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奥列扎森和普洛扎西兰在血脂异常管理中的应用:临床试验的叙述性综述。

Olezarsen and Plozasiran in Dyslipidemia Management: A Narrative Review of Clinical Trials.

机构信息

Johns Hopkins Bloomberg School of Public Health, Baltimore, USA.

Siberian State Medical University, Tomsk, Russia.

出版信息

High Blood Press Cardiovasc Prev. 2024 Nov;31(6):567-576. doi: 10.1007/s40292-024-00677-7. Epub 2024 Oct 1.

Abstract

Cardiovascular diseases are a worldwide known cause of mortality, often due to dyslipidemia and other modifiable and non-modifiable factors. Rare genetic conditions such as familial chylomicronemia are underdiagnosed and mismanaged. Traditional lipid-lowering therapies, such as statins, often have limitations, such as adverse effects and suboptimal lipid control in certain patient populations. Olezarsen and Plozasiran, as emerging therapies, offer potential benefits by targeting specific pathways involved in lipid metabolism. The asymptomatic presentation and high mortality rate warrant novel agents that can manage dyslipidemia. In this article, olezarsen and plozasiran are thoroughly reviewed. From clinical trials, plozasiran significantly improved non-HDL cholesterol levels, highlighting its comprehensive lipid-modifying effects. Olezarsen also demonstrated remarkable efficacy in reducing fasting triglycerides from baseline levels. Utilizing these medications for primary and secondary prevention of atherosclerotic cardiovascular diseases can significantly reduce the global burden of cardiovascular disease and its complications. The review discusses the therapeutic effects of Olezarsen and Plozasiran in managing dyslipidemia, especially familial chylomicronemia syndrome (FCS). While traditional treatments like lifestyle modifications and statins are common, novel antisense oligonucleotides such as Olezarsen and Plozasiran have significant modulatory effects on apolipoproteins, disrupting specific genes involved in lipid metabolism.

摘要

心血管疾病是全球范围内导致死亡的主要原因之一,通常与血脂异常和其他可改变和不可改变的因素有关。罕见的遗传性疾病,如家族性乳糜微粒血症,常常被漏诊和误诊。传统的降脂治疗方法,如他汀类药物,往往存在局限性,如在某些患者群体中出现不良反应和血脂控制不理想等问题。新兴的治疗方法如 Olezarsen 和 Plozasiran 通过靶向脂质代谢相关的特定途径,具有潜在的益处。鉴于其无症状表现和高死亡率,需要寻找能够有效管理血脂异常的新型药物。本文详细介绍了 Olezarsen 和 Plozasiran。临床试验表明,Plozasiran 可显著降低非高密度脂蛋白胆固醇水平,具有全面的调脂作用。Olezarsen 也能显著降低空腹甘油三酯水平。将这些药物用于动脉粥样硬化性心血管疾病的一级和二级预防,可显著降低心血管疾病及其并发症的全球负担。本文还讨论了 Olezarsen 和 Plozasiran 治疗血脂异常的疗效,特别是家族性乳糜微粒血症综合征(FCS)。尽管生活方式改变和他汀类药物等传统治疗方法较为常见,但新型反义寡核苷酸如 Olezarsen 和 Plozasiran 对载脂蛋白具有显著的调节作用,可干扰脂质代谢相关的特定基因。

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