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Efficacy and safety of pelacarsen in lowering Lp(a) in healthy Japanese subjects

Published:December 07, 2022DOI:https://doi.org/10.1016/j.jacl.2022.12.001

      Highlights

      • Pelacarsen was studied in subjects of Japanese ancestry.
      • Single (20, 40, 80 mg) and multiple doses of pelacarsen 80 mg were used.
      • Maximal, placebo-corrected Lp(a) reduction was -106% with 80 mg monthly dose.
      • No serious adverse events were noted.
      • No clinically relevant abnormalities in any laboratory parameters were noted.

      Abstract

      Background

      Pelacarsen is a liver-targeted antisense oligonucleotide that potently lowers lipoprotein(a) [Lp(a)] levels. Its safety and efficacy in diverse populations has not been extensively studied.

      Objective

      To assess the effect of pelacarsen, including monthly dosing of 80 mg, in subjects of Japanese ancestry.

      Methods

      A randomized double-blind, placebo-controlled, study was performed in 29 healthy Japanese subjects treated with single ascending doses (SAD) of pelacarsen 20, 40 and 80 mg subcutaneously or multiple doses (MD) of pelacarsen 80 mg monthly for 4 doses. The primary objective was to assess the safety and tolerability in healthy Japanese subjects; secondary objectives to assess the pharmacokinetics of pelacarsen; and exploratory objective to determine the effect of pelacarsen on plasma Lp(a) levels.

      Results

      No serious adverse events or clinically relevant abnormalities in any laboratory parameters were noted. In the MD cohort, mean plasma concentrations of pelacarsen peaked at ∼4 hours and declined in a bi-exponential manner thereafter. In the SAD cohorts, the placebo-corrected least-square mean (PCLSM) percent changes in Lp(a) at Day 30 were: -55.4% (p=0.0008), -58.9% (p=0.0003) and -73.7% (p<0.0001) for the 20 mg, 40 mg, and 80 mg pelacarsen-treated groups, respectively. In the MD cohort, the PCLSM at Days 29, 85, 113, 176 and 204 were -84.0% (p=0.0003), -106.2% (p<0.0001), -70.0 (p<0.0001), -80.0% (p=0.0104) and -55.8% (p=0.0707), respectively.

      Conclusions

      Pelacarsen demonstrates an acceptable safety and tolerability profile and potently lowers plasma levels of Lp(a) in healthy Japanese subjects, including with the 80 mg monthly dose being evaluated in the Lp(a) HORIZON trial.

      Keywords

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