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CompletedNCT03338816Updated Apr 22, 2024Results posted

ENVISION: A Study to Evaluate the Efficacy and Safety of Givosiran (ALN-AS1) in Patients With Acute Hepatic Porphyrias (AHP)

A Phase 3 interventional study of Givosiran and Placebo in Acute Hepatic Porphyria, Acute Intermittent Porphyria and Porphyria, Acute Intermittent, sponsored by Alnylam Pharmaceuticals. Completed at 36 sites in 18 countries. Open to participants aged 12 Years and older. Per ClinicalTrials.gov, last updated 2024-04-22.

Sponsored by Alnylam Pharmaceuticals · Phase 3, Interventional, and Treatment

Phase
Phase 3
Study type
Interventional
Enrollment
94
Allocation
Randomized
Ages
12 Years and older
Sex
All
01

Study summary

The purpose of this study is to evaluate the effect of subcutaneous givosiran (ALN-AS1), compared to placebo, on the rate of porphyria attacks in patients with Acute Hepatic Porphyrias (AHP).

02

Conditions studied

  • Acute Hepatic Porphyria
  • Acute Intermittent Porphyria
  • Porphyria, Acute Intermittent
  • Acute Porphyria
  • Hereditary Coproporphyria (HCP)
  • Variegate Porphyria (VP)
  • ALA Dehydratase Deficient Porphyria (ADP)

Keywords

  • Acute Intermittent Porphyria (AIP)
  • Acute Hepatic Porphyria (AHP)
  • Hereditary Coproporphyria (HCP)
  • Variegate Porphyria (VP)
  • ALA dehydratase deficient porphyria (ADP) (ALAD)
  • RNAi therapeutic
  • Porphyria
03

In context

Porphyria, Acute Intermittent

21 studies on the registry are indexed under Porphyria, Acute Intermittent; 3 are open to participants now.

This study's enrollment of 94 is above the median of 20 across 11 interventional studies indexed under Porphyria, Acute Intermittent.

Browse Porphyria, Acute Intermittent studies →

Lead sponsor

Alnylam Pharmaceuticals is the lead sponsor of 84 studies on the registry; 19 are open to participants now.

Of its 18 completed or terminated interventional studies of FDA-regulated products, 15 (83%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
12 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • ≥ 12 years of age
  • Diagnosed with Acute Hepatic Porphyria (Acute Intermittent Porphyria, Hereditary Corproporhyria, Variegate Porphyria, aminolevulinic acid (ALA) dehydratase deficient porphyria)
  • Elevated urinary or plasma porphobilinogen (PBG) or ALA values within the past year,
  • Have active disease, with at least 2 documented porphyria attacks within the last 6 months
  • Willing to discontinue or not initiate the use of prophylactic hemin throughout the study.
  • Women of child bearing potential must have a negative serum pregnancy test, not be nursing, and use acceptable

Exclusion criteria

Exclusion Criteria:

  • abnormal laboratory results
  • Anticipated liver transplantation
  • History of multiple drug allergies or intolerance to subcutaneous injections
  • Active , virus, or virus infection(s)
  • History of recurrent pancreatitis
Terms in these criteria, in plain language(5)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

Clinically significant

Judged by the study doctor to matter for your health or for the study. It is a doctor’s decision, so ask the study team if you are unsure whether something counts.

HIV

The human immunodeficiency virus, which weakens the immune system.

Many studies now accept people whose HIV is controlled on treatment, judged by the viral load and the CD4 count. Check the limits this study sets.

Hepatitis C tests

Hepatitis C is a virus that infects the liver. An HCV antibody test can stay positive after an infection has cleared (and is occasionally positive without one); an HCV RNA test shows whether the virus is there now.

After treatment, hepatitis C counts as cured when HCV RNA is still undetectable 12 weeks or more after the treatment ended. Studies often accept people cured this way.

Hepatitis B tests

Hepatitis B is a virus that infects the liver. These are separate tests: HBsAg positive usually means a current infection (a recent vaccination can briefly cause it too); total anti-HBc (HBcAb) positive means an infection now or in the past; HBV DNA measures how much virus is in the blood.

Some studies accept a past infection if HBV DNA is undetectable, sometimes with antiviral medicine during the study. Check what this study allows.

