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Regression of coronary atherosclerosis with infusions of the high-density lipoprotein mimetic CER-001 in patients with more extensive plaque burden

Identifieur interne : 000466 ( Main/Exploration ); précédent : 000465; suivant : 000467

Regression of coronary atherosclerosis with infusions of the high-density lipoprotein mimetic CER-001 in patients with more extensive plaque burden

Auteurs : Yu Kataoka [Australie] ; Jordan Andrews [Australie] ; Myngan Duong [Australie] ; Tracy Nguyen [Australie] ; Nisha Schwarz [Australie] ; Jessica Fendler [Australie] ; Rishi Puri [États-Unis] ; Julie Butters [Australie] ; Constance Keyserling [France] ; John F. Paolini [France] ; Jean-Louis Dasseux [France] ; Stephen J. Nicholls [Australie]

Source :

RBID : PMC:5440269

Abstract

Background

CER-001 is an engineered pre-beta high-density lipoprotein (HDL) mimetic, which rapidly mobilizes cholesterol. Infusion of CER-001 3 mg/kg exhibited a potentially favorable effect on plaque burden in the CHI-SQUARE (Can HDL Infusions Significantly Quicken Atherosclerosis Regression) study. Since baseline atheroma burden has been shown as a determinant for the efficacy of HDL infusions, the degree of baseline atheroma burden might influence the effect of CER-001.

Methods

CHI-SQUARE compared the effect of 6 weekly infusions of CER-001 (3, 6 and 12 mg/kg) vs. placebo on coronary atherosclerosis in 369 patients with acute coronary syndrome (ACS) using serial intravascular ultrasound (IVUS). Baseline percent atheroma volume (B-PAV) cutoff associated with atheroma regression following CER-001 infusions was determined by receiver-operating characteristics curve analysis. 369 subjects were stratified according to the cutoff. The effect of CER-001 at different doses was compared to placebo in each group.

Results

A B-PAV ≥30% was the optimal cutoff associated with PAV regression following CER-001 infusions. CER-001 induced PAV regression in patients with B-PAV ≥30% but not in those with B-PAV <30% (−0.45%±2.65% vs. +0.34%±1.69%, P=0.01). Compared to placebo, the greatest PAV regression was observed with CER-001 3mg/kg in patients with B-PAV ≥30% (−0.96%±0.34% vs. −0.25%±0.31%, P=0.01), whereas there were no differences between placebo (+0.09%±0.36%) versus CER-001 in patients with B-PAV <30% (3 mg/kg; +0.41%±0.32%, P=0.39; 6 mg/kg; +0.27%±0.36%, P=0.76; 12 mg/kg; +0.32%±0.37%, P=0.97).

Conclusions

Infusions of CER-001 3 mg/kg induced the greatest atheroma regression in ACS patients with higher B-PAV. These findings identify ACS patients with more extensive disease as most likely to benefit from HDL mimetic therapy.


Url:
DOI: 10.21037/cdt.2017.02.01
PubMed: 28567351
PubMed Central: 5440269


Affiliations:

Links toward previous steps (curation, corpus...)

Le document en format XML

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<addr-line>Adelaide</addr-line>
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<addr-line>Adelaide</addr-line>
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<country xml:lang="fr">Australie</country>
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<name sortKey="Schwarz, Nisha" sort="Schwarz, Nisha" uniqKey="Schwarz N" first="Nisha" last="Schwarz">Nisha Schwarz</name>
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<addr-line>Adelaide</addr-line>
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<country xml:lang="fr">Australie</country>
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<country xml:lang="fr">États-Unis</country>
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<name sortKey="Butters, Julie" sort="Butters, Julie" uniqKey="Butters J" first="Julie" last="Butters">Julie Butters</name>
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<addr-line>Adelaide</addr-line>
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<country xml:lang="fr">France</country>
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<country xml:lang="fr">France</country>
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,
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,
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<sec>
<title>Background</title>
<p>CER-001 is an engineered pre-beta high-density lipoprotein (HDL) mimetic, which rapidly mobilizes cholesterol. Infusion of CER-001 3 mg/kg exhibited a potentially favorable effect on plaque burden in the CHI-SQUARE (Can HDL Infusions Significantly Quicken Atherosclerosis Regression) study. Since baseline atheroma burden has been shown as a determinant for the efficacy of HDL infusions, the degree of baseline atheroma burden might influence the effect of CER-001.</p>
</sec>
<sec>
<title>Methods</title>
<p>CHI-SQUARE compared the effect of 6 weekly infusions of CER-001 (3, 6 and 12 mg/kg)
<italic>vs.</italic>
placebo on coronary atherosclerosis in 369 patients with acute coronary syndrome (ACS) using serial intravascular ultrasound (IVUS). Baseline percent atheroma volume (B-PAV) cutoff associated with atheroma regression following CER-001 infusions was determined by receiver-operating characteristics curve analysis. 369 subjects were stratified according to the cutoff. The effect of CER-001 at different doses was compared to placebo in each group.</p>
</sec>
<sec>
<title>Results</title>
<p>A B-PAV ≥30% was the optimal cutoff associated with PAV regression following CER-001 infusions. CER-001 induced PAV regression in patients with B-PAV ≥30% but not in those with B-PAV <30% (−0.45%±2.65%
<italic>vs.</italic>
+0.34%±1.69%, P=0.01). Compared to placebo, the greatest PAV regression was observed with CER-001 3mg/kg in patients with B-PAV ≥30% (−0.96%±0.34%
<italic>vs.</italic>
−0.25%±0.31%, P=0.01), whereas there were no differences between placebo (+0.09%±0.36%) versus CER-001 in patients with B-PAV <30% (3 mg/kg; +0.41%±0.32%, P=0.39; 6 mg/kg; +0.27%±0.36%, P=0.76; 12 mg/kg; +0.32%±0.37%, P=0.97).</p>
</sec>
<sec>
<title>Conclusions</title>
<p>Infusions of CER-001 3 mg/kg induced the greatest atheroma regression in ACS patients with higher B-PAV. These findings identify ACS patients with more extensive disease as most likely to benefit from HDL mimetic therapy.</p>
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