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Message: MOA of Apabetalone - only affects sick patients

"One of my favourite things about Apabetalone is that it does not affect healthy people,... from what I understand it only repairs whaT is broken/not working. What a great MOA!"

Yes, it seems that certain disease states greatly enhance BET bromodomain mediated gene expression changes that contribute to the disease. Therefore, BET bromodomain inhibition benefits these sick patients moreso than healthy patients. However, I would caution anyone from concluding that apabetalone does not affect healthy people. There really isn't much data available to make a blanket statement like that.

"tundup posted this June last year,.... do you think ASSURE would have succeeded if that 25% had low HDL,... as in the BETonMACE trial,..?"

Perhaps. Post-hoc of ASSURE did find the most plaque reduction in those with below median HDL levels. But the placebo group in ASSURE seemed to also experience an unexpected benefit. So unclear if more stringent low-HDL requirement alone would have led to ASSURE succeeding. Post-hoc also showed that rosuvastatin patients experienced more apabetalone-mediated plaque reducing benefit than those in the atorvastin group. And statin dose played a factor too. Lots of variables. By the way, both ASSURE and BETonMACE have the same low-HDL requirement: below 45 mg/dL for females or below 40 mg/dL for males. 

"Again it might be possible that since all patients in the BERonMACE trial have low HDL levels,... and I imagine it is rare that the low HDL levels in placebo group patients will automatically improve,... so if the patient reports show HDL levels rising it probably points to RVX-208 working. Does ot specifically state that HLD levels will be tested througout the trial,...?"

Yes, HDL-C and apo-AI are being followed over time in BETonMACE, along with many other clinical measures. See the secondary outcome list in the BETonMACE trial listing.

BearDownAZ

 

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