05

Study design

Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Quadruple (Participant, Care provider, Investigator, Outcomes assessor)
Enrollment
94 participants (actual)

Study arms

  • Experimental
    Givosiran/Givosiran

    Givosiran 2.5 mg/kg administered subcutaneously (SC), monthly (QM), for 6 months during the 6-Month Double-blind (DB) Period, followed by givosiran 2.5 mg/kg or 1.25 mg/kg SC, QM for 29 months during the Open-label Extension (OLE) Period.

    Drug: Givosiran · Drug: Placebo

  • Placebo comparator
    Placebo/Givosiran

    Matching placebo (normal saline \[0.9% NaCl\]) was administered SC, QM, for 6 months during the 6-Month DB Period, followed by givosiran 2.5 mg/kg or 1.25 mg/kg SC, QM for 29 months during the OLE period.

    Drug: Givosiran · Drug: Placebo

Interventions

  • Givosiran by SC

    Also known as: ALN-AS1, GIVLAARI

  • DrugPlacebo

    Matching placebo (normal saline \[0.9% NaCl\]) by SC

06

What researchers measure

Primary outcomes

  1. Annualized Rate of Porphyria Attacks in Participants With Acute Intermittent Porphyria (AIP)

    Porphyria attacks were defined as meeting all of the following criteria: an acute episode of neurovisceral pain in the abdomen, back, chest, extremities and/or limbs, no other medically determined cause, and required treatment with intravenous (IV) dextrose or hemin, carbohydrates, or analgesics, or other medications such as antiemetics at a dose or frequency beyond the participant's usual daily porphyria management. The annualized rate of porphyria attacks is a composite endpoint which included porphyria attacks requiring hospitalization, urgent healthcare visit, or IV hemin administration at home.

    Time frame: 6 months

Secondary outcomes

  1. The Pharmacodynamic (PD) Effect of Givosiran on Urine Levels of Delta-aminolevulinic Acid (ALA) in Participants With AIP

    The PD effect of givosiran was evaluated by spot urine ALA levels normalized to spot urine creatinine levels.

    Time frame: 3 and 6 months

  2. The PD Effect of Givosiran on Urine Levels of Porphobilinogen (PBG) in Participants With AIP

    The PD effect of givosiran was evaluated by spot urine PBG levels normalized to spot urine creatinine levels.

    Time frame: 6 months

  3. Annualized Rate of Hemin Administration in Participants With AIP

    Annualized rate of hemin doses was evaluated as annualized days of hemin use.

    Time frame: 6 months

  4. Annualized Rate of Porphyria Attacks in Participants With AHP

    Porphyria attacks were defined as meeting all of the following criteria: an acute episode of neurovisceral pain in the abdomen, back, chest, extremities and/or limbs, no other medically determined cause, and required treatment with intravenous (IV) dextrose or hemin, carbohydrates, or analgesics, or other medications such as antiemetics at a dose or frequency beyond the participant's usual daily porphyria management. The annualized rate of porphyria attacks is a composite endpoint which included porphyria attacks requiring hospitalization, urgent healthcare visit, or IV hemin administration at home.

    Time frame: 6 months

  5. Area Under the Curve (AUC) of the Change From Baseline in Weekly Mean Score of Daily Worst Pain as Measured by the Brief Pain Inventory-Short Form (BPI-SF) Numeric Rating Scale (NRS) in Participants With AIP

    Participants rated worst daily pain score in an eDiary using the 11-point BPI-SF NRS, in which 0=no pain and 10=worst pain. Daily eDiary entries were averaged into a weekly (i.e. 7 day) score. The change from baseline in weekly mean scores is defined as the post baseline weekly mean score minus the baseline score. Lower scores indicate an improvement. The 6-month AUC was calculated based on change from baseline in weekly mean scores.

    Time frame: Baseline and 6 months

  6. Average Change From Baseline in Weekly Mean Score of Daily Worst Pain as Measured by the Brief Pain Inventory-Short Form (BPI-SF) Numeric Rating Scale (NRS) in Participants With AIP

    Participants rated worst daily pain score in an eDiary using the 11-point BPI-SF NRS, in which 0=no pain and 10=worst pain. Daily eDiary entries were averaged into a weekly (i.e. 7 day) score. The change from baseline in weekly mean scores is defined as the postbaseline weekly mean score minus the baseline score. Lower scores indicate an improvement.

