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依洛尤单抗:一种靶向 PCSK9 的小干扰 RNA 策略,用于治疗高胆固醇血症。

Inclisiran: a small interfering RNA strategy targeting PCSK9 to treat hypercholesterolemia.

机构信息

Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates and Centre of Medical Education, University of Dundee, UK.

Department of Diabetes, Nutrition and Metabolic Diseases, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.

出版信息

Expert Opin Drug Saf. 2022 Jan;21(1):9-20. doi: 10.1080/14740338.2022.1988568. Epub 2021 Oct 14.

Abstract

INTRODUCTION

Inclisiran is a novel posttranscriptional gene silencing therapy that inhibits proprotein convertase subtilisin/kexin type 9 (PCSK9) synthesis by RNA interference and has a potent, dose-dependent, durable effect in lowering LDL-C, and therefore is an effective drug to treat dyslipidemia, reducing the risk for acute cardiovascular (CV) events. It is safe and well-tolerated.

AREAS COVERED

This paper aims to review the mechanism of action of inclisiran while evaluating its efficacy and safety in the treatment of dyslipidemia from data of the clinical trials in the ORION program.

EXPERT OPINION

Data from the clinical trials in the ORION program demonstrated efficacy and safety of inclisiran in patients with dyslipidemia. Adverse events were similar in the inclisiran and placebo groups in the clinical trials, although injection-site reactions were more frequent with inclisiran than with placebo. Although the combination of efficacy and safety makes inclisiran a good option for the treatment of dyslipidemia compared to other PCSK9 targeting therapeutic strategies, however, further studies should exclude the possibility that inclisiran, through lower-affinity interactions, may influence other mRNAs in the physiological milieu.

摘要

简介

依洛尤单抗是一种新型的转录后基因沉默疗法,通过 RNA 干扰抑制前蛋白转化酶枯草溶菌素/凝血酶 9(PCSK9)的合成,具有强大、剂量依赖性、持久的降低 LDL-C 的作用,因此是治疗血脂异常、降低急性心血管(CV)事件风险的有效药物。它是安全且耐受良好的。

涵盖领域

本文旨在综述依洛尤单抗的作用机制,同时评估 ORION 项目临床试验中该药治疗血脂异常的疗效和安全性。

专家意见

ORION 项目临床试验数据表明,依洛尤单抗治疗血脂异常有效且安全。临床试验中,依洛尤单抗组与安慰剂组的不良反应相似,但依洛尤单抗组的注射部位反应比安慰剂组更常见。尽管与其他 PCSK9 靶向治疗策略相比,依洛尤单抗的疗效和安全性使其成为治疗血脂异常的一个较好选择,但仍需进一步研究以排除依洛尤单抗通过低亲和力相互作用可能影响生理环境中其他 mRNA 的可能性。

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