Experimental drug reduces little-known cholesterol that raises heart attack risk

Researchers have discovered an experimental drug that significantly reduces a particle similar to cholesterol that can increase the risk of heart attacks and moves.

Many Americans are not aware that an elevated level of this particle – known as Lipoprotein (A) or LP (A) – circulate in their blood.

An elevated LP (A) cannot be changed with lifestyle changes, and it is called “one of the last non -treatment of the boundaries of the cardiovascular risk” Cleveland Clinic, who conducted the study.

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This new research has been confirmed by earlier discoveries that show that it is experimental drug – Lepodisated, made by Eli Lilly, who funded the studio – can “silence” the main gene responsible for synthesizing LP (A).

(Other experimental gene therapies with a similar mechanism of action are also in development, according to Cleveland Clinic.)

The findings were published in the New England Journal of Medicine and were also presented at an annual meeting of the US cardiology college on March 30.

What to know about LP (a)

Lipoprotein levels (a) are elevated at approximately 20-25% of people around the world, according to the US heart association.

This amounts to about 64 million people in the United States -in 1.4 billion people around the world.

LP (a) shares similarities with other lipoprotein that doctors aim to reduce the risk of heart disease, known as low-density lipoprotein (LDL)-is often called “bad cholesterol”.

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But Lipoprotein (a) is more inclined to accumulate plaque and clots in the arteries than LDL, according to the chief author Steven Nissen, MD

“Lipoprotein (a) is an independent risk factor for a heart disease that is largely determined by genetics – That is, inherit it, “added Dr. Deepak L. Bhatt, director of Mount Sinai Fuster Heart and professor of cardiovascular medicine at Icahn Medicine at Mount Sinai in New York, told Fox News Digital. (He was not part of the study.)

LP (a) is primarily determined by differences in one gene, while more genes are affected by LDL’s cholesterol levels.

“It’s a very big difference, and LDL has a much bigger component of the environment,” Nissen remarked.

“LP (a) is an independent risk factor for a heart disease that is largely determined by genetics.”

Diet, exercise and weight loss They can help reduce LDL levels, but they have no effect on LP (A) levels, experts say.

And unlike LDL, which can be reduced by drugs such as statins, there are currently no approved drugs that lower LP (A).

“There is no approved pharmacotherapy for lipoprotein (a) by regulatory bodies in any country in the world,” Nissen confirmed.

Studying design

Researchers performed a clinical trial of 320 individuals from Argentina, China, Denmark, Germany, Japan, Mexico, the Netherlands, Romania, Spain and USA from November 11, 2022 to 17 April 2023.

Participants were randomly assigned to receive a placebo or one or two subcutaneous injections are laid down.

Normal level LP (A) is less than 75 nanomol per liter and average level for People in trial There were about 250 nanomol per liter, Nissen told Fox News Digital.

“They were very high – more than three times more than the upper limit of normal,” he added.

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After one injection of the highest dose, the participants showed almost 100% lipoprotein levels (a) in six months.

Those who received the second dose in six months retained almost 100% reduction on a one -year mark.

In other words, therapy removed almost all the lipoprotein (a) from the blood, according to Nissen.

Cardiologists say that discoveries could ultimately Help with treatment Millions of Americans who increased the level of LP (A).

“The results are very impressive,” Bhatt said.

Potential limitations

Researchers have noticed that there are no bigger Concern for safetyBut 12% of participants reported a mild reaction at the injection site.

The study had only a few black man participants – a population that needed more research, as it is more likely to have elevated lipoprotein (a) concentrations of white, previous studies have shown.

(In order to solve this concern, researchers enroll in many more black patients in their larger clinical test of phase 3.)

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The second limit was that only two doses were applied in the test, so the effect of the effect is no longer known.

The study also did not show that reduction of LP (A) levels also reduces the risk of heart attacks and movesExternal experts noticed.

“Phase 3 testing, the testing of the clinical impact of this medicine, it is necessary to see whether the large decrease in the LP (A) is converted to lower heart attack rates,” Bhatt said.

Nissen confirmed that the trial of phases 3 to resolve this issue is already ongoing.

“No matter your level when you are 24, the level is when you are 64 – that does not change, because it is genetic.”

The European Society of Cardiology and the National Lipid Association in the United States recommend that all adults check LP (A) levels.

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“For many years I have been checking the level of LP (a) in all patients,” Bhatt said.

But unlike Traditional cholesterolWhat doctors usually monitor over time, Nissen pointed out that Lipoprotein (a) should only be checked once in their lives.

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“No matter your level when you are 24, the level is when you are 64 – that doesn’t change, because it’s genetic,” he said.

“So you only need to get it once, and if you get it early in life, then you know that you are at risk and in accordance with that you can live your life.”