Clinical trial • Phase III • Cardiology

Ezetimibe; Pitavastatin for Hypercholesterolemia

Phase III trial of Ezetimibe; Pitavastatin for Hypercholesterolemia.

Overview

Trial Therapeutic Area
Cardiology
Trial Disease
Hypercholesterolemia
Trial Stage
Phase III
Drug Modality
Small molecule

Key dates

Initial CTIS Submission Date
25-12-2025
First CTIS Authorization Date
24-04-2026

Trial design

Randomised, k-924 hd: 1 tablet orally once daily (investigational test product). eu-marketed pitavastatin 4 mg (livazo 4mg film-coated tablets): 1 tablet orally once daily (comparator). matched placebos (k-924 hd placebo and eu-marketed pitavastatin 4 mg placebo) used to maintain blinding.-controlled Phase III trial across 9 sites in Spain.

Randomised
Yes
Comparator
K-924 HD: 1 tablet orally once daily (investigational test product). EU-marketed pitavastatin 4 mg (Livazo 4mg film-coated tablets): 1 tablet orally once daily (comparator). Matched placebos (K-924 HD Placebo and EU-marketed pitavastatin 4 mg Placebo) used to maintain blinding.
Target Sample Size
40
Trial Duration For Participant
84

Eligibility

Recruits 40 The CTIS record flags isVulnerablePopulationSelected:true. Participants must be aged ≥18 and must sign the informed consent form. A subject information and informed consent form (Main ICF) document is provided. No details on assent procedures or specific vulnerable subgroup consent handling are provided in the available data..

Pregnancy Exclusion
(4) POCBP who is known to be pregnant, has a positive serum pregnancy test, is lactating and breastfeeding, planning to become pregnant or breastfeed during the trial, and who do not agree to use an acceptable method of contraception. POCBP must use one of the acceptable birth control methods as specified in Section 13.1.2 before enrollment, throughout the trial, and until ≥30 days after the last dose of trial intervention.
Vulnerable Population
The CTIS record flags isVulnerablePopulationSelected:true. Participants must be aged ≥18 and must sign the informed consent form. A subject information and informed consent form (Main ICF) document is provided. No details on assent procedures or specific vulnerable subgroup consent handling are provided in the available data.

Inclusion criteria

  • {"criterion_text":"- (1) Participants with hypercholesterolemia who are aged ≥18 years at the time of signing the ICF."}
  • {"criterion_text":"- (2) Participants who have been instructed to follow a certain diet and/or exercise regimen, taking into account regional, national or local guidelines, and been continuing the regimen without changes per Investigator’s judgement for ≥4 weeks prior to Visit 1."}
  • {"criterion_text":"- (3) Participants whose fasting LDL-C (Friedewald formula) at Visit 1 or Visit 1’, performed under pitavastatin 4 mg/day stable administration for ≥4 weeks, meets one of the following criteria: a. Low risk: fasting LDL-C of ≥116 mg/dL (≥3.0 mmol/L) b. Moderate risk: fasting LDL-C of ≥100 mg/dL (≥2.6 mmol/L) c. High risk: fasting LDL-C of ≥70 mg/dL (≥1.8 mmol/L) d. Very high risk: fasting LDL-C of ≥55 mg/dL (≥1.4 mmol/L) e. Extreme risk: fasting LDL-C of ≥40 mg/dL (≥1.0 mmol/L)"}
  • {"criterion_text":"- (4) Participants who have been receiving any of the following statins for ≥2 weeks at the time of IC. a. Atorvastatin ≥20 mg/day b. Pitavastatin 4 mg/day c. Rosuvastatin ≥5 mg/day d. Simvastatin ≥40 mg/day"}

