Results of a post hoc analysis of data from three placebo controlled trials of evinacumab have demonstrated reductions in calculated remnant cholesterol (TC – LDL-C – HDL-C) across all dosing groups. While advising caution as concerns the limitations of comparison of study results, Professor Robert Rosenson, Icahn School of Medicine at Mount Sinai, New York, USA, and colleagues, suggested that remnant cholesterol could be considered as a future target for lipid-lowering therapies.
In the Phase 3 ELIPSE trial (NCT03399786) in patients with homozygous familial cholesterolaemia and LDL-C ≥70 mg/dL, remnant cholesterol was reduced from baseline by 53.1% with evinacumab 15 mg/kg i.v. QW compared to an increase of 14.4% with placebo.
In the Phase 2 trial (NCT03175367) of evinacumab 450 mg s.c. weekly, or 300 mg s.c. weekly, or 300 mg s.c every 2 weeks in patients with refractory hypercholesterolaemia (LDL-C ≥70 mg/dL or ≥100 mg/dL for those with/without atherosclerotic CV disease), remnant cholesterol was reduced by 54.2%, 46% and 35.9% respectively. This compared with an increase of 9.9% with placebo. In patients treated with evinacumab 15 mg/kg i.v. or 5 mg/kg i.v., remnant cholesterol was reduced by 53.7% and 26.8% respectively, compared to a decrease of 5.6% with placebo.
In the Phase 2 trial (NCT03452228) of evinacumab 15 mg/kg i.v QW in patients with severe hypertriglyceridaemia (fasting TG ≥500 mg/dL), remnant cholesterol was reduced by 36% from baseline, compared with an increase of 40.4% with placebo.
Reference
Rosenson RS, Rader D, Ali S et al. Evinacumab reduces remnant cholesterol in patients with hypercholesterolaemia or hypertriglyceridaemia. Presented at the 90th European Atherosclerosis Society Congress, Milan, Italy, 22-25 May 2022, Poster 311.
Reportage by Jenny Bryan