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CompletedNCT04026178Updated Nov 26, 2025Results posted

Immunogenicity of Metreleptin in Patients With Generalized Lipodystrophy

A Phase 4 interventional study of Metreleptin in Generalized Lipodystrophy, sponsored by Aegerion Pharmaceuticals, Inc.. Completed at 8 sites in United States. Open to participants aged 1 Year and older. Per ClinicalTrials.gov, last updated 2025-11-26.

Sponsored by Aegerion Pharmaceuticals, Inc. · Phase 4, Interventional, and Treatment

Phase
Phase 4
Study type
Interventional
Enrollment
11
Allocation
Not applicable
Ages
1 Year and older
Sex
All
01

Study summary

MYALEPT™ (metreleptin) has been approved as an adjunct to diet as replacement therapy to treat the complications of leptin deficiency in patients with congenital or acquired generalized lipodystrophy (MYALEPT Prescribing Information). This study is a multicenter, open-label, Phase 4 trial to provide an assessment of the immunogenicity associated with metreleptin and of any major potential risks due to development of antibodies to metreleptin. The study is being conducted to comply with a postmarketing requirement.

02

Conditions studied

  • Generalized Lipodystrophy

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Keywords

  • Immunogenicity
  • Antibodies
  • Lipodystrophy
03

Who can participate

Ages eligible
1 Year and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  1. Provision of informed consent prior to any study specific procedures. If \<18 years of age, has a parent or guardian able to read, understand, and sign the Informed Consent Form (ICF) and a Child Assent form, communicate with the Investigator, and understand and comply with protocol requirements. Adolescent patients must also read and understand the Child Assent Form. If the child is too young or unable to read, then the Child Assent form must be explained to the child.
  2. Female and/or male patients ≥1 years of age.
  3. Physician-confirmed diagnosis of congenital or acquired generalized lipodystrophy and will begin treatment with MYALEPT for the first time.
  4. Negative pregnancy test (urine or serum) for female patients of childbearing potential.
  5. Female patients of childbearing potential must be 1 year postmenopausal, surgically sterile, or be willing to use an acceptable method of contraception (an acceptable method of contraception is defined as a barrier method in conjunction with a spermicide) for the duration of the study (from the time they sign consent). In addition, oral contraceptives, approved contraceptive implant, long-term injectable contraception, intrauterine device, or tubal ligation are allowed. Oral contraception alone is not acceptable; additional barrier methods in conjunction with spermicide must be used.
  6. Male patients must be surgically sterile or be willing to use an acceptable method of contraception (defined as barrier methods in conjunction with spermicides) for the duration of the study (from the time they sign consent).
  7. Patients who are blood donors should not donate blood during the study and for 3 months following their last dose of metreleptin.

Exclusion criteria

Exclusion Criteria:

  1. Involvement in the planning and/or conduct of the study (applies to both Aegerion staff and/or staff at the study site.)
  2. Previous treatment with metreleptin.
  3. Participation in another clinical study with an investigational product during the last 6 months.
  4. Patients with prior severe hypersensitivity reactions to metreleptin or to any of the product components.
  5. Known to have tested positive for human immunodeficiency virus, are immunocompromised, or are receiving immunomodulatory drugs.
  6. Known history of drug or alcohol abuse within 1 year of screening.
  7. Creatinine clearance \<30 mL/min using institutional standards:

    e.g., calculated using Cockcroft-Gault formula for patients ≥18 years of age; calculated using Schwartz equation for patients \<18 years of age.

  8. For women only - currently pregnant (confirmed with positive pregnancy test) or breast-feeding.
  9. Any condition where, in the opinion of the Investigator, participation in this study may pose a significant risk to the patient or could render the patient unable to successfully complete the study.
04

Study design

Phase
Phase 4
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
11 participants (actual)

Study arms

  • Experimental
    Metreleptin

    Subjects will receive prescribed dosage of metreleptin as indicated in the USPI Patients (males and females) ≤ 40 kg: 0.06mg/kg Male patients \> 40 kg: 2.5mg Female patients \> 40 kg: 5mg

    Drug: Metreleptin

Interventions

  • DrugMetreleptin

    Subjects will receive prescribed dosage of metreleptin as indicated in the USPI

05

What researchers measure

Primary outcomes

  1. Evaluate the Immunogenicity Associated With Daily Subcutaneous (SC) Metreleptin Treatment in Patients With Congenital Generalized Lipodystrophy (CGL) or Acquired Generalized Lipodystrophy (AGL).

    Anti-metreleptin, anti-human leptin (HuL) binding antidrug antibody (ADA) titers over time. Category of in vitro cell-based neutralizing antibody (NAb) activity to metreleptin, and titer in the receptor blocking (RB) NAb assay in ADA positive samples over time.