Exclusion criteria

  • {"criterion_text":"- (1) Participants with a history of myopathy or rhabdomyolysis caused by pitavastatin or ezetimibe"}
  • {"criterion_text":"- (2) Participants with a history of hypersensitivity to pitavastatin, ezetimibe or any excipient in formulations of either drug."}
  • {"criterion_text":"- (3) Participants with serious hepatic disorder (Child Pugh classification B or higher) or biliary obstruction."}
  • {"criterion_text":"- (4) POCBP who is known to be pregnant, has a positive serum pregnancy test, is lactating and breastfeeding, planning to become pregnant or breastfeed during the trial, and who do not agree to use an acceptable method of contraception. POCBP must use one of the acceptable birth control methods as specified in Section 13.1.2 before enrollment, throughout the trial, and until ≥30 days after the last dose of trial intervention."}
  • {"criterion_text":"- (5) Participants whose compliance with EU-marketed pitavastatin 4 mg during the screening period was <80% or >120%"}
  • {"criterion_text":"- (6) Participants whose CK is ≥3 × ULN at Visit 1 or Visit 1’."}
  • {"criterion_text":"- (7) Participants whose ALT and AST are both ≥2 × ULN at Visit 1 or Visit 1’."}
  • {"criterion_text":"- (8) Participants who meet any of the following conditions: - Type 1 diabetes - Poorly controlled type 2 diabetes defined as HbA1c >10% at Visit 1 or Visit 1’."}
  • {"criterion_text":"- (9) Participants with poorly controlled hypertension defined as SBP ≥160 mmHg or DBP ≥100 mmHg at Visit 1 or Visit 1’."}
  • {"criterion_text":"- (10) Participants with eGFR (CKD-EPI) <30 mL/min/1.73 m2 at Visit1 or Visit 1’, or those who are on dialysis."}
  • {"criterion_text":"- (11) Participants with heart failure with NYHA classification ≥III."}
  • {"criterion_text":"- (12) Participants who have had any of the following within 3 months prior to IC: - myocardial infarction, severe or unstable angina, coronary angioplasty, coronary artery bypass surgery, stroke, transient ischemic attack, symptomatic carotid stenosis, symptomatic peripheral arterial disease, abdominal aortic aneurysm, severe arrhythmia with poorly controlled, decompensated heart failure, symptomatic cardiac arrhythmia (or medication for arrythmia that was started or dose was changed), carotid surgery or stenting, endovascular procedure or surgical intervention for peripheral vascular disease."}
  • {"criterion_text":"- (13) Participants scheduled to undergo a major surgical or interventional procedure (e.g. PCI, CABG, carotid or peripheral revascularization)."}
  • {"criterion_text":"- (14) Participants with thyroid disease. Those who are considered to be well-controlled based on the Investigator’s discretion are permitted to participate."}
  • {"criterion_text":"- (15) Participants with homozygous familial hypercholesterolemia"}
  • {"criterion_text":"- (16) Participants who have known cancer complications or a history of malignancy within the 5 years prior to IC (except for non-invasive cancer or other stable, relatively benign conditions)."}
  • {"criterion_text":"- (17) Participants who have donated blood or who have had a major trauma, blood transfusion, or major surgery within 30 days prior to Visit 1."}
  • {"criterion_text":"- (18) Participants with previous history of clinically meaningful allergic reactions to a medication or study drug requiring treatment, in the judgement of the Investigator (e.g., anaphylactic shock)."}
  • {"criterion_text":"- (19) Participants who are required to receive concomitantly prohibited drugs after signing the ICF and during the trial period."}
  • {"criterion_text":"- (20) Participants whose fasting serum TG ≥400 mg/dL (4.5 mmol/L) at Visit 1 or Visit 1’."}
  • {"criterion_text":"- (21) Participants who are undergoing or plans to initiate an LDL-C apheresis."}
  • {"criterion_text":"- (22) Participants with a known history of HIV-1 or HIV-2 infection."}
  • {"criterion_text":"- (23) Participants who meet any of the following conditions within 5 years prior to Visit 1: - Have been treated for HCV. - Have active HCV infection defined as HCV antibody positive and presence of HCV-RNA. - Have active HBV infection defined as HBsAg positive"}
  • {"criterion_text":"- (24) Participants who have active HAV infection defined as HAV antibody positive, or have been cured of <3 months prior to Visit 1."}
  • {"criterion_text":"- (25) Participants with malabsorption or with a history of malabsorption, or who have undergone other surgical procedures of the gastrointestinal tract, including weight loss surgery such as Lap-Band or gastric bypass surgery (excluding appendicectomy, hernia repair, etc.) that may have affected absorption."}
  • {"criterion_text":"- (26) Participants who have a history of alcoholism or drug addiction within 2 years prior to IC."}
  • {"criterion_text":"- (27) Participants who participated in another clinical trial within 16 weeks prior to the administration of the trial intervention or 5 x half-life of the active ingredient, whichever is longer, and who received an investigational medicinal product other than a placebo that does not contain the active ingredient or those who plan to participate in another clinical trial concurrently with this one."}
  • {"criterion_text":"- (28) Participants deemed to be inappropriate for participation by the Investigators."}

