Drug May Lower Triglycerides And Reduce Risk Of Heart Disease

Triglycerides are a form of blood fat and high levels are linked to an increased risk of heart disease, according to the researchers, both studies found that olezarsen significantly lowered triglyceride levels as well as levels of other blood fats that are associated with disease risk. 

Not all blood fats are bad. Approximately 95% of the fats we eat are triglycerides, they are an essential source of energy, after eating them they eventually reach the bloodstream and once there they travel to our muscles to be used as energy or to the liver and fat cells for storage. However, while they are vital for health, high levels of triglycerides are associated with an increased risk of stroke and heart disease.

Particularly high levels are called hypertriglyceridemia, and in severe cases, this can lead to acute pancreatitis, which in severe cases can even lead to death. Familial chylomicronemia is a rare condition that causes elevated triglyceride levels, and those with this condition are at an even greater risk of developing acute pancreatitis. 

Recent estimates are that 1 in 4 Americans have high triglyceride levels, some of these people may respond to medications such as statins, but treatments that directly affect triglycerides are limited. Aside from medications, most people respond to certain lifestyle interventions such as regular physical activity, and following a healthy balanced diet can also help to reduce triglyceride levels. Unfortunately, those with familial chylomicronemia syndrome could have difficulty achieving satisfactory results with lifestyle changes unless they follow a diet that is extremely low in fat. 

One of the current studies involved 154 participants with either severe or moderate hypertriglyceridemia plus an elevated cardiovascular risk whole received either a monthly olezarsen injection or a placebo injection as the control group. Those receiving olezarsen were also split into two subgroups: those receiving either a 50mg or an 80mg dose. According to the researchers, compared to the control group, those receiving olezarsen experienced a 49.3% reduction in triglyceride levels in the 50mg group, and those in the 80mg group had a reduction of 53.1%. The treatment groups also experienced reductions in other blood fat levels that are linked to cardiovascular risk, namely non-HDL cholesterol, APOC3, and apolipoprotein B. 

The other study involved 66 participants with familial chylomicronemia syndrome who were split into 3 groups: those receiving a placebo injection every 4 weeks, those receiving a 50mg olezarsen injection, and those receiving an 80mg injection. According to the researchers, at 6 months, compared to the placebo, the 80mg dose was found to significantly reduce triglyceride levels but the 50mg dose did not. Additionally, there was also a reduction in acute pancreatitis. 

“Only one patient in the 80 mg group […] experienced an episode of acute pancreatitis, compared with 11 in the placebo group. This important finding supports the potential for olezarsen to be the standard of care for patients with [familial chylomicronemia syndrome],” said a representative from Ionis Pharmaceuticals, the producers of olezarsen. 

Gerald Watts, who is a Winthrop Professor at the University of Western Australia wrote an editorial on these two studies, said that he expects that the drug will soon be approved for familial chylomicronemia syndrome, but additional long-term research is required for those with moderate to high triglyceride levels demonstrating that the drug can decrease the development of atherosclerosis as well as the risk of cardiovascular disease in a larger and more diverse study population to examine the safety and efficacy before this therapy becomes mainstream. 

Overall, the professor believes that the drug will be useful. “Current therapies for severely elevated levels of triglycerides are ineffective, with a continuing risk of life-threatening acute pancreatitis, a gap that will probably be closed by olezarsen,” said Watts.