Division of Cardiology, University of Florida College of Medicine, 655 West 8th Street, Jacksonville, FL, 32209, USA.
Division of Cardiology, Department of Medical and Surgical Sciences, "Magna Graecia" University, Catanzaro, Italy.
Clin Pharmacokinet. 2023 Apr;62(4):541-558. doi: 10.1007/s40262-023-01224-8. Epub 2023 Mar 16.
Cardiovascular diseases are the leading cause of death worldwide. Although there have been substantial advances over the last decades, recurrent adverse cardiovascular events after myocardial infarction are still frequent, particularly during the first year of the index event. For decades, high-density lipoprotein (HDL) has been among the therapeutic targets for long-term prevention after an ischemic event. However, early trials focusing on increasing HDL circulating levels showed no improvement in clinical outcomes. Recently, the paradigm has shifted to increasing the functionality of HDL rather than its circulating plasma levels. For this purpose, apolipoprotein-AI-based infusion therapies have been developed, including reconstituted HDL, such as CSL112. During the last decade, CSL112 has been extensively studied in Phase 1 and 2 trials and has shown promising results. In particular, CSL112 has been studied in the Phase 2b AEGIS trial exhibiting good safety and tolerability profiles, which has led to the ongoing large-scale Phase 3 AEGIS-II trial. This systematic overview will provide a comprehensive summary of the CSL112 drug development program focusing on its pharmacodynamic, pharmacokinetic, and safety profiles.
心血管疾病是全球范围内的主要死亡原因。尽管在过去几十年中取得了重大进展,但心肌梗死后的复发性不良心血管事件仍然频繁发生,尤其是在指数事件发生后的第一年。几十年来,高密度脂蛋白(HDL)一直是缺血事件后长期预防的治疗靶点之一。然而,早期专注于提高 HDL 循环水平的试验并未显示出临床结局的改善。最近,这一模式已经转变为提高 HDL 的功能,而不是其循环血浆水平。为此,已经开发了基于载脂蛋白-AI 的输注疗法,包括再形成的 HDL,如 CSL112。在过去十年中,CSL112 已经在 1 期和 2 期试验中进行了广泛研究,并显示出了有前途的结果。特别是,CSL112 已经在 2b 期 AEGIS 试验中进行了研究,表现出良好的安全性和耐受性特征,这导致了正在进行的大规模 3 期 AEGIS-II 试验。本系统综述将全面总结 CSL112 的药物开发计划,重点介绍其药效学、药代动力学和安全性特征。