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摘要: 血脂异常是动脉粥样硬化性心血管疾病最为重要的致病危险因素之一。在2024年度,以前蛋白转化酶枯草溶菌素9、血管生成素样蛋白3、载脂蛋白C-Ⅲ、脂蛋白(a)[Lp(a)]等为靶点,利用单克隆抗体、小干扰RNA、反义寡核苷酸、重组融合蛋白等生物技术研发的多个血脂异常治疗新药临床试验公布,证实其能有效降低低密度脂蛋白胆固醇、甘油三酯和Lp(a)等脂质参数,且安全性良好,初步结果令人鼓舞,但其对心血管事件的影响仍有待大型临床试验进一步验证。Abstract: Dyslipidemia is one of the most important risk factors for atherosclerotic cardiovascular disease. In 2024, multiple clinical trials of new drugs for dyslipidemia targeting proprotein convertase subtilisin/kexin type 9, angiopoietin-like protein 3, apolipoprotein C-Ⅲ, and lipoprotein(a) [Lp(a)] were announced, using biotechnologies such as monoclonal antibodies, small interfering RNA, antisense oligonucleotides, and recombinant fusion proteins. These trials confirmed that these drugs can significantly reduce lipid parameters such as low-density lipoprotein cholesterol, triglycerides, and Lp(a), with good safety profiles. The preliminary results are encouraging, but their impact on cardiovascular events still needs to be further verified by large-scale clinical trials.
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[1] Xu M, Wang Z, Zhang Y, et al. Recaticimab monotherapy for nonfamilial hypercholesterolemia and mixed hyperlipemia: The Phase 3 REMAIN-1 Randomized Trial[J]. J Am Coll Cardiol, 2024, 84(20): 2026-2036. doi: 10.1016/j.jacc.2024.07.035
[2] Sun Y, Lv Q, Guo Y, et al. Recaticimab as add-on therapy to statins for nonfamilial hypercholesterolemia: The Randomized, Phase 3 REMAIN-2 Trial[J]. J Am Coll Cardiol, 2024, 84(20): 2037-2047. doi: 10.1016/j.jacc.2024.09.012
[3] Klug EQ, Llerena S, Burgess LJ, et al. Efficacy and safety of lerodalcibep in patients with or at high risk of cardiovascular disease: A Randomized Clinical Trial[J]. JAMA Cardiol, 2024, 9(9): 800-807. doi: 10.1001/jamacardio.2024.1659
[4] HPS3/TIMI55-REVEAL Collaborative Group; Bowman L, Hopewell JC, et al. Effects of anacetrapib in patients with atherosclerotic vascular disease[J]. N Engl J Med, 2017, 377(13): 1217-1227. doi: 10.1056/NEJMoa1706444
[5] Nicholls SJ, Ditmarsch M, Kastelein JJ, et al. Lipid lowering effects of the CETP inhibitor obicetrapib in combination with high-intensity statins: a randomized phase 2 trial[J]. Nat Med, 2022, 28(8): 1672-1678. doi: 10.1038/s41591-022-01936-7
[6] Ballantyne CM, Ditmarsch M, Kastelein JJ, et al. Obicetrapib plus ezetimibe as an adjunct to high-intensity statin therapy: A randomized phase 2 trial[J]. J Clin Lipidol, 2023, 17(4): 491-503. doi: 10.1016/j.jacl.2023.05.098
[7] Nicholls SJ, Nelson AJ, Ditmarsch M, et al. Obicetrapib on top of maximally tolerated lipid-modifying therapies in participants with or at high risk for atherosclerotic cardiovascular disease: rationale and designs of BROADWAY and BROOKLYN[J]. Am Heart J, 2024, 274: 32-45. doi: 10.1016/j.ahj.2024.05.002
[8] Chang B, Laffin LJ, Sarraju A, et al. Obicetrapib-the Rebirth of CETP Inhibitors?[J]. Curr Atheroscler Rep, 2024, 26(10): 603-608. doi: 10.1007/s11883-024-01231-5
[9] Raal FJ, Rosenson RS, Reeskamp LF, et al. Evinacumab for homozygous familial hypercholesterolemia[J]. N Engl J Med, 2020, 383(8): 711-720. doi: 10.1056/NEJMoa2004215
[10] Rosenson RS, Gaudet D, Hegele RA, et al. Zodasiran, an RNAi Therapeutic Targeting ANGPTL3, for Mixed Hyperlipidemia[J]. N Engl J Med, 2024, 391(10): 913-925. doi: 10.1056/NEJMoa2404147
[11] Bergmark BA, Marston NA, Prohaska TA, et al. Olezarsen for hypertriglyceridemia in patients at high cardiovascular risk[J]. N Engl J Med, 2024, 390(19): 1770-1780. doi: 10.1056/NEJMoa2402309
[12] Stroes ESG, Alexander VJ, Karwatowska-Prokopczuk E, et al. Olezarsen, acute pancreatitis, and familial chylomicronemia syndrome[J]. N Engl J Med, 2024, 390(19): 1781-1792. doi: 10.1056/NEJMoa2400201
[13] Gaudet D, Pall D, Watts GF, et al. Plozasiran(ARO-APOC3) for Severe Hypertriglyceridemia: The SHASTA-2 Randomized Clinical Trial[J]. JAMA Cardiol, 2024, 9(7): 620-630. doi: 10.1001/jamacardio.2024.0959
[14] Watts GF, Rosenson RS, Hegele RA, et al. Plozasiran for managing persistent chylomicronemia and pancreatitis risk[J]. N Engl J Med, 2025;392(2): 127-137.
[15] Nissen SE, Wang Q, Nicholls SJ, et al. Zerlasiran-a small-interfering RNA targeting lipoprotein(a): A Phase 2 Randomized Clinical Trial[J]. JAMA, 2024, 332(23): 1992-2002. doi: 10.1001/jama.2024.21957
[16] Nicholls SJ, Ni W, Rhodes GM, et al. Oral muvalaplin for lowering of lipoprotein(a): A Randomized Clinical Trial[J]. JAMA, 2024: e2424017.
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