Sek Kathiresan MD Profile picture
Apr 4, 2022 10 tweets 5 min read Read on X
A single IV infusion -->
96% lower plasma ANGPTL3 nearly 2y later in non-human primates!!

Coming era of "molecular surgery":
* one time Rx
* permanent switch off disease-causing gene in liver
* lifelong benefit

#ACC22

@ACCinTouch $VERV @VerveTx

newsfilter.io/a/45db4c967cb4…
some ASCVD patients start with very-high LDL

and

still do not reach LDL goal
despite oral standard-of-care and PCSK9i
In these patients,

ANGPTL3 inhibition with mAb (Evkeeza) proven to work,

to lower LDL-C by ~50% on top of oral SOC and PCSK9i
Complete lack of ANGPTL3 well-tolerated in humans:

human ANGPTL3 knockouts:
very low LDL-C, no liver fat
Key to LDL-C lowering with ANGPTL3 inhibition:

NEED NEAR-COMPLETE INHIBITION

this is clear from the human genetics:

compared with wild-type,

het deficiency (50% deficiency) led to minimal lower LDL-C

with 100% deficiency (human knockouts), 50% lower LDL-C
Can we achieve near-complete inactivation of ANGPTL3 with a once-and-done?
One-time IV infusion of ANGPTL3 base editor,

96% lower ANGPTL3 20 months later in NHPs
Well-tolerated out to 20 months

Stable LFTs, no change in T Bili
Grateful to @ambellinger and @VerveTx team

who over the last 3 years

have moved ANGPTL3 program from concept
to
proof-of-concept in NHPs!

👏👏

Full #ACC22 presentation here: ir.vervetx.com/static-files/6…
These developments raise the prospect of

sequential editing of two genes (PCSK9 followed by ANGPTL3)

for inactivation of two LDL-raising pathways in the same individual

Stay tuned for that thread.

• • •

Missing some Tweet in this thread? You can try to force a refresh
 

Keep Current with Sek Kathiresan MD

Sek Kathiresan MD Profile picture

Stay in touch and get notified when new unrolls are available from this author!

Read all threads

This Thread may be Removed Anytime!

PDF

Twitter may remove this content at anytime! Save it as PDF for later use!

Try unrolling a thread yourself!

how to unroll video
  1. Follow @ThreadReaderApp to mention us!

  2. From a Twitter thread mention us with a keyword "unroll"
@threadreaderapp unroll

Practice here first or read more on our help page!

More from @skathire

Feb 2, 2023
If LDL⬇️for a long time, really hard to get heart attack

Cool new evidence

Some lucky people born with DNA variation that naturally lowers LDL

~50 mg/dl⬇️LDL, lifelong
&
risk for heart attack/death is ~50%⬇️!

So, for every 1 mg/dl⬇️LDL lifelong,
~1%⬇️risk heart attack/death
@jsdron looked at sequence data from 2 different datasets

Dataset 1:

5 US cohorts, ~19K ppl,

~ 1 in 140 won genetic lottery,

carried DNA variant that
turned off
either PCSK9 gene
or APOB gene

49 mg/dl lower LDL (L)

49% reduction in risk for coronary heart disease (R)
Dataset 2:

@uk_biobank, ~200K ppl,

~ 1 in 250 won genetic lottery,

carried DNA variant that
turned off
either PCSK9 gene
or APOB gene

45 mg/dl lower LDL (L)

49% reduction in risk for coronary heart disease (R)
Read 7 tweets
Aug 22, 2022
Excited to announce today:

development candidate for 2nd program

(VERVE-201 targeting the ANGPTL3 gene)

to treat homozygous FH as well as ASCVD

data to be presented by @amitvkhera @escardio 2022

Press release: ir.vervetx.com/news-releases/…

Data: ir.vervetx.com/static-files/3…

$VERV
@VerveTx first program VERVE-101 (targeting PCSK9) is designed to permanently lower LDL cholesterol after a single treatment and is intended to treat FH and ASCVD

What's the unmet need beyond this?

Two patient populations👇🏽
In these two indications, inhibition of the ANGPTL3 protein by a monoclonal antibody has been proven to work
Read 14 tweets
May 9, 2022
Now, you thought @VerveTx was just a CVD product Co.

No, we invent delivery tech as well

New data today in wild-type NHPs:

our proprietary GalNAc-LNP *more potent & consistent* than standard LNP

with 98% reduction in plasma ANGPTL3!!

(editing of basically every hepatocyte)
We developed proprietary GalNAc-LNP last year in order to better treat patients with homozygous FH who completely lack LDLR

Now, the new NHP data suggests that GalNAc-LNP might become

best-in-class technology

to deliver genetic medicines to the liver

A thread on LNPs...
Standard LNP with four components: ionizable lipid, cholesterol, PEG-lipid, DSPC

Standard LNP: taken up by hepatocytes through LDL receptor

GalNAc-LNP: to four components, add a fifth component, Verve's proprietary GalNAc lipid

GalNAc-LNP: taken up by ASGPR & LDLR
Read 10 tweets
May 9, 2022
New NHP data from @ambellinger & team @VerveTx to address:

how durable & potent will VERVE-101 be?

*20 months & going for precursor

*68% lower LDL-C for VERVE-101 clinical formulation (n=22 NHPs)!

To be presented at TIDES meeting on Wed.

See here: ir.vervetx.com/static-files/e…
One-time treatment with VERVE-101

Permanently switch off PCSK9 gene in liver

Blood PCSK9 down 89% a year later
In a separate experiment started even earlier with a precursor formulation,

durability data extends out to 20 months!
Read 7 tweets
Apr 29, 2022
Today, @harijay from @VerveTx presenting

comprehensive off-target analyses for VERVE-101

@KeystoneSymp Precision Genome Engineering

ir.vervetx.com/static-files/d…

Some highlights: Image
Before we get to off-target, let's look at on-target site in PCSK9 gene

Single base pair change at canonical splice site between exon 1 & intron 1

Precise, stereotypical A to G change after treatment in 98.7% alleles (key advantage base editing)

No edits of bystander adenines! Image
Image
Read 19 tweets
Apr 4, 2022
Some patients with very high LDL-C who have already suffered a heart attack:

*may need both the PCSK9 and the ANGTPL3 pathways inactivated

*can we accomplish this with gene editing -

the switching off of two genes in the liver in the same individual?

#ACC22 @VerveTx $VERV
NHPs treated:
*day 0 with VERVE-101 targeting PCSK9 (one-time IV infusion)
*day 30 with ANGPTL3 base editor (one-time IV infusion)

*necropsy at day 90 -->
high level editing of each gene!!

69% editing PCSK9
61% editing ANGTPL3

Each edit designed to switch off respective gene
Day 0 - VERVE 101 Rx,
blood PCSK9 level plummets

Day 30 - ANGPTL3 base editor Rx,
blood ANGPTL3 level plummets

This will likely be durable for lifetime animal (person)!
Read 6 tweets

Did Thread Reader help you today?

Support us! We are indie developers!


This site is made by just two indie developers on a laptop doing marketing, support and development! Read more about the story.

Become a Premium Member ($3/month or $30/year) and get exclusive features!

Become Premium

Don't want to be a Premium member but still want to support us?

Make a small donation by buying us coffee ($5) or help with server cost ($10)

Donate via Paypal

Or Donate anonymously using crypto!

Ethereum

0xfe58350B80634f60Fa6Dc149a72b4DFbc17D341E copy

Bitcoin

3ATGMxNzCUFzxpMCHL5sWSt4DVtS8UqXpi copy

Thank you for your support!

Follow Us!

:(