[1]刘柯 赵金河.米波默森对降低Lp(a)水平疗效的meta分析[J].心血管病学进展,2025,(2):158.[doi:10.16806/j.cnki.issn.1004-3934.2025.02.014]
　LIU Ke,ZHAO Jinhe.Meta-analysis of the Efficacy of Mipomersen in Lowering Lp(a) Levels[J].Advances in Cardiovascular Diseases,2025,(2):158.[doi:10.16806/j.cnki.issn.1004-3934.2025.02.014]
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米波默森对降低Lp(a)水平疗效的meta分析()
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《心血管病学进展》[ISSN:51-1187/R/CN:1004-3934]

卷:
期数:
2025年2期
页码:
158
栏目:
论著
出版日期:
2025-02-25

文章信息/Info

Title:
Meta-analysis of the Efficacy of Mipomersen in Lowering Lp(a) Levels
作者:
刘柯 赵金河
(武汉科技大学附属天佑医院心血管内科,湖北 武汉 430061)
Author(s):
LIU Ke; ZHAO Jinhe
(Department of Cardiovascular Medicine,Tianyou Hospital,Affiliated Hospital of Wuhan University of Science and Technology,Wuhan 430061,Hubei ,China)
关键词:
反义寡核苷酸; 米波默森; 脂蛋白a; 随机对照试验
Keywords:
Antisense oligonucleotide; Mipomersen; Lipoprotein (a); Randomized controlled trial
DOI:
10.16806/j.cnki.issn.1004-3934.2025.02.014
摘要:
目的 系统评价反义寡核苷酸（ASO）类药物米波默森（mipomersen）对降低心血管风险患者血浆脂蛋白a[ Lp(a) ]水平的疗效。方法 所纳入研究中共包括1 101例患者，其中mipomersen组660例，对照组441例。结果 与对照组相比，试验组中mipomersen可显著降低Lp(a)浓度水平[MD=－24.08，95%CI（－28.02，－20.14），P＜0.000 01]，差异具有统计学意义。同时，高密度脂蛋白胆固醇水平可被显著提高[MD= 3.47，95%CI（0.55，6.38），P=0.02]，降低总胆固醇[MD=－23.49，95%CI（－30.18，－16.80），P＜0.000 0 1]，非高密度脂蛋白胆固醇[MD=－31.27，95%CI（－37.45，－25.09），P＜0.000 01]，极低密度脂蛋白胆固醇[MD=－16.15，95%CI（－26.76，－5.54），P=0.003]，甘油三酯[MD=－18.37，95%CI（－28.16，－8.58），P=0.000 2]，低密度脂蛋白胆固醇[MD=－34.68，95%CI（－43.03，－26.32），P＜0.000 01]，载脂蛋白B[MD=－32.57，95%CI（－37.35，－27.78），P＜0.000 01]。使用随机效应模型分析，与对照组相比，mipomersen在不良反应发生率如注射部位不良反应[RR= 1.83，95%CI（0.48，6.91），P=0.37]，流感样症状[RR= 1.41，95%CI（0.83，2.40），P=0.20]等方面，差异没有统计学意义，该药物具有良好的药物安全性。结论 ASO类代表药物mipomersen能有效降低血浆中Lp(a)水平，同时也可以有效改善其他血脂指标；同时mipomersen亚组分析显示不良反应与对照组无明显差异，表明该药物安全性良好。
Abstract:
Objective To systematically evaluate the efficacy of antisense oligonucleotide (ASO) drug mipomersen in reducing plasma lipoprotein (a) [Lp(a)] levels in patients wi th cardiovascular risk.Methods A total of 1 101 patients were included in this study,including 660 in the mipomersen group and 44 1 in the control group. Results Compared with the control group,mipomersen in the experimental group could significantly reduce the concentration of plasma Lp (a)[ MD=－24.08,95%CI(－28.02,－20.14),P<0.000 01],and the difference was statistically significant.At the same time,the plasma concentration of high-density lipoprotein cholesterol could be significantly increased [MD=3.47,95%CI(0.55,6.38),P=0.02],and the total cholesterol could be decreased [MD=－23.49,95%CI(－30.18,－16.80),P<0.000 0 1].Non-high-density lipoprotein cholesterol[MD=－31.27,95%CI(－37.45,－25.09),P<0.000 01],very low density lipoprotein cholesterol[MD=－16.15,95%CI(－26.76,－5.54),P=0.003],triglyceride[MD=－18.37,95%CI(－28.16,－8.58),P=0.000 2],low-density lipoprotein cholesterol[MD=－34.68,95%CI(－43.03,－26.32),P<0.000 01],Apolipoprotein B[MD=32.57,95% CI (37.35,27.78), P<0.000 01).Using random effects model analysis,compared with control group,mipomersen was associated with higher rates of adverse reactions such as injection site adverse reactions[ RR=1.83,95%CI(0.48,6.91),P=0.37],and influenza-like symptoms[RR=1.41,95%CI(0.83,2.40),P=0.20],the difference was not statistically significant,and the drug had good drug safety.Conclusion Mipomersen,a representative drug of ASO,can effectively reduce the level of Lp(a) in plasma,and can also effectively improve other lipid indexes.At the same time,mipomersen subgroup showed no significant difference in adverse reactions between the control group and the mipomersen subgroup ,indicating that the drug is safe

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更新日期/Last Update: 2025-03-11