Researchers report that injections of a novel "monoclonal antibody" lowered LDL cholesterol levels in patients with high cholesterol by as much as 72%.
This treatment could help lower levels of "bad" cholesterol for the one in five people who don't respond to the commonly prescribed cholesterol-lowering drugs known as statins. It may also be helpful for patients who can't get their cholesterol low enough with statins alone, the researchers added.
"If this pans out, it will be a whole new approach to lowering cholesterol," said James McKenney, PharmD, chief executive officer of National Clinical Research Inc. A report on the findings was published in the Journal of the American College of Cardiology.
The experimental compound appeared to lower LDL cholesterol by making it easier for the liver to remove LDL cholesterol from the bloodstream, McKenney said. Monoclonal antibodies are antibodies cloned from a single cell, which are all identical because they are cloned, the researchers explained.
The study was funded by the drug's manufacturers Sanofi US and Regeneron Pharmaceuticals. The research company that McKenney works for has also received funding from both drug makers.
Study Details
For this phase 2 study, McKenney's team randomly assigned 183 patients with high cholesterol who had been treated with atorvastatin (Lipitor) for more than six weeks, to one of six groups.
Three groups were given injections of the new drug in high, medium or low doses every two weeks. Two other groups were given very high doses of the drug every four weeks. The sixth group received a placebo.
After 12 weeks, the researchers found those who received the low dose of the monoclonal antibody saw their LDL levels drop by 40%. For those given the medium dose, LDL levels decreased 64% while those given the high dose saw their cholesterol levels drop by 72%.
For those in the two groups taking very high doses every four weeks, the drops in LDL cholesterol were 43% and 48%, the researchers said.
Implications
McKenney noted that more research is needed before this drug is ready for public use. Since it would need to be taken regularly, he sees it as akin to insulin, where the patient injects the drug in measured doses.
In terms of cost, it's far too early to say what a patient would have to spend for this therapy, the researchers said.
Longer trials have been planned. The study authors said they feel confident that the drug is safe and effective, but they need to confirm the results over the long-term.
Expert Response
Gregg Fonarow, MD, director of the Ahmanson-UCLA Cardiomyopathy Center and codirector of the UCLA Preventative Cardiology Program, said that "statin therapy has been remarkably effective in reducing fatal and nonfatal cardiovascular events."
Yet, many patients cannot achieve optimal reduction in LDL cholesterol levels with statins and some patients do not tolerate statins well, he noted.
"This novel therapy is exceptionally promising," Dr. Fonarow said. "Achieving LDL cholesterol reductions of up to 72% on top of statin therapy is very impressive."
"If further studies demonstrate the long-term safety, efficacy and effectiveness of this therapy, this will represent a tremendous advance in preventing and treating cardiovascular disease, which has remained the leading cause of premature death and disability in men and women," Dr. Fonarow added.
Results of another study also due out soon suggest that starting a type of statin therapy early in life might significantly reduce the risk for heart disease. Rather than actually treating patients with statins, the researchers looked at changes in DNA that, in this case, were linked to lower levels of cholesterol.
Since one has these mutations at birth, it's like being blessed with naturally low cholesterol. These mutations stand in for statin therapy, according to lead researcher Brian Ference, MD, director of the cardiovascular genomic research center at Wayne State University School of Medicine in Indiana.
"This research is a way of finding out the effects of lowering cholesterol early without having a lengthy clinical trial," Dr. Ference said.
The researchers looked at genes from participants of several studies, one including more than 350,000 patients, and found nine specific mutations.
For each single measure of reduced lifetime exposure to LDL cholesterol associated with having the mutations, the researchers found a 50% to 60% reduction in heart disease risk.
Drink OJ to Lower Bad Cholesterol
Drinking orange juice made from concentrate lowers cholesterol levels. A recent study of people with both high and normal cholesterol found that those who drank three cups of orange juice from concentrate daily had a significant improvement in HDL "good" cholesterol levels. Those with high cholesterol also had a drop in their LDL "bad" cholesterol levels. Other types of orange juice besides concentrate were not studied.
Eat Dark Meat for a Healthier Heart
Dark meat may lower coronary heart disease (CHD) risk.
Background: Taurine is a nutrient found in the dark meat of chicken and turkey as well as in some fish and shellfish.
Recent study: Researchers took blood samples to measure levels of taurine in 223 women (average age 59) with CHD.
Finding: Women with high cholesterol and high levels of taurine were 60% less likely to develop CHD over a 20-year period than similar women with low taurine levels.
