Harada-Shiba Mariko, Davdison Michael H, Ditmarsch Marc, Hsieh Andrew, Wuerdeman Erin, Kling Douglas, Nield Annie, Dicklin Mary R, Nakata Akitaka, Sueyoshi Atsushi, Kuroyanagi Satoshi, Kastelein John J P
Cardiovascular Center, Osaka Medical and Pharmaceutical University.
NewAmsterdam Pharma B.V.
J Atheroscler Thromb. 2024 Oct 1;31(10):1386-1397. doi: 10.5551/jat.64828. Epub 2024 Apr 3.
Obicetrapib is a highly selective cholesteryl ester transfer protein (CETP) inhibitor shown to reduce low-density lipoprotein cholesterol (LDL-C) and apolipoprotein B (apoB), when taken as monotherapy and in combination with ezetimibe on a background of statins, in clinical trials predominantly conducted in Northern European/Caucasian participants. We characterized the efficacy, safety, and tolerability of obicetrapib within an Asian-Pacific region population.
This double-blind, randomized, phase 2 trial examined obicetrapib 2.5, 5, and 10 mg/d, compared with placebo, for 8 weeks as an adjunct to stable statin therapy (atorvastatin 10 or 20 mg/d or rosuvastatin 5 or 10 mg/d) in Japanese men and women who had not achieved 2022 Japan Atherosclerosis Society Guidelines and had LDL-C >70 mg/dL or non-high-density lipoprotein cholesterol (non-HDL-C) >100 mg/dL and triglycerides (TG) <400 mg/dL. Endpoints included LDL-C, non-HDL-C, HDL-C, very low-density lipoprotein cholesterol, apolipoproteins, TG, steady state pharmacokinetics (PK) in obicetrapib arms, safety, and tolerability.
In the 102 randomized subjects (mean age 64.8 y, 71.6% male), obicetrapib significantly lowered median LDL-C, apoB, and non-HDL-C, and raised HDL-C at all doses; responses in the obicetrapib 10 mg group were -45.8%, -29.7%, -37.0%, and +159%, respectively (all p<0.0001 vs. placebo). The PK profile demonstrated near complete elimination of drug by 4 weeks. Obicetrapib was well tolerated and there were no adverse safety signals.
All doses of obicetrapib taken as an adjunct to stable statin therapy significantly lowered atherogenic lipoprotein lipid parameters, showed near complete elimination of drug by 4 weeks, and were safe and well tolerated in a Japanese population, similar to previous studies of obicetrapib conducted in predominantly Caucasian participants.
奥贝胆酸是一种高度选择性的胆固醇酯转移蛋白(CETP)抑制剂,在主要针对北欧/白种人参与者进行的临床试验中,作为单一疗法以及与依折麦布联合应用于他汀类药物背景下时,已显示可降低低密度脂蛋白胆固醇(LDL-C)和载脂蛋白B(apoB)。我们对亚太地区人群中奥贝胆酸的疗效、安全性和耐受性进行了评估。
这项双盲、随机、2期试验在未达到2022年日本动脉粥样硬化协会指南且LDL-C>70mg/dL或非高密度脂蛋白胆固醇(非HDL-C)>100mg/dL且甘油三酯(TG)<400mg/dL的日本男性和女性中,将2.5mg/d、5mg/d和10mg/d的奥贝胆酸与安慰剂进行比较,作为稳定他汀类药物治疗(阿托伐他汀10mg/d或20mg/d或瑞舒伐他汀5mg/d或10mg/d)的辅助治疗,为期8周。终点指标包括LDL-C、非HDL-C、HDL-C、极低密度脂蛋白胆固醇、载脂蛋白、TG、奥贝胆酸组的稳态药代动力学(PK)、安全性和耐受性。
在102名随机受试者(平均年龄64.8岁,71.6%为男性)中,奥贝胆酸在所有剂量下均显著降低了LDL-C、apoB和非HDL-C的中位数,并提高了HDL-C;奥贝胆酸10mg组的相应变化分别为-45.8%、-29.7%、-37.0%和+159%(与安慰剂相比,均p<0.0001)。PK曲线显示4周时药物几乎完全消除。奥贝胆酸耐受性良好,且没有不良安全信号。
作为稳定他汀类药物治疗的辅助药物,所有剂量的奥贝胆酸均显著降低了致动脉粥样硬化脂蛋白脂质参数,4周时显示药物几乎完全消除,在日本人群中安全且耐受性良好,与之前主要针对白种人参与者进行的奥贝胆酸研究结果相似。