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昂格西单抗在杂合子家族性高胆固醇血症中国患者中的疗效和安全性:一项随机、双盲、安慰剂对照的3期试验。

Efficacy and safety of ongericimab in Chinese patients with heterozygous familial hypercholesterolemia: A randomized, double-blind, placebo-controlled phase 3 trial.

作者信息

Lin Jie, Ji Yuan, Wang Gaopin, Ma Xueping, Yao Zhuhua, Han Xuebin, Chen Jie, Chen Jiyan, Huang Wei, Xu Guangma, Peng Daoquan, Yan Peishi, Qiao Ping, He Yongming, Tang Yida, Wang Minghui, Zhang Mengqi, Yu Jianjun, Hao Yu, Ma Changsheng

机构信息

Beijing AnZhen Hospital, Capital Medical University Affiliated Anzhen Hospital, Beijing, China.

The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, China.

出版信息

Atherosclerosis. 2025 Apr;403:119120. doi: 10.1016/j.atherosclerosis.2025.119120. Epub 2025 Jan 29.

Abstract

BACKGROUND AND AIMS

Heterozygous familial hypercholesterolemia (HeFH) is a prevalent autosomal dominant disorder of lipid metabolism but severely underdiagnosed and undertreated in China. This phase 3 trial aims to evaluate the efficacy and safety of ongericimab, a novel monoclonal antibody that targets proprotein convertase subtilisin/kexin type 9 (PCSK9), in Chinese patients with HeFH.

METHODS

Patients who have been diagnosed with definite HeFH according to Dutch Lipid Clinical Network criteria and receiving stable and optimized lipid-lowering therapy were enrolled. A total of 135 patients were randomly assigned in a 2:1:2:1 ratio to receive either ongericimab 150 mg or matching placebo every 2 weeks (Q2W), or ongericimab 450 mg or matching placebo every 4 weeks (Q4W) for 24 weeks. Patients were stratified according to the use of high-intensity statins. The primary endpoint was the percentage change in LDL-C from baseline to week 24.

RESULTS

Our findings demonstrated that treatment with ongericimab resulted in a significant reduction in LDL-C at week 24. The least-squares mean difference was -69.4 % (95 % confidence interval [CI]: -80.9 %, -57.9 %; p < 0.0001) for the ongericimab 150 mg Q2W group, and -80.6 % (95 % CI: -92.1 %, -69.1 %; p < 0.0001) for ongericimab 450 mg Q4W group compared to respective matching placebo groups. Meanwhile, ongericimab also favorably altered other lipid parameters. A similar incidence of adverse events was observed in the ongericimab and placebo groups.

CONCLUSIONS

Ongericimab administered at either 150 mg Q2W or 450 mg Q4W for 24 weeks, significantly reduced LDL-C levels and was well-tolerated in Chinese patients with HeFH.

CLINICAL TRIAL REGISTRATION

http://www.

CLINICALTRIALS

gov; Unique Identifier: NCT05325203.

摘要

背景与目的

杂合子家族性高胆固醇血症(HeFH)是一种常见的常染色体显性脂质代谢紊乱疾病,但在中国严重诊断不足且治疗不充分。这项3期试验旨在评估一种靶向前蛋白转化酶枯草溶菌素/kexin 9型(PCSK9)的新型单克隆抗体昂格西单抗在中国HeFH患者中的疗效和安全性。

方法

纳入根据荷兰脂质临床网络标准确诊为明确HeFH且接受稳定和优化降脂治疗的患者。总共135例患者按2:1:2:1的比例随机分组,每2周(Q2W)接受150 mg昂格西单抗或匹配安慰剂,或每4周(Q4W)接受450 mg昂格西单抗或匹配安慰剂,持续24周。患者根据高强度他汀类药物的使用情况进行分层。主要终点是从基线到第24周低密度脂蛋白胆固醇(LDL-C)的百分比变化。

结果

我们的研究结果表明,昂格西单抗治疗在第24周时导致LDL-C显著降低。与各自匹配的安慰剂组相比,昂格西单抗150 mg Q2W组的最小二乘均值差异为-69.4%(95%置信区间[CI]:-80.9%,-57.9%;p<0.0001),昂格西单抗450 mg Q4W组为-80.6%(95%CI:-92.1%,-69.1%;p<0.0001)。同时,昂格西单抗也有利地改变了其他脂质参数。在昂格西单抗组和安慰剂组中观察到相似的不良事件发生率。

结论

每2周150 mg或每4周450 mg给药24周的昂格西单抗显著降低了中国HeFH患者的LDL-C水平,且耐受性良好。

临床试验注册

http://www.

临床试验

gov;唯一标识符:NCT05325203。

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