Esperion Therapeutics Announces Positive Top-Line Phase 2b Results For ETC-1002, An Investigational Therapy For Patients With Hypercholesterolemia

Esperion Therapeutics, Inc.

, an emerging pharmaceutical company focused on developing and commercializing first-in-class, oral low-density lipoprotein cholesterol (LDL-cholesterol) lowering therapies for the treatment of hypercholesterolemia and other cardiometabolic risk markers, today announced positive top-line results from ETC-1002-008, a Phase 2b study evaluating the efficacy and safety of ETC-1002 monotherapy compared with ezetimibe monotherapy in patients with hypercholesterolemia, with or without statin intolerance. Top-line results showed the 12-week study met its primary endpoint of greater LDL-cholesterol lowering from baseline with ETC-1002 compared with ezetimibe. In patients who received ETC-1002 as monotherapy, there were 27 and 30 percent reductions in LDL-cholesterol at doses of 120 mg and 180 mg, respectively. These reductions were significantly different from ezetimibe alone (p=0.0008 and p< 0.0001, respectively). In patients who received the combination of 120 mg of ETC-1002 and 10 mg ezetimibe, substantial LDL-cholesterol reductions of 43 percent were significantly different from ezetimibe alone (p<0.0001). In patients who received the combination of 180 mg of ETC-1002 and 10 mg ezetimibe, substantial LDL-cholesterol reductions of 48 percent were significantly different from ezetimibe (p<0.0001). These reductions occurred within the first two weeks of dosing and continued throughout the treatment period. ETC-1002 monotherapy and ETC-1002 in combination with ezetimibe demonstrated significantly greater reductions than ezetimibe in high-sensitivity C-reactive protein (hsCRP), an important marker of inflammation in coronary disease. “Many people with hypercholesterolemia are not able to control their LDL-cholesterol levels with currently available therapies. This is especially true for patients who are statin intolerant because they have limited therapeutic options,” said Paul Thompson, M.D., Medical Director of Cardiology and The Athletes' Heart Program, Hartford Hospital. “ETC-1002 has the LDL-cholesterol lowering of a mid-dose statin and is well-tolerated, and could benefit these patients.” ETC-1002 appeared to be safe and well-tolerated. Discontinuation rates due to adverse events (AEs) with ETC-1002 were comparable to those seen with ezetimibe. Rates of adverse events (AEs) and serious adverse events (SAEs) were low and comparable across treatment groups. Elevations in liver enzymes were as expected and comparable to what is typically observed with approved LDL-cholesterol lowering therapies. In patients treated with ETC-1002, including those with statin intolerance, rates of muscle-related AEs were similar to those seen with ezetimibe. “I am very excited about the positive findings of the 008 study; they are transformational for both ETC-1002 and Esperion,” said Tim M. Mayleben, president and chief executive officer of Esperion. “Our ability to show significant differences between ETC-1002 and ezetimibe in both LDL-cholesterol lowering and reductions in hsCRP demonstrate the potential of ETC-1002 as a new oral therapeutic option for patients with hypercholesterolemia, especially those with statin intolerance. The similarity in muscle-related adverse events between ETC-1002 and ezetimibe is especially encouraging.” ETC-1002-008 Design The randomized, double-blind, active comparator-controlled, parallel group, multicenter Phase 2b study evaluated the efficacy and safety of ETC-1002 monotherapy versus ezetimibe monotherapy in patients with hypercholesterolemia, with or without statin intolerance, treated for 12 weeks. Secondary objectives were to characterize the dose response; assess the effect of ETC-1002 on additional lipid and cardiometabolic biomarkers; characterize the safety, tolerability and rates of muscle-related adverse events and assess lipid-lowering efficacy in combination with ezetimibe versus ezetimibe monotherapy. A total of 348 patients with hypercholesterolemia were washed out of any lipid-regulating therapies prior to a run-in period of five weeks. Ninety-nine patients were randomized to receive ETC-1002 120 mg; 100 patients were randomized to receive ETC-1002 180 mg; 99 patients were randomized to receive ezetimibe 10 mg; 26 patients were randomized to receive ETC-1002 120 mg + ezetimibe 10 mg; and 24 patients were randomized to receive ETC-1002 180 mg + ezetimibe 10 mg. A total of 177 patients had a history of statin intolerance. ETC-1002-008 Results ETC-1002 treated patients achieved LDL-cholesterol lowering of up to 30 percent at 12 weeks compared with 21 percent in the ezetimibe group, and LDL-cholesterol reductions of up to 48 percent when ETC-1002 was added to ezetimibe. Levels of hsCRP were reduced by up to 40 percent with ETC-1002 both as monotherapy and in combination with ezetimibe. The effects of ETC-1002 on atherogenic lipids and lipoproteins were directionally consistent and statistically significant, following the effects on LDL-cholesterol. Consistent with prior clinical studies with ETC-1002, no clinically relevant changes in high-density lipoprotein cholesterol or triglycerides were observed. ETC-1002 appeared to be safe and well tolerated, and was not associated with any dose-limiting side effects. In patients treated with ETC-1002, including those with statin intolerance, rates of muscle-related AEs were similar to those seen with ezetimibe. LDL-C Percent Change From Baseline to Week 12 Endpoint Week 12 Percent Change from Endpoint Baseline Baseline (mg/dL) (mg/dL) LS Mean P Value vs. Treatment n Mean (SD) Mean (SD) (SE) ezetimibe ETC-1002 120mg 97 164 (28) 119 (30) -27% (1.3) 0.0008 ETC-1002 180mg 99 166 (24) 115 (25) -30% (1.3) <0.0001 ezetimibe 10mg 98 165 (25) 129 (20) -21% (1.3) - ETC-1002 120mg + ezetimibe 10mg 24 161 (26) 92 (29) -43% (2.6) <0.0001 ETC-1002 180mg + ezetimibe 10mg 22 164 (27) 86 (21) -48% (2.8) <0.0001 LS = least squares; SD = standard deviation; SE = standard error; mITT population hsCRP Nonparametric Analysis Percent Change from Baseline Baseline Level Median P Value vs. Treatment n (mg/L) Change ezetimibe ETC-1002 120mg 92 1.60 -30% ≤0.01 ETC-1002 180mg 86 2.50 -40% ≤0.01 ezetimibe 10mg 94 2.60 -11% NS ETC-1002 120mg + ezetimibe 10mg 20 1.85 -38% NS ETC-1002 180mg + ezetimibe 10mg 21 1.25 -26% ≤0.05 LS = least squares Conference Call and Webcast Details The Esperion management team will host a conference call and webcast today at 4:30 p.m. Eastern Time (ET) to discuss these results. The live event will be accessible on the investor relations section of the Esperion website at www.esperion.com, or by calling (877) 831-3840 (domestic) or (253) 237-1184 (international). The access code is 12801596. A replay of the event will be available approximately one hour after completion and will be archived on the Company's website for approximately 90 days following the event. Esperion's Commitment to Cardiometabolic Disease Esperion is committed to improving the lives of patients with cardiometabolic diseases. The Esperion team leverages its understanding of, and experience with, key biological pathways to discover and develop innovative therapies for the treatment of patients with hypercholesterolemia who have uncontrolled cholesterol levels despite the use of currently available therapies. Esperion has assembled a portfolio of programs including one product candidate in late-stage clinical evaluation (ETC-1002) and two pre-clinical product candidates.