Findings from the Phase III PALISADE clinical trial of plozasiran, were presented at the American Heart Association (AHA) 2024 Annual Scientific Sessions, demonstrating significant reductions in triglyceride levels in adults with familial chylomicronemia syndrome (FCS). The trial, which involved 75 patients, highlighted plozasiran's potential as a targeted therapy for this rare genetic condition characterized by extremely high triglyceride levels and increased risk of acute pancreatitis.
Plozasiran, a small interfering-RNA (siRNA) therapy, targets and reduces the production of apolipoprotein C-III (APOC3), a key regulator of triglyceride metabolism. By inhibiting APOC3, plozasiran aims to lower triglyceride levels and normalize lipid profiles in FCS patients. The study randomized patients with genetically or clinically defined FCS to receive quarterly doses of plozasiran (25mg or 50mg) or placebo for 12 months.
Key Findings from the PALISADE Trial
The results, presented by Professor Gerald Watts from the University of Western Australia, indicated that plozasiran met its primary endpoint. Participants receiving 25mg and 50mg doses experienced an 80% median reduction in triglycerides from baseline at month 10, a significant improvement over the placebo group. Secondary endpoints also showed statistically significant improvements, including further reductions in triglycerides and APOC3 levels, as well as a decreased incidence of acute pancreatitis.
Reductions in triglycerides and APOC3 were observed as early as one month and sustained throughout the 12-month study period. Similar efficacy was noted in both genetically and clinically defined patients. Additionally, the treatment led to reductions in atherogenic triglyceride-rich lipoproteins (TRLs) and a minor increase in LDL-C, with no change in apo B. Importantly, plozasiran significantly reduced the incidence of acute pancreatitis, a major concern for individuals with FCS.
Safety and Tolerability
Plozasiran demonstrated a favorable safety profile, with adverse events similar to those observed with placebo. Severe and serious adverse events were less common in the plozasiran group, primarily due to fewer episodes of acute pancreatitis.
Unmet Needs in FCS Treatment
Currently, there are no FDA-approved treatments specifically for FCS, highlighting a critical unmet need in managing this condition. Plozasiran offers a promising solution by targeting the underlying causes of FCS, effectively lowering triglyceride levels, and preventing associated complications. Due to its efficacy across a range of hypertriglyceridemia patients, plozasiran is being further studied for its potential to treat chylomicronemia-related pancreatitis and reduce the risk of atherosclerotic cardiovascular disease (ASCVD) in individuals with mild to moderate hypertriglyceridemia. Plozasiran is projected to achieve $707 million in sales by 2032.
