receive benefit from this study.
Why it matters
Potential benefit: If successful, AZD0780 could reduce heart attacks, strokes, and other major vascular events and provide a convenient oral lipid-lowering option.
How similar studies have performed: Previous large outcomes trials of injectable PCSK9 inhibitors (for example alirocumab and evolocumab) have reduced cardiovascular events, so this oral approach builds on evidence from successful PCSK9-targeting therapies though oral PCSK9 agents are novel.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria:
* Meets one of the following:
1. Participants with history of an ASCVD event: Participants ≥ 18 years of age at the time of signing the ICF with a history of MI or ischaemic stroke suspected to be due to atherosclerotic vascular disease ≥ 1 month prior to randomisation (presumed lacunar or cardioembolic strokes are not qualifying events), or revascularisation for symptomatic lower limb PAD any time prior to screening
Additional risk factors based on the level of the LDL-C and timing of MI or stroke:
o Participants with an LDL-C ≥ 75 mg/dL (≥ 1.9 mmol/L) need to have at least one of the other additional risk factors (i to viii) below.
ii) T2DM requiring ongoing medical therapy iii) Age ≥ 65 years v) Previous above ankle amputation due to PAD vi) Previous diagnosis of non-end stage CKD
2. Participants at increased risk of a first ASCVD event: Male participant ≥ 50 years of age or female participant ≥ 55 years of age at the time of signing the ICF with LDL-C ≥ 100 mg/dL (≥ 2.6 mmol/L), with no prior history of MI, ischaemic stroke due to atherosclerotic disease, or leg revascularisation for symptomatic lower limb PAD, and with diagnostic evidence of at least one of the following disease categories (i, ii, or iii):
(i) Significant atherosclerotic artery disease (ii) High-risk Type 1 or Type 2 diabetes mellitus with manifestation of at least one of the following end-organ diseases:
1. Nephropathy - Persistent (≥ 2 readings) microalbuminuria (urine albumin/creatinine ratio ≥ 30 mg/g) and/or persistent eGFR \< 60 mL/min/1.73 m2. At least one reading must come from the medical record within the last 12 months in addition to the reading from screening
2. Retinopathy - Treated diabetic retinopathy (surgical intervention or injectable therapy) or prior diagnosis made by a relevant healthcare specialist
3. Neuropathy - Treated neuropathy (medical therapy for pain relief or symptom alleviation) or prior diagnosis made by a relevant healthcare specialist
4. ABI \< 0.9 or \> 1.4 - confirmed either in study during screening or randomisation, or from the medical record within the last 5 years (iii) Documented atherosclerosis of less significance
For (ii) and (iii), participants need to have at least one of the additional risk factors below:
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1. CKD with eGFR x mL/min/1.73 m2
2. Current tobacco use
3. Age ≥ 65
4. T2DM (if included on the less significant atherosclerosis criterion iii)
* Participants should receive a background lipid lowering regimen anticipated to achieve at least a \~50% reduction in LDL-C. Except in cases of intolerance, the regimen should include a high intensity statin therapy or lower intensity statin therapy in combination with an oral agent with proven outcome benefit (eg, ezetimibe and/or bempedoic acid).
Participants must achieve a stable background lipid lowering therapy \> 28 days before screening.
Exclusion criteria:
* Any underlying known disease, or condition including homozygous familial hypercholesterolaemia, or LDL or plasma apheresis within 12 months prior to randomisation, that, in the opinion of the investigator, might interfere with the interpretation of the clinical study results.
* Any revascularisation procedure planned within the next 3 months.
* Available imaging assessment within the last 3 years showing either coronary calcium score of zero, or a coronary computed tomography angiography with no atherosclerosis.
* Calculated eGFR \< 15 mL /min/1.73 m2 at screening.
* Any laboratory values with the following deviations at screening:
* AST or ALT \> 3 × ULN
* TBL \> 2 × ULN (except for participants with Gilbert's syndrome where TBL 3 × ULN is acceptable provided direct bilirubin \< 1.5 × ULN)
* Fasting triglycerides ≥ 400 mg/dL (≥ 4.52 mmol/L).
* Creatine kinase \> 5 × ULN
* Urine albumin/creatinine ratio ≥ 500 mg/g
* Uncontrolled T2DM defined as HbA1c ≥ 9.5% at screening.
