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Xu M, Zhu X, Wu J, Zhang Y, Zhao D, Wang X, Ding Y, Cao Y, Li C, Hu W, Sheng J, Luo Z, Zheng Z, Hu J, Liu J, Zhou X, Shen A, Ding X, Zhang Y, Zhao Y, Li Y, Zhong S, An S, Zou J, Yan L. PCSK9 inhibitor recaticimab for hypercholesterolemia on stable statin dose: a randomized, double-blind, placebo-controlled phase 1b/2 study. BMC Med 2022; 20:13. [PMID: 35039035 PMCID: PMC8763618 DOI: 10.1186/s12916-021-02208-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 12/06/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Recaticimab (SHR-1209, a humanized monoclonal antibody against PCSK9) showed robust LDL-C reduction in healthy volunteers. This study aimed to further assess the efficacy and safety of recaticimab in patients with hypercholesterolemia. METHODS In this randomized, double-blind, placebo-controlled phase 1b/2 trial, patients receiving stable dose of atorvastatin with an LDL-C level of 2.6 mmol/L or higher were randomized in a ratio of 5:1 to subcutaneous injections of recaticimab or placebo at different doses and schedules. Patients were recruited in the order of 75 mg every 4 weeks (75Q4W), 150Q8W, 300Q12W, 150Q4W, 300Q8W, and 450Q12W. The primary endpoint was percentage change in LDL-C from the baseline to end of treatment (i.e., at week 16 for Q4W and Q8W schedule and at week 24 for Q12W schedule). RESULTS A total of 91 patients were enrolled and received recaticimab and 19 received placebo. The dose of background atorvastatin in all 110 patients was 10 or 20 mg/day. The main baseline LDL-C ranged from 3.360 to 3.759 mmol/L. The least-squares mean percentage reductions in LDL-C from baseline to end of treatment relative to placebo for recaticimab groups at different doses and schedules ranged from -48.37 to -59.51%. No serious treatment-emergent adverse events (TEAEs) occurred. The most common TEAEs included upper respiratory tract infection, increased alanine aminotransferase, increased blood glucose, and increased gamma-glutamyltransferase. CONCLUSION Recaticimab as add-on to moderate-intensity statin therapy significantly and substantially reduced the LDL-C level with an infrequent administration schedule (even given once every 12 weeks), compared with placebo. TRIAL REGISTRATION ClinicalTrials.gov , number NCT03944109.
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Affiliation(s)
- Mingtong Xu
- Department of Endocrinology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, No. 107 Yanjiang Road West, Guangzhou, 510120, China
| | - Xiaoxue Zhu
- Phase I Clinical Trials Unit, The First Hospital of Jilin University, Changchun, China
| | - Junyan Wu
- Department of Pharmacy, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Yuling Zhang
- Department of Cardiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Dong Zhao
- Endocrinology Center, Capital Medical University, Beijing Luhe Hospital, Beijing, China
| | - Xuhong Wang
- Endocrinology Center, Capital Medical University, Beijing Luhe Hospital, Beijing, China
| | - Yanhua Ding
- Phase I Clinical Trials Unit, The First Hospital of Jilin University, Changchun, China
| | - Yu Cao
- Phase I Clinical Research Center, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Chengqian Li
- Department of Endocrinology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Wei Hu
- Department of Pharmacology, The Second Hospital of Anhui Medical University, Hefei, China
| | - Jianlong Sheng
- Department of Cardiology, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Zhu Luo
- Department of Clinical Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Zeqi Zheng
- Department of Cardiology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Jinfang Hu
- Department of Pharmacy, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Jianying Liu
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Xiaoyang Zhou
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Aizong Shen
- Department of Pharmacy, Anhui Provincial Hospital Affiliated to Anhui Medical University, Hefei, China
| | - Xiaomei Ding
- Department of Cardiology, Anhui Provincial Hospital Affiliated to Anhui Medical University, Hefei, China
| | - Yongdong Zhang
- Department of Pharmacy, Chenzhou First People's Hospital, Chenzhou, China
| | - Yonggang Zhao
- Department of Emergency Medicine, Chenzhou First People's Hospital, Chenzhou, China
| | - Yijing Li
- Clinical Research & Development, Jiangsu Hengrui Pharmaceuticals Co., Ltd., Shanghai, China
| | - Sheng Zhong
- Clinical Research & Development, Jiangsu Hengrui Pharmaceuticals Co., Ltd., Shanghai, China
| | - Shimin An
- Clinical Research & Development, Jiangsu Hengrui Pharmaceuticals Co., Ltd., Shanghai, China
| | - Jianjun Zou
- Clinical Research & Development, Jiangsu Hengrui Pharmaceuticals Co., Ltd., Shanghai, China
| | - Li Yan
- Department of Endocrinology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, No. 107 Yanjiang Road West, Guangzhou, 510120, China.
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