{"id":280761,"date":"2019-08-10T00:00:00","date_gmt":"2019-08-10T07:00:00","guid":{"rendered":"https:\/\/sdnews.com\/ucsd-professor-helps-lead-clinical-trial-for-rare-disease-where-people-cant-eat-fat\/"},"modified":"2019-08-10T00:00:00","modified_gmt":"2019-08-10T07:00:00","slug":"ucsd-professor-helps-lead-clinical-trial-for-rare-disease-where-people-cant-eat-fat","status":"publish","type":"post","link":"https:\/\/test.sdnews.com\/es\/ucsd-professor-helps-lead-clinical-trial-for-rare-disease-where-people-cant-eat-fat\/","title":{"rendered":"UCSD professor helps lead clinical trial for rare disease where people can\u2019t eat fat"},"content":{"rendered":"<p><span>People&nbsp;with familial chylomicronemia syndrome are born with a genetic&nbsp;mutation that&nbsp;prevents&nbsp;them from&nbsp;producing&nbsp;an enzyme called&nbsp;lipoprotein lipase. Without the enzyme, their bodies&nbsp;can&#8217;t break down dietary-derived fat in the blood.<br \/><\/span><span><br \/><\/span><span>Instead,&nbsp;fat-carrying molecules called chylomicrons build up in the blood,&nbsp;causing many life-threatening symptoms, most notably&nbsp;pancreatitis.&nbsp;People living with this condition must follow a strict low-fat diet,&nbsp;but there is no treatment.&nbsp;<br \/><\/span><span><br \/><\/span><span>Joseph&nbsp;Witztum, Ph.D., professor of medicine at University of California San&nbsp;Diego School of Medicine, recently helped lead a global&nbsp;research team&nbsp;that tested how well the drug volanesorsen reduces fat accumulation&nbsp;in the blood (triglycerides) of participants with&nbsp;familial&nbsp;chylomicronemia syndrome. In a randomized, double-blind Phase III&nbsp;clinical trial, 33 participants received the drug and 33&nbsp;received a&nbsp;placebo.<br \/><\/span><span><br \/><\/span><span>Volanesorsen&nbsp;reduced triglyceride levels by an average of 77%. In contrast, for&nbsp;participants who received a placebo, triglyceride levels&nbsp;increased by&nbsp;an average of 18%. These results will publish Aug. 8, 2019 in the New&nbsp;England Journal of Medicine.<br \/><\/span><span><br \/><\/span><span>Chylomicrons&nbsp;carry dietary triglycerides from the gut into the blood, where they&nbsp;are normally broken down by the enzyme lipoprotein&nbsp;lipase. Without&nbsp;that enzyme, chylomicrons accumulate and thicken the blood of people&nbsp;with familial chylomicronemia syndrome.<br \/><\/span><span><br \/><\/span><span>&ldquo;Chylomicrons&nbsp;are what you see when you see cream form on the top of milk,&rdquo;&nbsp;Witztum said. &ldquo;For most people, when you eat a fatty&nbsp;meal for&nbsp;dinner at 6 p.m., the triglycerides are transported into the blood by&nbsp;chylomicrons and then lipoprotein lipase clears those out of&nbsp;the&nbsp;blood by 9 p.m. That&#8217;s definitely not the case for patients with&nbsp;familial chylomicronemia syndrome.&rdquo;<br \/><\/span><span><br \/><\/span><span>Triglyceride&nbsp;levels are regulated by a molecule called apolipoprotein C-III, which&nbsp;is made in the liver, and then secreted into the blood.&nbsp;Volanesorsen,&nbsp;an antisense drug developed by Ionis Pharmaceuticals, is designed to&nbsp;block the mRNA in the liver that encodes&nbsp;apolipoprotein C-III.&nbsp;Reducing apolipoprotein C-III in the blood in turn reduces&nbsp;triglyceride levels. Triglycerides are often used as a&nbsp;measure for&nbsp;heart health, as high levels are associated with heart disease, even&nbsp;in otherwise healthy people.&nbsp;<br \/><\/span><span><br \/><\/span><span>Trial&nbsp;participants began by receiving 300 milligrams of volanesorsen under&nbsp;the skin once a week. The most common side effects were&nbsp;skin&nbsp;reactions at the injection site (20 of 33 participants who received&nbsp;volanesorsen vs. none in the placebo group) and&nbsp;thrombocytopenia (15&nbsp;of 33 participants who received volanesorsen vs. none in the placebo&nbsp;group). Thrombocytopenia, or low levels of&nbsp;blood cells known as&nbsp;platelets, can limit the body&#8217;s ability to form blood clots. Later&nbsp;in the trial, the doses were reduced to once every&nbsp;other week to&nbsp;reduce these side effects. The trial lasted for one year.