为了降低胆固醇,利用RNA干扰:Inclisiran的长沙到床边的故事
Michael J Wilkinson1, Archna Bajaj2, Margaret E Brousseau3
1Division of Cardiovascular Medicine, Department of Medicine Cardiovascular Institute, University of California San Diego San Diego CA USA.
Journal of the American Heart Association
|March 8, 2024
概括
作为一种RNA干扰疗法,Inclisiran可显著降低低密度脂蛋白胆固醇 (LDL-C) 的50%,每年服用两次. 这为动脉样硬化心血管疾病患者提供了新的选择,这些患者无法达到LDL-C的目标.
科学领域:
- 生物化学和分子生物学
- 心血管医学 心血管医学
- 药理学 药理学是指药理学的学科.
背景情况:
- 降低低密度脂蛋白胆固醇 (LDL-C) 是预防动脉样硬化心血管疾病 (ASCVD) 的关键.
- 由于各种障碍,现有的降低LDL-C的非他类疗法未得到充分利用,使许多患者低于指南推的目标.
- 增加ASCVD死亡率需要新的治疗策略来有效降低LDL-C.
研究的目的:
- 审查inclisiran的发展,一种新的RNA干扰治疗向性蛋白转化酶亚素/素9型 (PCSK9) 的治疗方法.
- 讨论临床试验计划,特征和inclisiran用于降低LDL-C的实际应用.
- 要突出inclisiran的旅程从发现到批准作为治疗高脂血症和ASCVD预防.
主要方法:
- 英克利西兰利用RNA干扰来抑制肝脏PCSK9合成,这是LDL受体的关键调节者.
- 治疗方案包括初始加重剂量,然后每年两次进行维持皮下注射.
- 临床试验评估了inclisiran的疗效,安全性和耐受性,特别是当它被添加到最大耐受度的他类药物治疗时.
主要成果:
- 与安慰剂相比,Inclisiran显示循环中的LDL-C水平持续下降约50%,与安慰剂相比.
- 这种每年两次的剂量疗法在患有已确定的ASCVD或家族性高胆固醇血症的患者中显著降低LDL-C的效果是显著的.
- 正在收集长期安全性和耐受性数据,正在进行评估心血管结果的研究.
结论:
- 在降低LDL-C的治疗中,Inclisiran代表了显著的进步,通过RNA干扰提供了一种新的作用机制.
- 它方便的剂量计划解决了与以前的非他类药物治疗相关的坚持挑战.
- 英克利西兰为管理高脂血症和预防动脉样硬化心血管疾病提供了有价值的新选择.
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