Prevention & lipidsRandomised controlled trial

Zerlasiran—A Small-Interfering RNA Targeting Lipoprotein(a)

JAMAPublished

  • Randomised controlled trial
  • multicentre
  • placebo-controlled
  • 26 sites in Europe and South Africa

Authors' conclusion

Zerlasiran was well-tolerated and reduced time-averaged lipoprotein(a) concentration by more than 80% during 36 weeks of treatment in patients with ASCVD.

Study context

Population
Patients with stable atherosclerotic cardiovascular disease (ASCVD) and serum lipoprotein(a) ≥125 nmol/L172 completed
Participants
178 patients
Comparison
Zerlasiran vs placebo
  • 450 mg every 24 weeksn = 45
  • 300 mg every 16 weeksn = 42
  • 300 mg every 24 weeksn = 44
Primary endpoint
Time-averaged percent change in lipoprotein(a) concentration from baseline
Follow-up
36 weeks

Primary result

As reported in the abstract

Time-averaged % change in lipoprotein(a) vs pooled placebo (least-squares mean) · week 36
Each group vs placeboLeast-squares mean difference, % (95% CI)
450 mg every 24 weeks
−85.6(−90.9% to −80.3%)
300 mg every 16 weeks
−82.8(−88.2% to −77.4%)
300 mg every 24 weeks
−81.3(−86.7% to −76.0%)

Further findings

Median, %

OutcomePlacebo450 mg every 24 weeks300 mg every 16 weeks300 mg every 24 weeks
Percent change in lipoprotein(a) · week 36Not reported in the abstract−94.5 (IQR −97.3%–-84.2%)−96.4 (IQR −97.7%–-92.3%)−90.0 (IQR −93.7%–-81.3%)

Safety

Injection site reactions (mild pain, first day after dosing)

Mild pain at injection site, range across zerlasiran groups
2.3% to 7.1%
  • most common treatment-related adverse effects

Serious adverse events

Serious adverse events
20 in 17 patients
Serious adverse events considered related to study drug
0

Original publication

Zerlasiran—A Small-Interfering RNA Targeting Lipoprotein(a). JAMA. Published 17 December 2024. doi:10.1001/jama.2024.21957

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