阿利西尤单抗在日本杂合子家族性高胆固醇血症患者或他汀类药物治疗后高胆固醇血症控制不佳的高心血管风险患者中的疗效和安全性——ODYSSEY日本随机对照试验
Efficacy and Safety of Alirocumab in Japanese Patients With Heterozygous Familial Hypercholesterolemia or at High Cardiovascular Risk With Hypercholesterolemia Not Adequately Controlled With Statins - ODYSSEY JAPAN Randomized Controlled Trial.
作者信息
Teramoto Tamio, Kobayashi Masahiko, Tasaki Hiromi, Yagyu Hiroaki, Higashikata Toshinori, Takagi Yoshiharu, Uno Kiyoko, Baccara-Dinet Marie T, Nohara Atsushi
机构信息
Teikyo Academic Research Center, Teikyo University.
出版信息
Circ J. 2016 Aug 25;80(9):1980-7. doi: 10.1253/circj.CJ-16-0387. Epub 2016 Jul 22.
BACKGROUND
The ODYSSEY Japan study was designed to demonstrate the reduction in low-density lipoprotein cholesterol (LDL-C) by alirocumab as add-on to existing lipid-lowering therapy in Japanese patients with heterozygous familial hypercholesterolemia (heFH) or non-FH at high cardiovascular risk who require additional pharmacological management to achieve their LDL-C treatment goal (<2.6 or <3.1 mmol/L, depending on risk category).
METHODS AND RESULTS
This randomized, double-blind, parallel-group, 52-week study was conducted in Japan. Patients (n=216) with heFH, non-FH at high cardiovascular risk with coronary disease, or classified as category III were enrolled. The prespecified safety analysis was done after the last patient completed 52 weeks. Patients were randomized (2:1, alirocumab:placebo) with stratification for heFH to s.c. alirocumab (75 mg every 2 weeks [Q2 W] with increase to 150 mg if week 8 LDL-C ≥2.6/3.1 mmol/L) or placebo for 52 weeks plus stable statin therapy. At week 24, mean±SE change in LDL-C from baseline was -62.5±1.3% in the alirocumab group and 1.6±1.8% in the placebo group (difference, -64.1±2.2%; P<0.0001); the reduction was sustained to week 52 (alirocumab, -62.5±1.4%; placebo, -3.6±1.9%). No patterns were evident between treatment groups for adverse events at 52 weeks.
CONCLUSIONS
In high-risk Japanese patients with hypercholesterolemia on stable statin therapy, alirocumab markedly reduced LDL-C vs. placebo and was well tolerated over 52 weeks. (Circ J 2016; 80: 1980-1987).
背景
ODYSSEY日本研究旨在证明,对于需要额外药物治疗以实现低密度脂蛋白胆固醇(LDL-C)治疗目标(根据风险类别,<2.6或<3.1 mmol/L)的杂合子家族性高胆固醇血症(heFH)日本患者或高心血管风险的非FH患者,在现有降脂治疗基础上加用阿利西尤单抗可降低LDL-C水平。
方法与结果
这项随机、双盲、平行组、为期52周的研究在日本开展。纳入了患有heFH、患有冠心病且心血管风险高的非FH患者或III类患者(n = 216)。在最后一名患者完成52周治疗后进行预设的安全性分析。患者按2:1随机分组(阿利西尤单抗:安慰剂),heFH患者分层,皮下注射阿利西尤单抗(每2周75 mg [Q2W],如果第8周LDL-C≥2.6/3.1 mmol/L则增至150 mg)或安慰剂,持续52周,同时接受稳定的他汀类药物治疗。在第24周时,阿利西尤单抗组LDL-C较基线的平均±标准误变化为-62.5±1.3%,安慰剂组为1.6±1.8%(差异为-64.1±2.2%;P<0.0001);这种降低持续到第52周(阿利西尤单抗,-62.5±1.4%;安慰剂,-3.6±1.9%)。在52周时,各治疗组之间不良事件无明显差异。
结论
在接受稳定他汀类药物治疗的高风险日本高胆固醇血症患者中,与安慰剂相比,阿利西尤单抗显著降低了LDL-C水平,且在52周内耐受性良好。(《循环杂志》2016年;80: 1980 - 1987)