    Time frame: Baseline and 6 months

  7. AUC of the Change From Baseline in Weekly Mean Score of Daily Worst Fatigue Score as Measured by the Brief Fatigue Inventory-Short Form (BFI-SF) NRS in Participants With AIP

    Participants rated daily worst fatigue score in an eDiary using the 11-point BFI-SF NRS, in which 0=no fatigue and 10=worst fatigue. Daily eDiary entries were averaged into a weekly (i.e. 7 day) score. The change from baseline in weekly mean scores is defined as the post baseline weekly mean score minus the baseline score. Lower scores indicate an improvement. The 6-month AUC was calculated based on change from baseline in weekly mean scores.

    Time frame: Baseline and 6 months

  8. Average Change From Baseline in Weekly Mean Score of Daily Worst Fatigue Score as Measured by the Brief Fatigue Inventory-Short Form (BFI-SF) NRS in Participants With AIP

    Participants rated daily worst fatigue score in an eDiary using the 11-point BFI-SF NRS, in which 0=no fatigue and 10=worst fatigue. Daily eDiary entries were averaged into a weekly (i.e. 7 day) score. The change from baseline in weekly mean scores is defined as the postbaseline weekly mean score minus the baseline score. Lower scores indicate an improvement.

    Time frame: Baseline and 6 months

  9. AUC of the Change From Baseline in Weekly Mean Score Daily Worst Nausea Score as Measured by NRS in Participants With AIP

    Participants rated worst daily nausea score in an eDiary using an 11-point NRS, in which 0=no nausea and 10=worst nausea. Daily eDiary entries were averaged into a weekly (i.e. 7 day) score. The change from baseline in weekly mean scores is defined as the postbaseline weekly mean score minus the baseline score. Lower scores indicate an improvement. The 6-month AUC was calculated based on change from baseline in weekly mean scores.

    Time frame: Baseline and 6 months

  10. Average Change From Baseline in Weekly Mean Score Daily Worst Nausea Score as Measured by NRS in Participants With AIP

    Participants rated worst daily nausea score in an eDiary using an 11-point NRS, in which 0=no nausea and 10=worst nausea. Daily eDiary entries were averaged into a weekly (i.e. 7 day) score. The change from baseline in weekly mean scores is defined as the postbaseline weekly mean score minus the baseline score. Lower scores indicate an improvement.

    Time frame: Baseline and 6 months

  11. Change From Baseline in the Physical Component Summary (PCS) of the 12-Item Short Form Survey (SF-12) in Participants With AIP

    The SF-12 is a survey designed for use in patients with multiple chronic conditions. This 12-item scale can be used to assess the physical and mental health of respondents. 10 of the 12 questions are answered on a 5 point likert scale and 2 are answered on a 3 point likert scale. The questions are then scored and weighted into 2 subscales, physical health and mental health. Respondents can have a score that ranges from 0-100 with 100 being the best score and indicating high physical or mental health. A 3 point change in SF-12 score reflects a meaningful difference. A higher score indicates improvement.

    Time frame: Baseline and 6 months

07

Results

Posted Feb 11, 2020

Participant flow

Participants with acute hepatic porphyrias (AHP) were enrolled at thirty-six sites in Australia, Bulgaria, Canada, Germany, Denmark, Spain, Finland, France, United Kingdom, Italy, Japan, Korea (the Republic of), Mexico, Netherlands, Poland, Sweden, Taiwan and the United States.

