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LIPOPROTEIN REDUCTION IN PATIENTS WITH CARDIOVASCULAR DISEASES

Dr. Muhammad Ghufran, Dr.Alman Hassan, Dr. Ali Ahmed Ranjha

Introduction: Lipoprotein(a) (Lp(a)) is an LDL-like molecule containing an apolipoprotein B-100 (apo(B-100)) particle locked by a disulphide bridge to apo(a). Cardiovascular diseases cause 3% of all deaths in North America being the foremost common explanation for death in European men under 65 years of aged and therefore the second most common cause in women. Method: 256 patients were blindly randomized. Patients got the hepatocyte-directed antisense oligonucleotide AKCEA-APO(a)-LRx, named to here as APO(a)-LRx, or saline placebo subcutaneously for six to 12 months. Results: dose dependent mean percent reductions in lipoprotein(a) from baseline were noticed, with decreases of 46% at a dose of 20 mg every 4 weeks, 66% at 40 mg every 4 weeks, 58% at 20 mg every 2 weeks, 82% at 60 mg every 4 weeks, and 89% at 20 mg every week, as compared with 9% for the pooled placebo group (P value range for the comparison with placebo, 0.003 to <0.001). The two regimens of the same monthly dose (40 mg) — 40 mg every 4 weeks and 20 mg every 2 weeks — lessened lipoprotein(a) to similar extents. Conclusion: Lipoprotein(a) levels were lowered by APO(a)-LRx in a dose-dependent manner in patients who had elevated lipoprotein(a) levels and established cardiovascular disease.