Literature DB >> 32919280

No benefit of HDL mimetic CER-001 on carotid atherosclerosis in patients with genetically determined very low HDL levels.

Kang H Zheng1, Yannick Kaiser1, Casper C van Olden1, Raul D Santos2, Jean-Louis Dasseux3, Jacques Genest4, Daniel Gaudet5, Jan Westerink6, Constance Keyserling3, Hein J Verberne1, Eran Leitersdorf7, Robert A Hegele8, Olivier S Descamps9, Paul Hopkins10, Aart J Nederveen1, Erik S G Stroes11.   

Abstract

BACKGROUND AND AIMS: Infusion of high-density lipoprotein (HDL) mimetics failed to induce regression of atherosclerosis in recent randomized clinical trials. However, patients in these previous trials had normal levels of HDL-cholesterol, which potentially limited efficacy. Patients with very low levels of HDL-cholesterol and impaired cholesterol efflux capacity can be expected to derive the most potential benefit from infusion of HDL mimetics. This randomized clinical trial evaluated the efficacy of infusions of the HDL mimetic CER-001 in patients with genetically determined very low levels of HDL cholesterol.
METHODS: In this multicenter, randomized clinical trial, we recruited patients with familial hypoalphalipoproteinemia (due to ABCA1 and/or APOA1 loss-of-function variants). Participants were randomized to intravenous infusions of 8 mg/kg CER-001 or placebo (2:1 ratio), comprising 9 weekly infusions followed by infusions every two weeks. Patients underwent repeated 3T-MRI to assess mean vessel wall area and 18F-FDG PET/CT to quantify arterial wall inflammation.
RESULTS: A total of 30 patients with a mean age of 52.7 ± 7.4 years and HDL-cholesterol of 0.35 ± 0.25 mmol/L were recruited. After 24 weeks, the absolute change in mean vessel wall area was not significantly different in the CER-001 group compared with placebo (n = 27; treatment difference: 0.77 mm2, p = 0.21). Furthermore, there was no significant difference in carotid arterial wall inflammation (n = 24, treatment difference: 0.10 target-to-background ratio of the most diseased segment, p = 0.33) after 24 weeks.
CONCLUSION: In patients with genetically determined very low HDL-cholesterol, 24 weeks of treatment with HDL mimetic CER-001 did not reduce carotid vessel wall dimensions or arterial wall inflammation, compared with placebo. Crown
Copyright © 2020. Published by Elsevier B.V. All rights reserved.

Entities:  

Keywords:  CER-001; Familial hypoalphalipoproteinemia; HDL; MRI; PET/CT; Randomized clinical trial

Mesh:

Substances:

Year:  2020        PMID: 32919280     DOI: 10.1016/j.atherosclerosis.2020.08.004

Source DB:  PubMed          Journal:  Atherosclerosis        ISSN: 0021-9150            Impact factor:   5.162


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