6-Month Double-blind Period
Participant flow — 6-Month Double-blind Period
MilestonePlacebo 6-Month DBGivosiran 2.5 mg/kg 6-Month DBPlacebo/GivosiranGivosiran/Givosiran
Started464800
Completed464800
Not completed0000
6-Month DB + Open-Label Extension Period
Participant flow — 6-Month DB + Open-Label Extension Period
MilestonePlacebo 6-Month DBGivosiran 2.5 mg/kg 6-Month DBPlacebo/GivosiranGivosiran/Givosiran
Started004647
Completed003841
Not completed0086
Withdrew: Adverse event0020
Withdrew: Death0001
Withdrew: Lost to follow-up0010
Withdrew: Physician decision0010
Withdrew: Pregnancy0011
Withdrew: Withdrawal by subject0033
Withdrew: Patient desired lower dose0001

Outcome measures

PrimaryAnnualized Rate of Porphyria Attacks in Participants With Acute Intermittent Porphyria (AIP)

Porphyria attacks were defined as meeting all of the following criteria: an acute episode of neurovisceral pain in the abdomen, back, chest, extremities and/or limbs, no other medically determined cause, and required treatment with intravenous (IV) dextrose or hemin, carbohydrates, or analgesics, or other medications such as antiemetics at a dose or frequency beyond the participant's usual daily porphyria management. The annualized rate of porphyria attacks is a composite endpoint which included porphyria attacks requiring hospitalization, urgent healthcare visit, or IV hemin administration at home.

Time frame:
6 months
Reported as:
Mean · annualized attack rate
Annualized Rate of Porphyria Attacks in Participants With Acute Intermittent Porphyria (AIP)
annualized attack ratePlaceboGivosiran 2.5 mg/kg
Annualized Rate of Porphyria Attacks in Participants With Acute Intermittent Porphyria (AIP)12.52 (9.35 to 16.76)3.22 (2.25 to 4.59)
Statistical analysis
  • Placebo vs Givosiran 2.5 mg/kg · Negative binomial regression model · p = <0.0001 (P=6.040E-09) · Rate ratio: 0.26 · 95% CI 0.16 to 0.41
SecondaryThe Pharmacodynamic (PD) Effect of Givosiran on Urine Levels of Delta-aminolevulinic Acid (ALA) in Participants With AIP

The PD effect of givosiran was evaluated by spot urine ALA levels normalized to spot urine creatinine levels.

Time frame:
3 and 6 months
Reported as:
Least squares mean · mmol/mol creatinine (Cr)
The Pharmacodynamic (PD) Effect of Givosiran on Urine Levels of Delta-aminolevulinic Acid (ALA) in Participants With AIP
mmol/mol creatinine (Cr)PlaceboGivosiran 2.5 mg/kg
Month 319.965 ± 1.4751.756 ± 1.413
Month 623.150 ± 2.5344.013 ± 2.352
SecondaryThe PD Effect of Givosiran on Urine Levels of Porphobilinogen (PBG) in Participants With AIP

The PD effect of givosiran was evaluated by spot urine PBG levels normalized to spot urine creatinine levels.

Time frame:
6 months
Reported as:
Least squares mean · mmol/mol Cr
The PD Effect of Givosiran on Urine Levels of Porphobilinogen (PBG) in Participants With AIP
mmol/mol CrPlaceboGivosiran 2.5 mg/kg
The PD Effect of Givosiran on Urine Levels of Porphobilinogen (PBG) in Participants With AIP49.110 ± 4.95912.906 ± 4.642
SecondaryAnnualized Rate of Hemin Administration in Participants With AIP

Annualized rate of hemin doses was evaluated as annualized days of hemin use.

Time frame:
6 months
Reported as:
Mean · annualized rate of use
Annualized Rate of Hemin Administration in Participants With AIP
annualized rate of usePlaceboGivosiran 2.5 mg/kg
Annualized Rate of Hemin Administration in Participants With AIP29.71 (18.41 to 47.94)6.77 (4.20 to 10.92)
SecondaryAnnualized Rate of Porphyria Attacks in Participants With AHP

Porphyria attacks were defined as meeting all of the following criteria: an acute episode of neurovisceral pain in the abdomen, back, chest, extremities and/or limbs, no other medically determined cause, and required treatment with intravenous (IV) dextrose or hemin, carbohydrates, or analgesics, or other medications such as antiemetics at a dose or frequency beyond the participant's usual daily porphyria management. The annualized rate of porphyria attacks is a composite endpoint which included porphyria attacks requiring hospitalization, urgent healthcare visit, or IV hemin administration at home.

