在高胆固醇症中使用Inclisiran的治疗策略:VICTORION- Difference试验
Ulf Landmesser1, Ulrich Laufs2, Ulrike Schatz3
1Department of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charité; Charité-Universitätsmedizin Berlin, German Center for Cardiovascular Research (DZHK), Partner Site Berlin, Germany.
European heart journal
|August 30, 2025
概括
在高胆固醇血症患者中,Inclisiran显著改善了低密度脂蛋白胆固醇 (LDL- C) 目标的实现和降低. 与优化降脂疗法相比,这种治疗显示肌肉相关的不良事件较少.
科学领域:
- 心脏病学
- 药理学
- 临床试验
背景情况:
- 低密度脂蛋白胆固醇 (LDL-C) 是动脉样硬化心血管疾病的一个关键风险因素.
- 欧洲心脏病学会的指导方针建议结合治疗以达到LDL-C的目标.
- 作为一个小干扰RNA (siRNA),Inclisiran针对PCSK9mRNA进行持续的LDL- C降低.
研究的目的:
- 在接受inclisiran加个人优化降脂疗法 (ioLLT) 和安慰剂加ioLLT的患者中,评估90日LDL- C目标的实现.
- 评估与肌肉相关的不良事件 (MRAE) 和平均LDL-C降低作为次要目标.
主要方法:
- 第4期,双盲,安慰剂控制的VICTORION-差异试验.
- 患有高/ 非常高心脏病风险的成年人随机分为inclisiran或安慰剂.
- 所有参与者都接受了ioLLT,包括开放式的罗斯瓦斯升级.
主要成果:
- 在第90天,使用inclisiran的LDL- C目标达到更高 (84. 9%) 与ioLLT (31. 0%) (OR 12. 09, p< 0. 001).
- 从基线到第360天的平均LDL- C降低为inclisiran的-59. 5%,而ioLLT的-24. 3% (LSMTD为-35. 14%,p< 0. 001).
- 与ioLLT (19. 2%) 相比,使用inclisiran报告的MRAE较少 (或0. 57, p< 0. 001).
结论:
- 在高胆固醇血症中,基于Inclisiran的治疗对达到LDL- C目标优于ioLLT.
- 提供早期,持续的LDL- C降低,具有良好的安全性.
- 这项研究观察到使用inclisiran的MRAE较少,生活质量指标改善.
相关概念视频
Lipid-Lowering Drugs: Statins and Miscellaneous Agents
865
Hyperlipidemia, a medical condition often referred to as high cholesterol, is characterized by abnormally elevated levels of lipids in the bloodstream. When present in excess, these lipids, specifically cholesterol and triglycerides, can lead to serious health complications, often involving cardiovascular diseases. Illnesses like atherosclerosis, heart attacks, and pancreatitis have all been linked to untreated hyperlipidemia. This means controlling and regulating cholesterol and triglyceride...
865
Atherosclerosis III: Management
33
Management of atherosclerosis involves an integrated strategy encompassing pharmacological treatment, surgical interventions, lifestyle changes, and nutrition therapy to address the multifactorial nature of the disease.Pharmacological TherapyA cornerstone of atherosclerosis management is the use of pharmacological agents. Statins, such as atorvastatin, are pivotal in inhibiting HMG-CoA reductase, an enzyme that catalyzes an initial step in cholesterol synthesis in the liver. This reduction in...
33
Treatment for Pulmonary Arterial Hypertension: Prostacyclin Receptor Agonists
251
Prostacyclin receptor agonists are a class of therapeutic agents integral to managing pulmonary arterial hypertension (PAH). These drugs operate by mimicking the action of prostaglandin I2, or PGI2, a naturally occurring compound in the body.
These agonists bind to the IPR receptor situated on the plasma membrane of the pulmonary artery smooth muscle cells. This binding triggers a cascade of reactions known as the GS-AC-cAMP-PKA pathway. This pathway results in the relaxation of smooth muscle...
These agonists bind to the IPR receptor situated on the plasma membrane of the pulmonary artery smooth muscle cells. This binding triggers a cascade of reactions known as the GS-AC-cAMP-PKA pathway. This pathway results in the relaxation of smooth muscle...
251
Treatment for Pulmonary Arterial Hypertension: Endothelin Receptor Antagonists
223
Endothelins (ETs) are potent vasoactive peptides critical in the human body's various physiological and pathological processes. One of the most promising therapeutic strategies for treating pulmonary arterial hypertension (PAH) involves counteracting the effects of these endothelins using a class of drugs known as endothelin receptor antagonists.
ETs are synthesized through a complex sequence of enzymatic steps, primarily involving an enzyme referred to as endothelin-converting enzyme...
ETs are synthesized through a complex sequence of enzymatic steps, primarily involving an enzyme referred to as endothelin-converting enzyme...
223
Coronary Artery Disease V: Interprofessional Care
30
Interprofessional care for coronary artery disease includes pharmacological therapy and revascularization procedures.Pharmacological therapy for Coronary Artery Disease (CAD) aims to manage symptoms, prevent complications, and improve patient outcomes through various classes of medications:Antiplatelet Agents:Aspirin and Clopidogrel: These medications inhibit platelet aggregation, preventing blood clots, which is crucial for avoiding heart attacks and strokes. Doctors often prescribe these...
30
Treatment for Pulmonary Arterial Hypertension: Phosphodiesterase Inhibitors
247
Phosphodiesterase 5 (PDE5) inhibitors are potent enzymes that function to hydrolyze cyclic nucleotides to their corresponding 5' monophosphates. Their unique biochemical properties have been applied in treating Pulmonary Arterial Hypertension (PAH).
Among the PDE5 inhibitors, sildenafil (Revatio) stands out as a competitive and selective inhibitor. It operates by elevating cellular levels of cGMP and augmenting signaling through the cGMP-PKG pathway, promoting vasodilation. Upon oral...
Among the PDE5 inhibitors, sildenafil (Revatio) stands out as a competitive and selective inhibitor. It operates by elevating cellular levels of cGMP and augmenting signaling through the cGMP-PKG pathway, promoting vasodilation. Upon oral...
247