* Inadequately treated hypothyroidism defined as TSH \> 1.5 × ULN at screening or participants whose thyroid replacement therapy was initiated or modified within the last 3 months prior to screening.
* Use of mipomersen or lomitapide (cholesterol-lowering medications) within 12 months of screening or planned use during the study.
* Use of gemfibrozil within one week prior to the Screening Visit or planned use during the study.
* Use of PCSK9 inhibitors: evolocumab/alirocumab within 12 weeks of the Screening Visit or planned use during the study, or inclisiran within 18 months of the Screening Visit or planned use during the study, or any other approved PCSK9 inhibitor use within 5 half lives prior to the Screening Visit or planned use during the study.
Where this trial is running
Birmingham, Alabama and 1263 other locations
- Research Site — Birmingham, Alabama, United States (Recruiting)
- Research Site — Fairhope, Alabama, United States (Recruiting)
- Research Site — Foley, Alabama, United States (Recruiting)
- Research Site — Huntsville, Alabama, United States (Recruiting)
- Research Site — Mobile, Alabama, United States (Recruiting)
- Research Site — Saraland, Alabama, United States (Recruiting)
- Research Site — Vestavia Hills, Alabama, United States (Recruiting)
- Research Site — Gilbert, Arizona, United States (Recruiting)
- Research Site — Glendale, Arizona, United States (Recruiting)
- Research Site — Mesa, Arizona, United States (Suspended)
- Research Site — Peoria, Arizona, United States (Recruiting)
- Research Site — Phoenix, Arizona, United States (Recruiting)
- Research Site — Phoenix, Arizona, United States (Recruiting)
- Research Site — Phoenix, Arizona, United States (Recruiting)
- Research Site — Scottsdale, Arizona, United States (Recruiting)
- Research Site — Tempe, Arizona, United States (Recruiting)
- Research Site — Tucson, Arizona, United States (Recruiting)
- Research Site — Tucson, Arizona, United States (Suspended)
- Research Site — Tucson, Arizona, United States (Recruiting)
- Research Site — Beverly Hills, California, United States (Recruiting)
- Research Site — Canoga Park, California, United States (Recruiting)
- Research Site — Castroville, California, United States (Recruiting)
- Research Site — Chula Vista, California, United States (Recruiting)
- Research Site — Fountain Valley, California, United States (Recruiting)
- Research Site — Garden Grove, California, United States (Recruiting)
- Research Site — La Jolla, California, United States (Not_yet_recruiting)
- Research Site — Lake Forest, California, United States (Withdrawn)
- Research Site — Lancaster, California, United States (Recruiting)
- Research Site — Loma Linda, California, United States (Recruiting)
- Research Site — Loma Linda, California, United States (Not_yet_recruiting)
- Research Site — Los Angeles, California, United States (Recruiting)
- Research Site — Los Angeles, California, United States (Recruiting)
- Research Site — Lynwood, California, United States (Recruiting)
- Research Site — Monterey Park, California, United States (Recruiting)
- Research Site — Newport Beach, California, United States (Recruiting)
- Research Site — Norco, California, United States (Recruiting)
- Research Site — Northridge, California, United States (Recruiting)
- Research Site — Pomona, California, United States (Recruiting)
- Research Site — Poway, California, United States (Withdrawn)
- Research Site — Riverside, California, United States (Recruiting)
- Research Site — Sacramento, California, United States (Not_yet_recruiting)
- Research Site — San Diego, California, United States (Recruiting)
- Research Site — San Dimas, California, United States (Recruiting)
- Research Site — Santa Ana, California, United States (Recruiting)
- Research Site — Stanford, California, United States (Not_yet_recruiting)
- Research Site — Tarzana, California, United States (Recruiting)
- Research Site — Thousand Oaks, California, United States (Recruiting)
- Research Site — Torrance, California, United States (Not_yet_recruiting)
- Research Site — West Hills, California, United States (Recruiting)
- Research Site — Stamford, Connecticut, United States (Withdrawn)
+1214 more sites — see ClinicalTrials.gov for the full list.
Study contacts
- Study coordinator: AstraZeneca Clinical Study Information Center
- Email: information.center@astrazeneca.com
- Phone: 1-877-240-9479
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.