Time frame:
6 months
Reported as:
Mean · annualized attack rate
Annualized Rate of Porphyria Attacks in Participants With AHP
annualized attack ratePlaceboGivosiran 2.5 mg/kg
Annualized Rate of Porphyria Attacks in Participants With AHP12.26 (9.22 to 16.29)3.35 (2.37 to 4.74)
SecondaryArea Under the Curve (AUC) of the Change From Baseline in Weekly Mean Score of Daily Worst Pain as Measured by the Brief Pain Inventory-Short Form (BPI-SF) Numeric Rating Scale (NRS) in Participants With AIP

Participants rated worst daily pain score in an eDiary using the 11-point BPI-SF NRS, in which 0=no pain and 10=worst pain. Daily eDiary entries were averaged into a weekly (i.e. 7 day) score. The change from baseline in weekly mean scores is defined as the post baseline weekly mean score minus the baseline score. Lower scores indicate an improvement. The 6-month AUC was calculated based on change from baseline in weekly mean scores.

Time frame:
Baseline and 6 months
Reported as:
Median · score on a scale*week
Area Under the Curve (AUC) of the Change From Baseline in Weekly Mean Score of Daily Worst Pain as Measured by the Brief Pain Inventory-Short Form (BPI-SF) Numeric Rating Scale (NRS) in Participants With AIP
score on a scale*weekPlaceboGivosiran 2.5 mg/kg
Area Under the Curve (AUC) of the Change From Baseline in Weekly Mean Score of Daily Worst Pain as Measured by the Brief Pain Inventory-Short Form (BPI-SF) Numeric Rating Scale (NRS) in Participants With AIP5.286 (-23.048 to 11.145)-11.514 (-29.181 to 3.040)
SecondaryAverage Change From Baseline in Weekly Mean Score of Daily Worst Pain as Measured by the Brief Pain Inventory-Short Form (BPI-SF) Numeric Rating Scale (NRS) in Participants With AIP

Participants rated worst daily pain score in an eDiary using the 11-point BPI-SF NRS, in which 0=no pain and 10=worst pain. Daily eDiary entries were averaged into a weekly (i.e. 7 day) score. The change from baseline in weekly mean scores is defined as the postbaseline weekly mean score minus the baseline score. Lower scores indicate an improvement.

Time frame:
Baseline and 6 months
Reported as:
Median · score on a scale
Average Change From Baseline in Weekly Mean Score of Daily Worst Pain as Measured by the Brief Pain Inventory-Short Form (BPI-SF) Numeric Rating Scale (NRS) in Participants With AIP
score on a scalePlaceboGivosiran 2.5 mg/kg
Average Change From Baseline in Weekly Mean Score of Daily Worst Pain as Measured by the Brief Pain Inventory-Short Form (BPI-SF) Numeric Rating Scale (NRS) in Participants With AIP0.245 (-1.020 to 0.470)-0.506 (-1.309 to 0.143)
SecondaryAUC of the Change From Baseline in Weekly Mean Score of Daily Worst Fatigue Score as Measured by the Brief Fatigue Inventory-Short Form (BFI-SF) NRS in Participants With AIP

Participants rated daily worst fatigue score in an eDiary using the 11-point BFI-SF NRS, in which 0=no fatigue and 10=worst fatigue. Daily eDiary entries were averaged into a weekly (i.e. 7 day) score. The change from baseline in weekly mean scores is defined as the post baseline weekly mean score minus the baseline score. Lower scores indicate an improvement. The 6-month AUC was calculated based on change from baseline in weekly mean scores.

Time frame:
Baseline and 6 months
Reported as:
Least squares mean · score on a scale*week
AUC of the Change From Baseline in Weekly Mean Score of Daily Worst Fatigue Score as Measured by the Brief Fatigue Inventory-Short Form (BFI-SF) NRS in Participants With AIP
score on a scale*weekPlaceboGivosiran 2.5 mg/kg
AUC of the Change From Baseline in Weekly Mean Score of Daily Worst Fatigue Score as Measured by the Brief Fatigue Inventory-Short Form (BFI-SF) NRS in Participants With AIP-4.208 ± 4.689-11.148 ± 4.501
SecondaryAverage Change From Baseline in Weekly Mean Score of Daily Worst Fatigue Score as Measured by the Brief Fatigue Inventory-Short Form (BFI-SF) NRS in Participants With AIP

Participants rated daily worst fatigue score in an eDiary using the 11-point BFI-SF NRS, in which 0=no fatigue and 10=worst fatigue. Daily eDiary entries were averaged into a weekly (i.e. 7 day) score. The change from baseline in weekly mean scores is defined as the postbaseline weekly mean score minus the baseline score. Lower scores indicate an improvement.

