Department of Cardiology, Hospital Italiano de Buenos Aires, Peron 4190, Buenos Aires, C1199ABB, Argentina.
Department of Cardiology, Hospital Militar Campo de Mayo, Buenos Aires, Argentina.
Rev Endocr Metab Disord. 2024 Oct;25(5):817-825. doi: 10.1007/s11154-024-09893-x. Epub 2024 Jul 13.
In recent years, novel apoC3 inhibitor therapies for the treatment of hypertriglyceridemia have been developed and assessed through phase II and III clinical trials. The objective of this study was to perform an updated meta-analysis on the impact of new apoC3 inhibitor drugs on triglyceride and apoC3 levels, as well as on the incidence of pancreatitis. We conducted a meta-analysis of randomized, placebo-controlled studies assessing the effects of apoC3 inhibitors therapy (antisense oligonucleotides and small interfering RNA) on triglyceride levels, apoC3 levels, and the occurrence of acute pancreatitis. This meta-analysis was performed according to PRISMA guidelines. The random-effects model was performed. Nine randomized clinical trials (n = 717 patients) were considered eligible for this systematic review. ApoC3 inhibitor drugs were consistently associated with decreased triglyceride levels (MD -57.0%; 95% CI -61.9 to -52.1, I 82%) and lowered apoC3 values (MD -76; 95% CI -80.1 to -71.8, I 77%) when compared to placebo. Furthermore, the use of apoC3 inhibitor drugs demonstrated a reduction in the risk of acute pancreatitis (OR 0.11; 95% CI 0.04 to 0.27, I 0%). The present updated meta-analysis of randomized clinical trials demonstrated that the utilization of apoC3 inhibitors in patients with hypertriglyceridemia correlated with reduced apoC3 and triglyceride levels, along with a decreased risk of acute pancreatitis compared to the placebo.
近年来，已经开发出了新型的 apoC3 抑制剂疗法，用于治疗高甘油三酯血症，并通过 II 期和 III 期临床试验进行了评估。本研究的目的是对新型 apoC3 抑制剂药物对甘油三酯和 apoC3 水平的影响以及胰腺炎的发生率进行更新的荟萃分析。我们对评估 apoC3 抑制剂治疗（反义寡核苷酸和小干扰 RNA）对甘油三酯水平、apoC3 水平和急性胰腺炎发生影响的随机、安慰剂对照研究进行了荟萃分析。本荟萃分析根据 PRISMA 指南进行。采用随机效应模型。有 9 项随机临床试验（n=717 名患者）被认为符合本系统评价的纳入标准。apoC3 抑制剂药物与安慰剂相比，始终与甘油三酯水平降低（MD-57.0%；95%CI-61.9 至-52.1，I 82%）和 apoC3 值降低（MD-76；95%CI-80.1 至-71.8，I 77%）相关。此外，apoC3 抑制剂药物的使用降低了急性胰腺炎的风险（OR 0.11；95%CI 0.04 至 0.27，I 0%）。本更新的随机临床试验荟萃分析表明，与安慰剂相比，在高甘油三酯血症患者中使用 apoC3 抑制剂与 apoC3 和甘油三酯水平降低以及急性胰腺炎风险降低相关。
