Prevention & lipidsRandomised controlled trial

Single Ascending and Multiple-Dose Trial of Zerlasiran, a Short Interfering RNA Targeting Lipoprotein(a)

JAMAPublished

  • Randomised controlled trial
  • single ascending dose
  • multiple-dose
  • placebo-controlled
  • multicentre (7 sites)

Authors' conclusion

Zerlasiran was well tolerated and reduced lipoprotein(a) concentrations with infrequent administration.

Study context

Population
Healthy participants (single dose) and patients with stable atherosclerotic cardiovascular disease (ASCVD) (multiple dose) with lipoprotein(a) >150 nmol/L; 7 sites in US, Netherlands, UK and Australia, 2020–202336 of 37 completed (multiple dose)
Participants
8 / 6 / 6 / 9 / 9 / 9 / 9
Comparison
Zerlasiran) vs placebo
  • Placebo (single dose)n = 8reference
  • Zerlasiran 300 mg (single dose)n = 6
  • Zerlasiran 600 mg (single dose)n = 6
  • Placebo (2 doses)n = 9reference
  • Zerlasiran 200 mgn = 9
  • Zerlasiran 300 mgn = 9
  • Zerlasiran 450 mgn = 9
Primary endpoint
Safety and tolerability

Primary result

As reported in the abstract

Serious adverse events

0

Secondary outcomes

OutcomeValues
Median change in lipoprotein(a), single dose · 365 daysPlacebo (single dose) median 14% (IQR 13%–15%) · Zerlasiran 300 mg (single dose) median −30% (IQR −51%–-18%) · Zerlasiran 600 mg (single dose) median −29% (IQR −39%–-7%)
Maximal median change in lipoprotein(a), after 2 dosesPlacebo (2 doses) median 19 (IQR −17–28) nmol/L · Maximal median percent change 7% (IQR, −4% to 21%) · Zerlasiran 200 mg median −258 (IQR −289–-188) nmol/L · Maximal median percent change −97% (IQR, −98% to −95%) · Zerlasiran 300 mg median −310 (IQR −368–-274) nmol/L · Maximal median percent change −98% (IQR, −99% to −97%) · Zerlasiran 450 mg median −242 (IQR −343–-182) nmol/L · Maximal median percent change −99% (IQR, −99% to −98%)
Median percent change in lipoprotein(a), after 2 doses · 201 days after administrationPlacebo (2 doses) median 0.3% (IQR −2%–21%) · Zerlasiran 200 mg median −60% (IQR −71%–-40%) · Zerlasiran 300 mg median −90% (IQR −91%–-74%) · Zerlasiran 450 mg median −89% (IQR −91%–-76%)
  • Maximal median change in lipoprotein(a), after 2 doses: baseline median 288 (IQR, 199-352) nmol/L

Safety

Serious adverse events

No serious adverse events

Original publication

Single Ascending and Multiple-Dose Trial of Zerlasiran, a Short Interfering RNA Targeting Lipoprotein(a). JAMA. Published 14 May 2024. doi:10.1001/jama.2024.4504

Summarised from the published abstract; every number is checked against it