Endpoints

Primary endpoints

  • {"endpoint_text":"- Percent change from baseline in LDL-C (Friedewald formula) at 12 weeks of treatment Note: When TG is ≥400 mg/dL (4.5 mmol/L) or calculated LDL-C (Friedewald formula) is <50 mg/dL (1.3 mmol/L), LDL-C (Friedewald formula) is replaced by LDL-C (direct enzymatic method).","definition_or_measurement_approach":"Measured as percent change from baseline in LDL-C using the Friedewald formula at Week 12; if TG ≥400 mg/dL or calculated LDL-C <50 mg/dL, LDL-C is measured by a direct enzymatic method."}
  • {"endpoint_text":"- Presence or absence of AEs and ADRs after the administration of IMP","definition_or_measurement_approach":"Safety assessed by recording presence or absence of adverse events (AEs) and adverse drug reactions (ADRs) following IMP administration."}

Secondary endpoints

  • {"endpoint_text":"- 1. Presence or absence of participants achieving LDL-C goals at Week 6 and 12 LDL-C goals - Low or moderate risk: fasting LDL-C of <100 mg/dL (<2.6 mmol) - High risk: fasting LDL-C of <70 mg/dL (<1.8 mmol) - Very high risk: fasting LDL-C of <55 mg/dL (<1.4 mmol)","definition_or_measurement_approach":"Measured presence/absence of participants meeting LDL-C thresholds at Weeks 6 and 12 by fasting LDL-C values."}
  • {"endpoint_text":"- 2. Percent change from baseline in LDL-C (direct enzymatic method), HDL-C (direct enzymatic method), non-HDLC, TC, TG, LDL-C (Friedewald formula)/HDL-C and non-HDLC/HDL-C at Week 6 and 12","definition_or_measurement_approach":"Percent change from baseline for listed lipid parameters at Weeks 6 and 12; LDL-C may be measured by direct enzymatic method per rules for high TG or low calculated LDL-C."}
  • {"endpoint_text":"- 3. Values, change and percent change from baseline in fasting LDL-C (Friedewald formula), LDL-C (direct enzymatic method), HDL-C (direct enzymatic method), non-HDL-C, TC, TG, LDL-C (Friedewald formula)/HDL-C and non-HDLC/ HDL-C at Week 6 and 12","definition_or_measurement_approach":"Absolute values, changes and percent changes from baseline for listed lipid measures at Weeks 6 and 12; replacement of LDL-C calculation by direct enzymatic method where specified."}
  • {"endpoint_text":"- 4. Change and percent change from baseline in ApoB at Week 12 Note: When TG is ≥400 mg/dL (4.5 mmol/L) or calculated LDL-C (Friedewald formula) is <50 mg/dL (1.3 mmol/L), LDL-C (Friedewald formula) is replaced by LDL-C (direct enzymatic method). Regarding Apo B, due to the nature of the examination, it will be treated as an exploratory measure.","definition_or_measurement_approach":"Change and percent change in ApoB at Week 12; ApoB is treated as an exploratory measure. LDL-C measurements follow replacement rules when TG ≥400 mg/dL or calculated LDL-C <50 mg/dL."}
  • {"endpoint_text":"- 5. Measurement values and changes from baseline of physiological and clinical laboratory test values at each timepoint","definition_or_measurement_approach":"Assessment of laboratory and physiological test values and their changes from baseline at scheduled timepoints."}

Recruitment

Planned Sample Size
40
Recruitment Window Months
8
Consent Approach
Informed consent must be signed by participants (aged ≥18 years). A main subject information and informed consent form (Main ICF) is provided (document available). Recruitment and consent materials are available in Spanish (ES) as per document titles. No information on assent (not applicable as minimum age is 18) or additional languages is provided in the available data.

Geography

Total Number Of Sites
9
Total Number Of Participants
40

Spain

Earliest CTIS Part Ii Submission Date
27-03-2026
Latest Decision Or Authorization Date
24-04-2026
Processing Time Days
28
Number Of Sites
9
Number Of Participants
40