&nbsp;Participants were aged 20 to 75 years old, 80% were white and&nbsp;55%&nbsp;were female.<br \/><\/span><span><br \/><\/span><span>Volanesorsen&nbsp;was recently approved for clinical use in Europe, as an adjunct to&nbsp;diet in adult patients who have genetically confirmed&nbsp;familial&nbsp;chylomicronemia syndrome and are at high risk for pancreatitis, and&nbsp;who haven&#8217;t responded to diet and triglyceride-lowering&nbsp;therapy.&nbsp;The team is now waiting for Food and Drug Administration approval to&nbsp;market the drug in the United States.<br \/><\/span><span><br \/><\/span><span>According&nbsp;to Witztum, this clinical trial also helped unravel some of the basic&nbsp;biology underlying dietary fat processing. Researchers had&nbsp;previously&nbsp;thought that lipoprotein lipase was a necessary intermediate that&nbsp;allowed apolipoprotein C-III to raise triglycerides levels. This&nbsp;trial revealed that that&#8217;s not always the case &mdash; apolipoprotein&nbsp;C-III has a second role independent of lipoprotein lipase, in which&nbsp;it&nbsp;inhibits the liver from taking up triglyceride-carrying particles.<br \/><\/span><span><br \/><\/span><span>&ldquo;This&nbsp;is the sort of information that could help inform better prevention&nbsp;methods and treatments for many types of heart disease, not just&nbsp;this&nbsp;particular rare condition,&rdquo; Witztum said.<br \/><\/span><span><br \/><\/span><span>To&nbsp;see the full study, visit&nbsp;doi.org\/10.1056\/NEJMoa1715944.<\/span><\/p>","protected":false},"excerpt":{"rendered":"<p>People&nbsp;with familial chylomicronemia syndrome are born with a genetic&nbsp;mutation that&nbsp;prevents&nbsp;them from&nbsp;producing&nbsp;an enzyme called&nbsp;lipoprotein lipase. Without the enzyme, their bodies&nbsp;can&#8217;t break down dietary-derived fat in the blood.Instead,&nbsp;fat-carrying molecules called chylomicrons build up in the blood,&nbsp;causing many life-threatening symptoms, most notably&nbsp;pancreatitis.&nbsp;People living with this condition must follow a strict low-fat diet,&nbsp;but there is no treatment.&nbsp;Joseph&nbsp;Witztum, Ph.D., professor [&hellip;]<\/p>","protected":false},"author":726,"featured_media":280702,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_seopress_robots_primary_cat":"11560","_seopress_titles_title":"UCSD professor helps lead clinical trial for rare disease where people can\u2019t eat fat","_seopress_titles_desc":"","_seopress_robots_index":"","jnews-multi-image_gallery":[],"jnews_single_post":[],"jnews_primary_category":[],"jnews_social_meta":[],"jnews_override_counter":[],"footnotes":""},"categories":[11560,11551],"tags":[],"class_list":["post-280761","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-la-jolla-village-news","category-news"],"_links":{"self":[{"href":"https:\/\/test.sdnews.com\/es\/wp-json\/wp\/v2\/posts\/280761","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/test.sdnews.com\/es\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/test.sdnews.com\/es\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/test.sdnews.com\/es\/wp-json\/wp\/v2\/users\/726"}],"replies":[{"embeddable":true,"href":"https:\/\/test.sdnews.com\/es\/wp-json\/wp\/v2\/comments?post=280761"}],"version-history":[{"count":0,"href":"https:\/\/test.sdnews.com\/es\/wp-json\/wp\/v2\/posts\/280761\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/test.sdnews.com\/es\/wp-json\/wp\/v2\/media\/280702"}],"wp:attachment":[{"href":"https:\/\/test.sdnews.com\/es\/wp-json\/wp\/v2\/media?parent=280761"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/test.sdnews.com\/es\/wp-json\/wp\/v2\/categories?post=280761"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/test.sdnews.com\/es\/wp-json\/wp\/v2\/tags?post=280761"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}