A Study of AKCEA-APOCIII-LRx Administered to Patients With Familial Chylomicronemia Syndrome (FCS) (BALANCE)
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ClinicalTrials.gov Identifier: NCT04568434 |
Recruitment Status :
Recruiting
First Posted : September 29, 2020
Last Update Posted : February 2, 2021
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Condition or disease | Intervention/treatment | Phase |
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Familial Chylomicronemia Syndrome | Drug: AKCEA-APOCIII-LRx Drug: Placebo | Phase 3 |
Study Type : | Interventional (Clinical Trial) |
Estimated Enrollment : | 60 participants |
Allocation: | Randomized |
Intervention Model: | Parallel Assignment |
Masking: | Double (Participant, Investigator) |
Primary Purpose: | Treatment |
Official Title: | A Randomized, Double-Blind, Placebo-Controlled, Phase 3 Study of AKCEA-APOCIII-LRx Administered Subcutaneously to Patients With Familial Chylomicronemia Syndrome (FCS) |
Actual Study Start Date : | November 18, 2020 |
Estimated Primary Completion Date : | March 2023 |
Estimated Study Completion Date : | June 2023 |

Arm | Intervention/treatment |
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Experimental: AKCEA-APOCIII-LRx
AKCEA-APOCIII-LRx will be administered once every 4 weeks by subcutaneous (SC) injection from Week 1 through Week 49.
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Drug: AKCEA-APOCIII-LRx
AKCEA-APOCIII-LRx will be administered by SC injection.
Other Name: ISIS 678354 |
Placebo Comparator: Placebo
AKCEA-APOCIII-LRx-matching placebo will be administered once every 4 weeks by SC injection from Week 1 through Week 49.
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Drug: Placebo
AKCEA-APOCIII-LRx-matching placebo will be administered by SC injection. |
- Percent Change from Baseline in Fasting TG at 6 Months (average of Weeks 23, 25, and 27) compared to placebo [ Time Frame: Baseline and Month 6 ]
- Percent Change from Baseline in Fasting TG at 12 months (average of Weeks 51 and 53) compared to placebo [ Time Frame: Baseline and Month 12 ]
- Change from Baseline in the Proportion of Participants who Achieve ≥ 40% Reduction in Fasting TG at 6 Months Compared to Placebo [ Time Frame: Baseline and Month 6 ]
- Percent Change form Baseline in Fasting Apolipoprotein B-48 (apoB-48) at 6 Months Compared to Placebo [ Time Frame: At Month 6 ]
- Proportion of Participants who Achieve Fasting TG ≤ 750 mg/dL at 6 Months compared to placebo [ Time Frame: At Month 6 ]
- Adjudicated Acute Pancreatitis Event Rate during the Treatment Period Compared to Placebo, in Participants with ≥ 2 Events of Adjudicated Acute Pancreatitis in 5 Years prior to Enrollment [ Time Frame: Week 1 through Week 53 ]
- Adjudicated Acute Pancreatitis Event Rate during the Treatment Period Compared to Placebo [ Time Frame: Week 1 through Week 53 ]
- Change from Baseline in the Proportion of Participants who Achieve ≥ 70% Reduction in Fasting TG at 6 Months Compared to Placebo [ Time Frame: Baseline and Month 6 ]
- Proportion of Participants who Achieve Fasting TG ≤ 500 mg/dL at 6 Months Compared to Placebo [ Time Frame: At Month 6 ]

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Ages Eligible for Study: | 18 Years and older (Adult, Older Adult) |
Sexes Eligible for Study: | All |
Accepts Healthy Volunteers: | No |
Key Inclusion Criteria:
- A diagnosis of genetically confirmed Familial Chylomicronemia Syndrome (type 1 Hyperlipoproteinemia)
- Fasting TG ≥ 880 mg/dL (10 millimoles per liter (mmol/L)) at Screening
- History of pancreatitis
- Stable doses of statins, omega-3 fatty acids, fibrates, or other lipid-lowering medications are allowed
Key Exclusion Criteria:
- Acute coronary syndrome within 6 months of Screening
- Major surgery within 3 months of Screening
- Have any other conditions, which, in the opinion of the Investigator would make the participant unsuitable for inclusion, or could interfere with participating in or completing the study

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT04568434
Contact: Ionis Pharmaceuticals | 800-679-4747 | patients@ionisph.com |
United States, California | |
IONIS Investigative Site | Recruiting |
Huntington Beach, California, United States, 92648 | |
United States, Florida | |
IONIS Investigative Site | Recruiting |
Boca Raton, Florida, United States, 33434 | |
United States, Kansas | |
IONIS Investigative Site | Recruiting |
Kansas City, Kansas, United States, 66160 | |
United States, Texas | |
IONIS Investigative Site | Recruiting |
Houston, Texas, United States, 77030 | |
United States, Virginia | |
IONIS Investigative Site | Recruiting |
Norfolk, Virginia, United States, 23510 | |
Canada, Quebec | |
IONIS Investigative Site | Recruiting |
Chicoutimi, Quebec, Canada, G7H 7K9 | |
IONIS Investigative Site | Recruiting |
Québec, Quebec, Canada, G1V 4W2 |
Responsible Party: | Ionis Pharmaceuticals, Inc. |
ClinicalTrials.gov Identifier: | NCT04568434 |
Other Study ID Numbers: |
ISIS 678354-CS3 2020-002536-67 ( EudraCT Number ) |
First Posted: | September 29, 2020 Key Record Dates |
Last Update Posted: | February 2, 2021 |
Last Verified: | January 2021 |
Individual Participant Data (IPD) Sharing Statement: | |
Plan to Share IPD: | No |
Studies a U.S. FDA-regulated Drug Product: | Yes |
Studies a U.S. FDA-regulated Device Product: | No |
Product Manufactured in and Exported from the U.S.: | Yes |
FCS |
Hyperlipoproteinemia Type I Syndrome Disease Pathologic Processes Lipid Metabolism, Inborn Errors Metabolism, Inborn Errors |
Genetic Diseases, Inborn Hyperlipoproteinemias Hyperlipidemias Dyslipidemias Lipid Metabolism Disorders Metabolic Diseases |