Gachon University Gil Medical Center, Incheon, Korea.
Keimyung University Dongsan Medical Center, Daegu, South Korea.
J Clin Lipidol. 2018 Jan-Feb;12(1):162-172.e6. doi: 10.1016/j.jacl.2017.09.007. Epub 2017 Oct 19.
Alirocumab, a fully human monoclonal antibody to proprotein convertase subtilisin/kexin type 9, has been shown to provide significant reductions in low-density lipoprotein cholesterol (LDL-C). Data about its efficacy and safety in patients from South Korea and Taiwan are limited.
ODYSSEY KT assessed the efficacy and safety of alirocumab in patients from South Korea and Taiwan.
Patients with hypercholesterolemia at high cardiovascular risk who were on maximally tolerated statin were randomized (1:1) to alirocumab (75 mg every 2 weeks, with dose increase to 150 mg every 2 weeks at week 12 if LDL-C ≥70 mg/dL at week 8) or placebo for 24 weeks. The primary efficacy endpoint was percentage change in LDL-C from baseline to week 24. Safety was assessed throughout.
At week 24, alirocumab changed LDL-C levels by -57.1% (placebo: +6.3%). In the alirocumab group, 9 patients (9.5%) received dose increase at week 12. At week 24, 85.8% of patients in the alirocumab group reached LDL-C <70 mg/dL (placebo: 14.2%; P ≤ .0001 vs placebo). Alirocumab significantly improved non-high-density lipoprotein cholesterol (non-HDL-C), apolipoprotein B, total cholesterol, lipoprotein (a), and HDL-C vs placebo (P ≤ .05). Two consecutive calculated LDL-C values <25 mg/dL were recorded in 27.8% of alirocumab-treated patients. Overall, 58.8% (alirocumab) and 61.8% (placebo) of patients experienced treatment-emergent adverse events; 2.1% and 1.0% discontinued treatment due to treatment-emergent adverse events, respectively.
Alirocumab significantly improved LDL-C, apolipoprotein B, non-HDL-C, lipoprotein (a), HDL-C, and total cholesterol in Asian patients. Alirocumab was generally well tolerated. These findings are consistent with ODYSSEY findings to date.
前蛋白转化酶枯草溶菌素 9(PCSK9)单克隆抗体阿里西尤单抗可显著降低低密度脂蛋白胆固醇(LDL-C)。目前有关其在韩国和中国台湾患者中的疗效和安全性的数据有限。
ODYSSEY KT 评估了阿里西尤单抗在韩国和中国台湾患者中的疗效和安全性。
心血管疾病风险较高的高胆固醇血症患者在最大耐受剂量他汀类药物治疗的基础上,按 1:1 比例随机分配至阿里西尤单抗(75 mg,每 2 周 1 次,若第 8 周 LDL-C≥70 mg/dL,则第 12 周剂量增加至 150 mg,每 2 周 1 次)或安慰剂组,治疗 24 周。主要疗效终点为治疗 24 周时 LDL-C 较基线的变化百分比。整个研究期间评估安全性。
治疗 24 周时,阿里西尤单抗使 LDL-C 降低 57.1%(安慰剂组升高 6.3%)。在阿里西尤单抗组中,9 例(9.5%)患者在第 12 周时增加了剂量。治疗 24 周时,阿里西尤单抗组 85.8%的患者 LDL-C<70 mg/dL(安慰剂组为 14.2%;P≤.0001 与安慰剂相比)。与安慰剂相比,阿里西尤单抗显著降低非高密度脂蛋白胆固醇(non-HDL-C)、载脂蛋白 B、总胆固醇、脂蛋白(a)和 HDL-C(P≤.05)。在接受阿里西尤单抗治疗的患者中,有 27.8%的患者连续两次检测 LDL-C<25 mg/dL。总体而言,58.8%(阿里西尤单抗)和 61.8%(安慰剂)的患者发生治疗期间出现的不良事件;分别有 2.1%和 1.0%的患者因治疗期间出现的不良事件而停止治疗。
在亚洲患者中,阿里西尤单抗可显著降低 LDL-C、载脂蛋白 B、非高密度脂蛋白胆固醇、脂蛋白(a)、HDL-C 和总胆固醇。阿里西尤单抗总体上具有良好的耐受性。这些发现与 ODYSSEY 迄今为止的研究结果一致。