2023-09-04 14:30:00
Cholesterol is naturally produced by the body. It is both essential to the body but also dangerous. THE “bad cholesterol” is LDL: it is transported by so-called low-density lipoproteins. Its presence in excess in the body can be the consequence of a poor diet, but not only: some people suffer from a particular form of hypercholesterolemia, caused by lipoprotein (a), and of genetic origin. For the first time, Australian researchers have developed a treatment capable of reducing the level of Lp(a) in the blood. Their work is presented in JAMA.
Cholesterol: what are the consequences of a high Lp(a) level?
One in five individuals worldwide has elevated Lp(a): it is generally defined as such when it is above 50 mg/dl (500 mg/l) or 120 nmol/l. “People with high Lp(a) and atherosclerosis may be at increased risk of heart attack, heart failure, peripheral arterial disease, and stroke, compared to people with low Lp (a), prevents the fondation FH Europe, a network of associations for patients with hypercholesterolemia. High levels of Lp(a) may also be associated with an increased risk of aortic valve stenosis (narrowing of the valve allowing blood to pass from the heart to the aorta).”
Cholesterol: Lp(a), a “silent killer”
There is no treatment to reduce this rate. Medications commonly prescribed to lower LDL, such as statins, do not have the same effect on Lp(a). “Being largely genetic, Lp(a) is also difficult to control through diet, exercise and other lifestyle changes,” warn the authors of this new study. For them, this inability to cure Lp(a) makes it a “silent killer”.
A promising trial to lower this cholesterol level
In their trial, they tested a drug called muvalapline in 114 participants. This oral treatment works by preventing Lp(a) from forming in the body. “Muvalapline lowered plasma Lp(a) levels within 24 hours of the first dose, with a further reduction in Lp(a) on repeated dosing, the authors note in their work. The maximum Lp(a) reduction (a) adjusted to placebo was 63% to 65%, resulting in plasma Lp(a) levels below 50 mg/dL in 93% of participants, with similar effects at daily doses of 100 mg or more.” They did not observe any significant side effects. Australian scientists point out that studies on larger patient samples will be necessary, but they are already pleased with these initial results. “This drug is a game-changer in more ways than one,” said Stephen Nicholls, study director. “Not only do we have an option to lower an incurable form of cholesterol, but being able to deliver it as an oral tablet means it will be more accessible to patients.”
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