Time frame:
Baseline and 6 months
Reported as:
Least squares mean · score on a scale
Average Change From Baseline in Weekly Mean Score of Daily Worst Fatigue Score as Measured by the Brief Fatigue Inventory-Short Form (BFI-SF) NRS in Participants With AIP
score on a scalePlaceboGivosiran 2.5 mg/kg
Average Change From Baseline in Weekly Mean Score of Daily Worst Fatigue Score as Measured by the Brief Fatigue Inventory-Short Form (BFI-SF) NRS in Participants With AIP-0.182 ± 0.209-0.502 ± 0.200
SecondaryAUC of the Change From Baseline in Weekly Mean Score Daily Worst Nausea Score as Measured by NRS in Participants With AIP

Participants rated worst daily nausea score in an eDiary using an 11-point NRS, in which 0=no nausea and 10=worst nausea. Daily eDiary entries were averaged into a weekly (i.e. 7 day) score. The change from baseline in weekly mean scores is defined as the postbaseline weekly mean score minus the baseline score. Lower scores indicate an improvement. The 6-month AUC was calculated based on change from baseline in weekly mean scores.

Time frame:
Baseline and 6 months
Reported as:
Least squares mean · score on a scale
AUC of the Change From Baseline in Weekly Mean Score Daily Worst Nausea Score as Measured by NRS in Participants With AIP
score on a scalePlaceboGivosiran 2.5 mg/kg
AUC of the Change From Baseline in Weekly Mean Score Daily Worst Nausea Score as Measured by NRS in Participants With AIP-4.011 ± 3.4531.481 ± 3.310
SecondaryAverage Change From Baseline in Weekly Mean Score Daily Worst Nausea Score as Measured by NRS in Participants With AIP

Participants rated worst daily nausea score in an eDiary using an 11-point NRS, in which 0=no nausea and 10=worst nausea. Daily eDiary entries were averaged into a weekly (i.e. 7 day) score. The change from baseline in weekly mean scores is defined as the postbaseline weekly mean score minus the baseline score. Lower scores indicate an improvement.

Time frame:
Baseline and 6 months
Reported as:
Least squares mean · score on a scale
Average Change From Baseline in Weekly Mean Score Daily Worst Nausea Score as Measured by NRS in Participants With AIP
score on a scalePlaceboGivosiran 2.5 mg/kg
Average Change From Baseline in Weekly Mean Score Daily Worst Nausea Score as Measured by NRS in Participants With AIP-0.181 ± 0.1540.067 ± 0.147
SecondaryChange From Baseline in the Physical Component Summary (PCS) of the 12-Item Short Form Survey (SF-12) in Participants With AIP

The SF-12 is a survey designed for use in patients with multiple chronic conditions. This 12-item scale can be used to assess the physical and mental health of respondents. 10 of the 12 questions are answered on a 5 point likert scale and 2 are answered on a 3 point likert scale. The questions are then scored and weighted into 2 subscales, physical health and mental health. Respondents can have a score that ranges from 0-100 with 100 being the best score and indicating high physical or mental health. A 3 point change in SF-12 score reflects a meaningful difference. A higher score indicates improvement.

Time frame:
Baseline and 6 months
Reported as:
Least squares mean · score on a scale
Change From Baseline in the Physical Component Summary (PCS) of the 12-Item Short Form Survey (SF-12) in Participants With AIP
score on a scalePlaceboGivosiran 2.5 mg/kg
Change From Baseline in the Physical Component Summary (PCS) of the 12-Item Short Form Survey (SF-12) in Participants With AIP1.431 ± 1.2205.369 ± 1.169

