ACC.25, 2025

Our highlights from this year’s American College of Cardiology Scientific Sessions in Chicago, USA (29-31 March 2025), extend across encouraging results on ANGPTL3 inhibition with solbinsiran in mixed dyslipidaemia and SHR-1918 in sub-optimally controlled hyperlipidaemia, mechanistic and resource utilisation data supporting olezarsen in familial chylomicronaemia syndrome, latest insights from the PROMINENT trial of pemafibrate, and […]

In adults with mixed dyslipidaemia, a 400 mg dose of the ANGPTL3 siRNA, solbinsiran, significantly reduced ANGPTL3 over 270 days, together with significant reductions in apoB, and TG. These were the key findings of the Phase 2 PROLONG-ANG3 trial, presented by Professor Kausik Ray, Imperial College London, UK, at ACC.25, and published simultaneously in The Lancet.

The ANGPTL3 monoclonal antibody, SHR-1918, reduces LDL-C and TG when added to standard lipid lowering therapy in patients at moderate or higher risk of atherosclerotic cardiovascular disease, according to results of a Phase 2 study presented at the congress and published in the Journal of the American College of Cardiology.

Extensive data presented at the congress on the apoCIII antisense oligonucleotide, olezarsen, recently approved in the USA for adults with familial chylomicronaemia syndrome (FCS), supported its positive effects on lipoprotein profiles and potential benefits for resource utilisation.  

No association between elevated apoB or LDL-C and cardiovascular (CV) outcomes in patients taking pemafibrate in the PROMINENT trial has been identified, compared to those taking placebo. These findings cast doubt over the hypothesis that the failure to reduce CV events in the trial (despite a 26% reduction in TG) may have been linked to modest elevations in apoB and LDL-C. 

Declining use and spending on TG-lowering therapies has been reported among beneficiaries of the Medicare Part D prescription drug plan in a cross-sectional study of trends from 2013-2021. Using the Medicare database, the researchers assessed annual expenditure for all generic and brand name formulations of fibrates, omega-3 acid ethyl esters and niacin, together with the number of beneficiaries.