一个2期随机临床试验
Steven E Nissen1, Qiuqing Wang1, Stephen J Nicholls2
1Cleveland Clinic Coordinating Center for Clinical Research, Cleveland, Ohio.
JAMA
|November 18, 2024
概括
在患有动脉样硬化心血管疾病 (ASCVD) 的患者中,泽拉西兰显著降低了80%以上的脂蛋白水平. 这种小干扰RNA疗法对控制ASCVD风险因素具有前景.
科学领域:
- 心血管医学
- 药理学
- 遗传学
背景情况:
- 血脂蛋白升高是动脉样硬化心血管疾病 (ASCVD) 和大动脉狭窄的重要危险因素.
- 针对肝脏的阿波脂蛋白合成提供了降低脂蛋白水平的潜在治疗策略.
研究的目的:
- 评估小干扰RNA (siRNA) 治疗药物泽拉西兰在降低血清脂蛋白度方面的疗效.
- 在已确诊的ASCVD患者中评估泽拉西兰的安全性和耐受性.
主要方法:
- 一个多中心的随机试验,涉及患有稳定的ASCVD和高脂蛋白 (≥125nmol/ L) 的患者.
- 参与者每16周或每24周接受皮下安慰剂或不同剂量的泽拉西兰 (300毫克或450毫克),最多服用3剂.
- 主要结局是从基线到36周的脂蛋白的时间平均百分比变化.
主要成果:
- 与安慰剂相比,泽拉西兰治疗导致脂蛋白水平大幅降低,时间平均变化为-81. 3%至-85. 6%.
- 在Zerlasiran组中,36周后的中位数减少值得注意,高达-96. 4%.
- 治疗耐受性良好,最常见的不良反应是注射部位的轻微反应;没有严重的不良事件被认为与研究药物有关.
结论:
- 在ASCVD患者中有效且显著降低脂蛋白度.
- 这种siRNA疗法显示出良好的安全性,这表明它可以作为一种与高脂蛋白相关的心血管风险的治疗方法.
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