ODYSSEY and Anti-histamines
posted on
Mar 11, 2018 10:33AM
ODYSSEY CVOT trial results were announced at ACC 2018 yesterday. There seems to be a mixed bag a reaction, but overall the results of Sanofi/Regeneron's Alirocumab (Praluent) in ODYSSEY seem to be more impressive than Amgen's Evolocumab (Repatha) in FOURIER. The effects seem to be most pronounced in those patients with baseline LDL-C above 100 mg/dL. And the MACE reducing effects in ODYSSEY seem to get better over time. The FOURIER trial had hints of this too. There seems to be a huge price cut being planned/discussed for these PCSK9 antibody drugs from the ~$14,000/year down to closer to $4000-$5000/year for high-risk patients.
This doesn't affect Resverlogix, since LDL modulation is not a mechanism of action of apabetalone. It will be interesting to see how ESPR gets hit with the price lowering announcement since they recently announced plans to price bempedoic acid, which is less potent than PCSK9 antibodies for LDL lowering, in this same price range. Furthermore, mitigating ther cardiovascular risk in diabetes patients necessitates more than just LDL-lowering alone. Hence, the awesome potential of apabetalone.
http://www.acc.org/latest-in-cardiology/clinical-trials/2018/03/09/08/02/odyssey-outcomes
https://www.statnews.com/2018/03/10/regeneron-praulent/
Also of interest, rndtbl posted on IV about a new paper showing the apo-AI elevating effect (in liver cells) of antagonists of the histamine H1 receptor such as Zyrtec, Allegra and Benadryl. Another good reason for me to take my allergy med more regularly! Histamines repress, whereas the H1 receptor antogonists increased apo-AI in a mechanism involving PPARalpha. PPARalpha was already known to be a regulator of apo-AI transcription, but the involvement of histamines and H1 receptor antagonists is novel.
https://www.sciencedirect.com/science/article/pii/S001429991830044X?via=ihub