Adverse events

Collected over From the first dose of study drug through completion of the OLE Period (up to 39 months).. Non-serious events are listed at a 5% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Placebo 6-Month DB0/46 (0%)4/46 (8.7%)37/46 (80.4%)
Givosiran 2.5 mg/kg 6-Month DB0/48 (0%)10/48 (20.8%)43/48 (89.6%)
Placebo/Givosiran0/46 (0%)17/46 (37%)44/46 (95.7%)
Givosiran/Givosiran1/48 (2.1%)20/48 (41.7%)47/48 (97.9%)
All Givosiran1/94 (1.1%)37/94 (39.4%)91/94 (96.8%)
Most frequent serious events
Showing 10 of 81
Most frequent serious events
EventPlacebo 6-Month DBGivosiran 2.5 mg/kg 6-Month DBPlacebo/GivosiranGivosiran/GivosiranAll Givosiran
Pulmonary embolismRespiratory, thoracic and mediastinal disorders0/460/481/463/484/94
Device related infectionInfections and infestations2/461/480/460/480/94
Blood homocysteine increasedInvestigations0/460/482/460/482/94
Chronic kidney diseaseRenal and urinary disorders0/462/480/460/480/94
Chronic kidney diseaseRenal and urinary disorders0/460/480/462/482/94
PyrexiaGeneral disorders1/461/480/460/480/94
Escherichia urinary tract infectionInfections and infestations1/460/480/460/480/94
SepsisInfections and infestations1/460/480/460/480/94
Septic shockInfections and infestations1/460/480/460/480/94
Fractured sacrumInjury, poisoning and procedural complications1/460/480/460/480/94
Most frequent other events
Showing 10 of 91
Most frequent other events
EventPlacebo 6-Month DBGivosiran 2.5 mg/kg 6-Month DBPlacebo/GivosiranGivosiran/GivosiranAll Givosiran
NauseaGastrointestinal disorders0/460/4812/4622/4834/94
Injection site reactionGeneral disorders0/460/4814/4616/4830/94
NasopharyngitisInfections and infestations0/460/4811/4614/4825/94
FatigueGeneral disorders0/460/4813/4612/4825/94
NauseaGastrointestinal disorders5/4613/480/460/480/94
HeadacheNervous system disorders0/460/487/4613/4820/94
Upper respiratory tract infectionInfections and infestations0/460/4812/467/4819/94
Urinary tract infectionInfections and infestations0/460/4810/469/4819/94
Abdominal painGastrointestinal disorders0/460/488/466/4814/94
VomitingGastrointestinal disorders0/460/488/467/4815/94

Baseline characteristics

Safety Analysis Set (SAS) consisted of all participants who received at least one dose of study drug.

Age, Continuous
Age, Continuous(years)PlaceboGivosiranTotal
Mean37.4 ± 10.540.1 ± 12.138.8 ± 11.4
Sex: Female, Male
Sex: Female, Male(Participants)PlaceboGivosiranTotal
Female414384
Male5510
Ethnicity (NIH/OMB)
Ethnicity (NIH/OMB)(Participants)PlaceboGivosiranTotal
Hispanic or Latino358
Not Hispanic or Latino424284
Unknown or Not Reported112
Race/Ethnicity, Customized
Race/Ethnicity, Customized(Participants)PlaceboGivosiranTotal
Asian7815
Native Hawaiian or Other Pacific Islander101
Black or African American101
White343973
More than One Race101
Unknown or Not Reported213
08