Sites

Site Name
Hospital Universitario La Paz
Department Name
Endocrinology
Principal Investigator Name
Jose Raul Moreno Gomez
Principal Investigator Email
raulmorenog@hotmail.com
Contact Person Name
Jose Raul Moreno Gomez
Contact Person Email
raulmorenog@hotmail.com
Site Name
Bellvitge University Hospital
Department Name
Endocrinology
Principal Investigator Name
Xavier Pinto Sala
Principal Investigator Email
Xpinto@bellvitgehospital.cat
Contact Person Name
Xavier Pinto Sala
Contact Person Email
Xpinto@bellvitgehospital.cat
Site Name
Hospital Nisa Sevilla Aljarafe
Department Name
Endocrinology
Principal Investigator Name
Christobal Jesus Morales Portillo
Principal Investigator Email
cr.morales@hotmail.com
Contact Person Name
Christobal Jesus Morales Portillo
Contact Person Email
cr.morales@hotmail.com
Site Name
Hospital Universitario Miguel Servet
Department Name
Endocrinology
Principal Investigator Name
Estibaliz Jarauta Simon
Principal Investigator Email
estijarauta@gmail.com
Contact Person Name
Estibaliz Jarauta Simon
Contact Person Email
estijarauta@gmail.com
Site Name
Hospital Universitario Ramon Y Cajal
Department Name
Endocrinology
Principal Investigator Name
José Luis Zamorano Gomez
Principal Investigator Email
zamorano@secardiologia.es
Contact Person Name
José Luis Zamorano Gomez
Contact Person Email
zamorano@secardiologia.es
Site Name
Instituto Medico Quirurgico San Rafael S.A.
Department Name
Endocrinology
Principal Investigator Name
Alfonso Soto Gonzalez
Principal Investigator Email
galfonso.soto.gonzalez@sergas.es
Contact Person Name
Alfonso Soto Gonzalez
Site Name
Hospital Universitario Virgen De La Victoria
Department Name
Endocrinology
Principal Investigator Name
Francisco Jose Tinahones Madueño
Principal Investigator Email
Fjtinahones@hotmail.com
Contact Person Name
Francisco Jose Tinahones Madueño
Contact Person Email
Fjtinahones@hotmail.com
Site Name
Hospital Ruber Juan Bravo
Department Name
Endocrinology
Principal Investigator Name
Esteban Jodar Gimeno
Principal Investigator Email
esteban.jodar@gmail.com
Contact Person Name
Esteban Jodar Gimeno
Contact Person Email
esteban.jodar@gmail.com
Site Name
Hospital Universitario La Paz (duplicate site entry not expected?)
Department Name
Endocrinology
Principal Investigator Name
Jose Raul Moreno Gomez
Principal Investigator Email
raulmorenog@hotmail.com
Contact Person Name
Jose Raul Moreno Gomez
Contact Person Email
raulmorenog@hotmail.com

Sponsor

Primary sponsor

Full Name
Kowa Co. Ltd.
Organisation Type
Pharmaceutical company
Country Of Registered Address
Japan

Contract research organisations

Name
Fortrea Inc.
Responsibilities
sponsorDuties codes: 1,12,5,8
Name
Catalent Germany Schorndorf GmbH
Responsibilities
sponsorDuties codes: 14
Name
Labcorp Central Laboratory Services LP
Responsibilities
sponsorDuties codes: 4

Third parties

  • {"country":"United States","full_name":"Fortrea Inc.","duties_or_roles":"sponsorDuties codes: 1,12,5,8","organisation_type":"Pharmaceutical company"}
  • {"country":"Germany","full_name":"Catalent Germany Schorndorf GmbH","duties_or_roles":"sponsorDuties codes: 14","organisation_type":"Pharmaceutical company"}
  • {"country":"United States","full_name":"Labcorp Central Laboratory Services LP","duties_or_roles":"sponsorDuties codes: 4","organisation_type":"Pharmaceutical company"}
  • {"country":"United States","full_name":"Scarritt Group Inc.","duties_or_roles":"sponsorDuties codes: 15 (Patient reimbursement)","organisation_type":"Non-Pharmaceutical company"}

Investigational products

Investigational Product Name
K-924
Active Substance
Ezetimibe; Pitavastatin
Modality
Small molecule
Routes Of Administration
Oral
Route
Oral
Authorisation Status
Investigational (prodAuthStatus 1)
Starting Dose
1 tablet
Frequency
Once daily
Maximum Dose
14 mg (maxDailyDoseAmount)
Investigational Product Name
Livazo 4mg film-coated tablets
Active Substance
Pitavastatin
Modality
Small molecule
Routes Of Administration
Oral
Route
Oral
Authorisation Status
Authorised (marketing authorisation present)
Starting Dose
4 mg (1 tablet) once daily
Frequency
Once daily
Maximum Dose
4 mg (maxDailyDoseAmount)
Investigational Product Name
K-924 HD Placebo: The same IMP as test drug but no active ingredients.
Modality
Other
Authorisation Status
Placebo (not applicable)
Investigational Product Name
EU-marketed pitavastatin 4 mg Placebo: The same drug as comparator but no active ingredients
Modality
Other
Authorisation Status
Placebo (not applicable)
Investigational Product Name
PITAVASTATIN
Active Substance
Pitavastatin
Modality
Small molecule
Routes Of Administration
Oral
Route
Oral
Authorisation Status
Authorised (prodAuthStatus 2)
Starting Dose
4 mg (where used as auxiliary)
Frequency
Once daily
Maximum Dose
4 mg (maxDailyDoseAmount)
Combination Treatment
Yes

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