    Time frame: 36 months

Secondary outcomes

  1. Assess 2 Methods of Measuring in Vitro NAb Activity to Metreleptin.

    The percent (standard error) of patients with a positive result was compared for the RB NAb assay and the cell-based NAb assay over time.

    Time frame: 36 months

  2. Evaluate the Safety and Tolerability in Relation to the Development of or Absence of Anti-metreleptin and Anti-HuL Binding ADAs, and/or in Vitro NAb Activity to Metreleptin in Patients With CGL or AGL

    Serious adverse events (SAEs), AEs leading to discontinuation, loss of response (as assessed by glycated hemoglobin (HbA1c) and serum triglycerides), severe infections and/or sepsis, standard laboratory tests, and vital signs over time.

    Time frame: 36 months

Other outcomes

  1. Evaluate the Efficacy With Daily Metreleptin in Patients With GL

    Change from Baseline in HbA1c over time.

    Time frame: 36 months

  2. Evaluate the Efficacy With Daily Metreleptin in Patients With GL

    Percent change from Baseline in fasting triglycerides over time.

    Time frame: 36 months

06

Results

Posted Nov 26, 2025
Limitations and caveats
Following limitations may have occurred: 1. Exposure misclassification 2. Selection bias 3. Attrition 4. Confounders (e.g., concomitant use of antidiabetic medications, metreleptin dose and compliance, pregnancy, puberty) 5. Small sample size

Participant flow

Patients were recruited from 4 centers in the US. Prescribing Investigators for this study were those who were certified under REMS for MYALEPT prescription and able to ensure prescription of metreleptin was as per the USPI.

Participant flow — Overall Study
MilestoneMetreleptin
Started11
Completed7
Not completed4

Outcome measures

SecondaryAssess 2 Methods of Measuring in Vitro NAb Activity to Metreleptin.

The percent (standard error) of patients with a positive result was compared for the RB NAb assay and the cell-based NAb assay over time.

Time frame:
36 months
Reported as:
Count of participants · Participants
Assess 2 Methods of Measuring in Vitro NAb Activity to Metreleptin.
ParticipantsMetreleptin
NAb cell based+1
NAb receptor blocking+10
SecondaryEvaluate the Safety and Tolerability in Relation to the Development of or Absence of Anti-metreleptin and Anti-HuL Binding ADAs, and/or in Vitro NAb Activity to Metreleptin in Patients With CGL or AGL

Serious adverse events (SAEs), AEs leading to discontinuation, loss of response (as assessed by glycated hemoglobin (HbA1c) and serum triglycerides), severe infections and/or sepsis, standard laboratory tests, and vital signs over time.

Time frame:
36 months
Reported as:
Count of participants · Participants
Evaluate the Safety and Tolerability in Relation to the Development of or Absence of Anti-metreleptin and Anti-HuL Binding ADAs, and/or in Vitro NAb Activity to Metreleptin in Patients With CGL or AGL
ParticipantsMetreleptin
All AE — AEs leading to discomntinuation11
SAE — AEs leading to discomntinuation7
AEs leading to discontinuation — AEs leading to discomntinuation1
Severe infections and/or sepsis — AEs leading to discomntinuation2
Blood Triglycerides increased — AEs leading to discomntinuation3
Glycosylated haemoglobin increased — AEs leading to discomntinuation1
Other pre-specifiedEvaluate the Efficacy With Daily Metreleptin in Patients With GL

Change from Baseline in HbA1c over time.

Time frame:
36 months
Reported as:
Median · Percentage
Evaluate the Efficacy With Daily Metreleptin in Patients With GL
PercentageMetreleptin
Absolute change in HbA1c from baseline to Month 12-0.3 (-6.5 to 2.3)
Absolute change in HbA1c from baseline to Month 24-0.5 (-7.2 to 1.8)
Absolute change in HbA1c from baseline to Month 36-0.7 (-7.3 to 1.9)
PrimaryEvaluate the Immunogenicity Associated With Daily Subcutaneous (SC) Metreleptin Treatment in Patients With Congenital Generalized Lipodystrophy (CGL) or Acquired Generalized Lipodystrophy (AGL).

Anti-metreleptin, anti-human leptin (HuL) binding antidrug antibody (ADA) titers over time. Category of in vitro cell-based neutralizing antibody (NAb) activity to metreleptin, and titer in the receptor blocking (RB) NAb assay in ADA positive samples over time.

