Farina Christopher J, Lu Wenqi, Nilsson Jan
Abcentra, Los Angeles, California, USA.
Department of Clinical Sciences Malmö, Lund University, Lund, Sweden.
Curr Opin Lipidol. 2025 Aug 1;36(4):170-178. doi: 10.1097/MOL.0000000000000990. Epub 2025 May 2.
Myocardial infarction survivors are at a high risk of a recurrent event despite receiving guideline preventive therapy. There is accumulated evidence that persistent atherosclerotic plaque inflammation contributes to this risk. Oxidized low-density lipoprotein (LDL) is widely recognized as a key factor in plaque inflammation and instability; however, no therapies that directly target oxidized LDL are to date available for clinical use. We will here review recent observations indicating that treatment with the anti-oxidized LDL antibody orticumab specifically inhibits plaque inflammation.
The effect of orticumab on coronary inflammation in a randomized, double-blind, placebo-controlled pilot phase 2a trial in subjects with moderate to severe psoriasis is a new and recent finding. Coronary inflammation was assessed by calculation of the fat attenuation index (FAI)-Score in the pericoronary adipose tissue in coronary computed tomography angiograms. After 15 weeks of treatment the mean FAI-Score of the three main coronary arteries was significantly reduced in the orticumab group while no change occurred in the placebo group. The effect of orticumab was most pronounced in those with most inflammation at baseline.
Treatment with orticumab represents a new and plaque-specific way to reduce arterial inflammation.
尽管接受了指南推荐的预防性治疗，但心肌梗死幸存者仍有很高的复发风险。有越来越多的证据表明，持续性动脉粥样硬化斑块炎症会导致这种风险。氧化型低密度脂蛋白（LDL）被广泛认为是斑块炎症和不稳定的关键因素；然而，迄今为止，尚无直接针对氧化型LDL的治疗方法可用于临床。我们将在此回顾最近的观察结果，这些结果表明用抗氧化型LDL抗体orticumab进行治疗可特异性抑制斑块炎症。
在一项针对中度至重度银屑病患者的随机、双盲、安慰剂对照2a期试验中，orticumab对冠状动脉炎症的影响是一项新的近期发现。通过计算冠状动脉计算机断层血管造影中冠状动脉周围脂肪组织的脂肪衰减指数（FAI）评分来评估冠状动脉炎症。治疗15周后，orticumab组三条主要冠状动脉的平均FAI评分显著降低，而安慰剂组无变化。orticumab的效果在基线时炎症最严重的患者中最为明显。
用orticumab进行治疗是一种减少动脉炎症的新的、针对斑块的方法。
