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27-03-2024 | PCSK9 Inhibitor | Review

Oral PCSK9 Inhibitors

Authors: Anandita Agarwala, Ramsha Asim, Christie M. Ballantyne

Published in: Current Atherosclerosis Reports

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Abstract

Purpose of Review

In this review, we will discuss the data from early clinical studies of MK-0616 and summarize clinical trials of other oral proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors.

Recent Findings

The success of PCSK9 inhibition with monoclonal antibody injections has fueled the development of additional therapies targeting PCSK9, including oral formulations, the most advanced of which is MK-0616. MK-0616 is a novel, orally administered macrocyclic peptide that binds to PCSK9 and inhibits binding of PCSK9 to the LDL receptor, thereby decreasing plasma levels of LDL-C.

Summary

Clinical trial data on the safety and efficacy of MK-0616 are promising and report LDL-C–lowering efficacy comparable to that provided by injectable PCSK9 inhibitors. Ongoing and future studies of oral PCSK9 inhibitors in development will evaluate the safety, efficacy, and effectiveness of these agents and their potential role in preventing cardiovascular disease events.
Literature
11.
go back to reference • Alleyne C, Amin RP, Bhatt B, Bianchi E, Blain JC, Boyer N, et al. Series of novel and highly potent cyclic peptide PCSK9 inhibitors derived from an mRNA display screen and optimized via structure-based design. J Med Chem. 2020;63(22):13796–824. https://doi.org/10.1021/acs.jmedchem.0c01084. This article reports the iterative medical chemistry alterations and drug design enhancements involved in developing oral agents for PCSK9 inhibition.CrossRefPubMed • Alleyne C, Amin RP, Bhatt B, Bianchi E, Blain JC, Boyer N, et al. Series of novel and highly potent cyclic peptide PCSK9 inhibitors derived from an mRNA display screen and optimized via structure-based design. J Med Chem. 2020;63(22):13796–824. https://​doi.​org/​10.​1021/​acs.​jmedchem.​0c01084. This article reports the iterative medical chemistry alterations and drug design enhancements involved in developing oral agents for PCSK9 inhibition.CrossRefPubMed
15.
go back to reference • Ballantyne CM, Banka P, Mendez G, Garcia R, Rosenstock J, Rodgers A, et al. Phase 2b randomized trial of the oral PCSK9 inhibitor MK-0616. J Am Coll Cardiol. 2023;81(16):1553–64. https://doi.org/10.1016/j.jacc.2023.02.018. This article reports significant, dose-dependent LDL-C reduction with good tolerability with the oral PCSK9 inhibitor MK-0616 in 381 patients with hypercholesterolemia.CrossRefPubMed • Ballantyne CM, Banka P, Mendez G, Garcia R, Rosenstock J, Rodgers A, et al. Phase 2b randomized trial of the oral PCSK9 inhibitor MK-0616. J Am Coll Cardiol. 2023;81(16):1553–64. https://​doi.​org/​10.​1016/​j.​jacc.​2023.​02.​018. This article reports significant, dose-dependent LDL-C reduction with good tolerability with the oral PCSK9 inhibitor MK-0616 in 381 patients with hypercholesterolemia.CrossRefPubMed
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go back to reference Koren MJ, Descamps O, Hata Y, Hengeveld EM, Hovingh GK, Ikonomidis I, et al. PCSK9 inhibition with orally administered NNC0385–0434 in hypercholesterolaemia: a randomised, double-blind, placebo-controlled and active-controlled phase 2 trial. Lancet Diabetes Endocrinol. 2024;12(3):174–183. https://doi.org/10.1016/S2213-8587(23)00325-X. Koren MJ, Descamps O, Hata Y, Hengeveld EM, Hovingh GK, Ikonomidis I, et al. PCSK9 inhibition with orally administered NNC0385–0434 in hypercholesterolaemia: a randomised, double-blind, placebo-controlled and active-controlled phase 2 trial. Lancet Diabetes Endocrinol. 2024;12(3):174–183. https://​doi.​org/​10.​1016/​S2213-8587(23)00325-X.
Metadata
Title
Oral PCSK9 Inhibitors
Authors
Anandita Agarwala
Ramsha Asim
Christie M. Ballantyne
Publication date
27-03-2024
Publisher
Springer US
Keyword
PCSK9 Inhibitor
Published in
Current Atherosclerosis Reports
Print ISSN: 1523-3804
Electronic ISSN: 1534-6242
DOI
https://doi.org/10.1007/s11883-024-01199-2
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