Time frame:
36 months
Reported as:
Count of participants · Participants
Evaluate the Immunogenicity Associated With Daily Subcutaneous (SC) Metreleptin Treatment in Patients With Congenital Generalized Lipodystrophy (CGL) or Acquired Generalized Lipodystrophy (AGL).
ParticipantsMetreleptin
ADA positive — ADA+10
NAb cell based + — ADA+1
NAb receptor blocking+ — ADA+10
Other pre-specifiedEvaluate the Efficacy With Daily Metreleptin in Patients With GL

Percent change from Baseline in fasting triglycerides over time.

Time frame:
36 months
Reported as:
Median · Percent Change
Evaluate the Efficacy With Daily Metreleptin in Patients With GL
Percent ChangeMetreleptin
Precent change in triglycerides from baseline to Month 12-49.68 (-91.26 to 174.77)
Precent change in triglycerides from baseline to Month 24-46.72 (-92.25 to 593.01)
Precent change in triglycerides from baseline to Month 36-58.12 (-98.55 to -22.16)

Adverse events

Collected over From signing the ICF up until either the last scheduled Follow-up Visit (36 months) or at least 4 weeks after the last dose of study medication in the case of an early termination. Non-serious events are listed at a 5% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Metreleptin1/11 (9.1%)7/11 (63.6%)11/11 (100%)
Most frequent serious events
Most frequent serious events
EventMetreleptin
COVID-19Infections and infestations1/11
Autoimmune hepatitisHepatobiliary disorders1/11
Pancreatitis relapsingGastrointestinal disorders1/11
OsteomyelitisInfections and infestations1/11
SepsisInfections and infestations1/11
Abortion spontaneousPregnancy, puerperium and perinatal conditions1/11
ConstipationGastrointestinal disorders1/11
Most frequent other events
Showing 10 of 60
Most frequent other events
EventMetreleptin
COVID-19Infections and infestations4/11
Abdominal painGastrointestinal disorders3/11
Abdominal painGastrointestinal disorders3/11
Maternal exposure during pregnancyInjury, poisoning and procedural complications2/11
Blood triglycerides increasedInvestigations2/11
AnemiaBlood and lymphatic system disorders1/11
Cardiac failureCardiac disorders1/11
Cerumen impactionEar and labyrinth disorders1/11
CataractEye disorders1/11
DiarrheaGeneral disorders1/11

Baseline characteristics

Age, Categorical
Age, Categorical(Participants)Metreleptin
<=18 years3
Between 18 and 65 years8
>=65 years0
Sex: Female, Male
Sex: Female, Male(Participants)Metreleptin
Female9
Male2
Race (NIH/OMB)
Race (NIH/OMB)(Participants)Metreleptin
American Indian or Alaska Native0
Asian0
Native Hawaiian or Other Pacific Islander0
Black or African American1
White9
More than one race0
Unknown or Not Reported1
Ethnicity (NIH/OMB)
Ethnicity (NIH/OMB)(Participants)Metreleptin
Hispanic or Latino2
Not Hispanic or Latino9
Unknown or Not Reported0
Lipodystrophy diagnosis
Lipodystrophy diagnosis(Participants)Metreleptin
Congenital Generalised Lipodystrophy6
Acquired Generalised Lipodystrophy5
Medical History
Medical History(Participants)Metreleptin
Hypertriglyceridemia8
Diabetes7
Pancreatitis5
Hypertension4
Hepatic steatosis3
Polycystic ovary syndrome2
Proteinuric2
Hepatic cirrhosis1
07

Study locations

8 sites
  • Univ. Alabama-Birmingham
    Birmingham, Alabama 35294, United States
  • Ochsner Clinic
    New Orleans, Louisiana 70121, United States
  • University of Michigan
    Ann Arbor, Michigan 48109, United States
  • Endocrinology Research Associates
    Columbus, Ohio 43201, United States
  • Ohio State University
    Columbus, Ohio 43203, United States
  • Childrens Hospital of Philadelphia
    Philadelphia, Pennsylvania 19104, United States
  • University Texas Southwestern INT
    Dallas, Texas 75390, United States
  • Seattle Children's Hospital
    Seattle, Washington 98105, United States
08

References and documents

Study documents

  • Study protocol · Feb 8, 2018
  • Statistical analysis plan · Apr 24, 2025

Documents are hosted by the registry — open the source record to download them.

Individual participant data

Plan to share: Yes — only IPD that underly results in a publication

Supporting information: Study protocol, Icf

09

Registry details

Key details

Study ID
NCT04026178
Lead sponsor
Aegerion Pharmaceuticals, Inc.
Responsible party
Sponsor
First posted
Jul 19, 2019
Start date
Nov 14, 2018
Primary completion
Oct 31, 2024
Completion
Oct 31, 2024
Results posted
Nov 26, 2025
Last update
Nov 26, 2025

Study contacts

Janet Boylan
study director · Aegerion Pharmaceuticals, Inc.

Oversight

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

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