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Antisense Oligonucleotides in Dyslipidemia Management: A Review of Clinical Trials
Ikponmwosa Jude Ogieuhi1, Kristen Callender2, God-Dowell O Odukudu3
1Siberian State Medical University, Tomsk, Russia. Jude.ogieuhi@gmail.com.
Introduction:
Elevated serum total cholesterol levels, very low-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides, or a decreased serum high-density lipoprotein cholesterol concentration characterize dyslipidemia. Antisense Oligonucleotide therapy in dyslipidemia targets apolipoprotein B (ApoB), an essential component of low-density lipoprotein (LDL) associated with atherosclerosis development.
Aim:
This review aims to critically evaluate the efficacy and safety of this group of medications in mitigating dyslipidemia in at-risk individuals and its potential role in advancing personalized medicine in the management of dyslipidemias.
Methods:
A detailed search was conducted from multiple databases adhering to the PRISMA guidelines. Clinical trials and randomized controlled trials on antisense oligonucleotides for management of dyslipidemias were included, excluding non-English studies, case reports and all forms of reviews. Data was screened, with duplicates removed, and key findings were synthesized using a narrative approach.
Results And Conclusion:
The potential of antisense oligonucleotides (ASOs) to treat dyslipidemia and other disorders has attracted much interest. Several studies and clinical trials have been conducted on the safety and tolerability of ASOs for dyslipidemia. Although statins are the mainstay management of hypercholesterolemia, there is evidence from clinical trials that ASOs can even be more effective with little to no side effects. Novel therapeutic approaches such as antisense oligonucleotides (ASOs) offer tailored therapeutic alternatives. ASOs such as Mipomersen and Volanesorsen provide additional treatment options for patients with inherited lipid abnormalities by lowering certain atherogenic lipoproteins such as apo B and ApoC-III, respectively.
Insights
Antisense Oligonucleotide therapy shows promise in managing dyslipidemia, offering a potentially more effective and safer alternative to statins for lowering atherogenic lipoproteins like ApoB.
Area of Science:
- Biochemistry and Pharmacology
- Cardiovascular Medicine
- Genetics and Personalized Medicine
Background:
- Dyslipidemia is characterized by abnormal levels of serum lipids, including cholesterol and triglycerides, contributing to atherosclerosis.
- Antisense Oligonucleotide (ASO) therapy targets key components like apolipoprotein B (ApoB) involved in low-density lipoprotein (LDL) metabolism.
Purpose of the Study:
- To critically evaluate the efficacy and safety of Antisense Oligonucleotide therapy for dyslipidemia.
- To assess the potential of ASOs in advancing personalized medicine for dyslipidemia management.
Main Methods:
- Systematic literature search adhering to PRISMA guidelines across multiple databases.
- Inclusion of clinical trials and randomized controlled trials on ASOs for dyslipidemia.
- Exclusion of non-English studies, case reports, and reviews; narrative synthesis of key findings.
Main Results:
- Antisense Oligonucleotide therapy demonstrates significant potential in treating dyslipidemia.
- Clinical trials indicate ASOs can be highly effective with minimal side effects compared to statins.
- Specific ASOs like Mipomersen and Volanesorsen effectively lower atherogenic lipoproteins (ApoB, ApoC-III).
Conclusions:
- Antisense Oligonucleotides represent a promising novel therapeutic approach for dyslipidemia.
- ASOs offer tailored treatment alternatives, particularly for patients with inherited lipid abnormalities.
- These therapies provide valuable options beyond traditional statin use.
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