在高胆固醇血症患者中,联合使用 gemcabene 作为稳定他汀类药物治疗的附加疗法的疗效和安全性。

Efficacy and safety of gemcabene as add-on to stable statin therapy in hypercholesterolemic patients.

机构信息

Metabolic & Atherosclerosis Research Center, Cincinnati, OH.

Louisville Metabolic & Atherosclerotic Research Center, Louisville, KY.

出版信息

J Clin Lipidol. 2016 Sep-Oct;10(5):1212-22. doi: 10.1016/j.jacl.2016.08.002. Epub 2016 Aug 10.

Abstract

BACKGROUND

Ezetimibe added to statin therapy further reduces LDL-C and clinical atherosclerotic cardiovascular disease compared to statin alone. However, the number of effective and safe oral agents for patients not at LDL-C goal is limited. In prior clinical trials, gemcabene reduced LDL-C and was generally well-tolerated in nearly 900 patients treated for up to 12 weeks.

OBJECTIVE

To evaluate the LDL-C lowering and safety of gemcabene as add-on to stable statin therapy in hypercholesterolemic patients.

METHODS

This was an 8-week, double-blind, placebo-controlled, randomized, phase 2 study in men and postmenopausal women ≥18 and ≤65 years of age with LDL-C ≥130 mg/dL (3.4 mmol/L) while on low-intensity to high-intensity stable statin (the majority on moderate intensity) therapy. Sixty-six patients were randomized 1:1:1 to gemcabene 300 mg, 900 mg, or placebo QD.

RESULTS

Gemcabene 300 mg and 900 mg produced a mean percent change in LDL-C of -23.4 ± 4.7% (P = .005) and -27.7 ± 4.3% (P < .001), respectively, vs -6.2 ± 4.3% for placebo. The median percent change in CRP was -26.1% (P = .196) and -53.9% (P < .001) for gemcabene 300 mg and 900 mg, respectively, vs -11.1% for placebo. Gemcabene 300 mg and 900 mg were well-tolerated with no significant difference in AEs compared to placebo.

CONCLUSIONS

Gemcabene as add-on to stable statin therapy demonstrated additional dose-dependent and statistically significant reductions in LDL-C of >20% and CRP >40% compared to placebo. The results support gemcabene-continued development for patients requiring LDL-C lowering beyond that provided by background statin therapy.

摘要

背景

与单独使用他汀类药物相比,依折麦布联合他汀类药物治疗可进一步降低 LDL-C 水平并减少临床动脉粥样硬化性心血管疾病。然而,对于未达到 LDL-C 目标的患者,有效的口服药物数量有限。在之前的临床试验中,加巴喷丁可降低 LDL-C,在近 900 名接受治疗长达 12 周的患者中通常具有良好的耐受性。

目的

评估加巴喷丁作为添加物与稳定的他汀类药物联合治疗对高胆固醇血症患者的 LDL-C 降低作用和安全性。

方法

这是一项为期 8 周的、双盲、安慰剂对照、随机、2 期研究,纳入了 LDL-C≥130mg/dL(3.4mmol/L)且正在接受低强度至高强度稳定他汀类药物(大多数为中强度)治疗的年龄≥18 岁且≤65 岁的男性和绝经后女性。66 名患者按 1:1:1 的比例随机分为加巴喷丁 300mg、900mg 或安慰剂,每日一次。

结果

加巴喷丁 300mg 和 900mg 分别使 LDL-C 的平均百分比变化降低了-23.4±4.7%(P=0.005)和-27.7±4.3%(P<0.001),而安慰剂组则降低了-6.2±4.3%。加巴喷丁 300mg 和 900mg 组的 CRP 中位数百分比变化分别为-26.1%(P=0.196)和-53.9%(P<0.001),而安慰剂组为-11.1%。与安慰剂相比,加巴喷丁 300mg 和 900mg 均具有良好的耐受性,不良事件发生率无显著差异。

结论

与安慰剂相比,加巴喷丁联合稳定的他汀类药物治疗可使 LDL-C 降低>20%和 CRP 降低>40%,且呈剂量依赖性,差异具有统计学意义。这些结果支持继续开发加巴喷丁,用于需要在背景他汀类药物治疗的基础上进一步降低 LDL-C 的患者。

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