Study locations

36 sites
  • Clinical Trial Site
    Little Rock, Arkansas 72205, United States
  • Clinical Trial Site
    San Francisco, California 94143, United States
  • Clinical Trial Site
    Boston, Massachusetts 02114, United States
  • Clinical Trial Site
    Ann Arbor, Michigan 48109, United States
  • Clinical Trial Site
    New York, New York 10029, United States
  • Clinical Trial Site
    Winston-Salem, North Carolina 27157, United States
  • Clinical Trial Site
    Philadelphia, Pennsylvania 19107, United States
  • Clinical Trial Site
    Galveston, Texas 77555, United States
  • Clinical Trial Site
    Salt Lake City, Utah 84112, United States
  • Clinical Trial Site
    Seattle, Washington 98195, United States
  • Clinical Trial Site
    Parkville, Victoria 3050, Australia
  • Clinical Trial Site
    Auchenflower, 4066, Australia
  • Clinical Trial Site
    Camperdown, 2050, Australia
  • Clinical Trial Site
    Sofia, 1431, Bulgaria
  • Clinical Trial Site
    Edmonton, T6G 2R3, Canada
  • Clinical Trial Site
    Odense, 5000, Denmark
  • Clinical Trial Site
    Helsinki, 00290, Finland
  • Clinical Trial Site
    Paris, 75877, France
  • Clinical Trial Site
    Chemnitz, 09116, Germany
  • Clinical Trial Site
    Munich, 80331, Germany
  • Clinical Trial Site
    Modena, 41124, Italy
  • Clinical Trial Site
    Hamamatsu, 430-0929, Japan
  • Clinical Trial Site
    Iizuka, 820-8505, Japan
  • Clinical Trial Site
    Tokyo, 108-0073, Japan
  • Clinical Trial Site
    Seoul, 05030, Korea, Republic of
  • Clinical Trial Site
    Mexico City, 04530, Mexico
  • Clinical Trial Site
    Rotterdam, 3015, Netherlands
  • Clinical Trial Site
    Warsaw, 02-776, Poland
  • Clinical Trial Site
    Barcelona, 08036, Spain
  • Clinical Trial Site
    El Palmar, 30120, Spain
  • Clinical Trial Site
    Pamplona, 31008, Spain
  • Clinical Trial Site
    Stockholm, 171 76, Sweden
  • Clinical Trial Site
    Taichung, 40705, Taiwan
  • Clinical Trial Site
    Taipei city, 10002, Taiwan
  • Clinical Trial Site
    Taoyuan city, 33305, Taiwan
  • Clinical Trial Site
    London, SE5 9RS, United Kingdom
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References and documents

Publications

  • Wang B, Ventura P, Takase KI, Thapar M, Cassiman D, Kubisch I, Liu S, Sweetser MT, Balwani M. Disease burden in patients with acute hepatic porphyria: experience from the phase 3 ENVISION study. Orphanet J Rare Dis. 2022 Aug 26;17(1):327. doi: 10.1186/s13023-022-02463-x. PubMed 36028858 ↗
  • Balwani M, Sardh E, Ventura P, Peiro PA, Rees DC, Stolzel U, Bissell DM, Bonkovsky HL, Windyga J, Anderson KE, Parker C, Silver SM, Keel SB, Wang JD, Stein PE, Harper P, Vassiliou D, Wang B, Phillips J, Ivanova A, Langendonk JG, Kauppinen R, Minder E, Horie Y, Penz C, Chen J, Liu S, Ko JJ, Sweetser MT, Garg P, Vaishnaw A, Kim JB, Simon AR, Gouya L; ENVISION Investigators. Phase 3 Trial of RNAi Therapeutic Givosiran for Acute Intermittent Porphyria. N Engl J Med. 2020 Jun 11;382(24):2289-2301. doi: 10.1056/NEJMoa1913147. PubMed 32521132 ↗

Study documents

PDFs hosted by the registry, ClinicalTrials.gov.

Individual participant data

Plan to share: Yes — Access to Anonymized individual participant data that support these results is made available 12 months after study completion and not less than 12 months after the product and indication have been approved in the US and/or the EU. Data will be provided contingent upon the approval of a research proposal and the execution of a data sharing agreement. Requests for access to data can be submitted via the website www.vivli.org.

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Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reached

Ran from Nov 2017 to primary completion in Jan 2019, 14 months.

Results were first posted in Feb 2020, 1 year after primary completion.

How these figures are worked out, and which studies are left out of them.

Registered
Nov 7, 2017
First posted
Nov 9, 2017
StartActual
Nov 16, 2017
Primary completionActual
Jan 31, 2019
CompletionActual
May 31, 2021
Results first posted
Feb 11, 2020
Last update
Apr 22, 2024
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Apr 22, 2024, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT03338816
Responsible party
Sponsor
First posted
Nov 9, 2017
Start date
Nov 16, 2017
Primary completion
Jan 31, 2019
Completion
May 31, 2021
Results posted
Feb 11, 2020
Last update
Apr 22, 2024

Study contacts

Medical Director
study director · Alnylam Pharmaceuticals

Oversight

Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is completed, as verified in May 2022. You cannot join it, but the record below documents what was studied.

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Discussion

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Studies of the drug tested here: Givosiran

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