The Scottish Mail on Sunday

Britons trial radical drug that reduces your ‘bad’ cholestero­l

- By Stephen Adams MEDICAL EDITOR

BRITONS at high risk of heart attacks are to join a trial of a geneeditin­g medicine that promises to permanentl­y lower cholestero­l.

The ground-breaking drug – codenamed Verve-101 – deletes a tiny hereditary flaw which causes lifethreat­ening amounts of the fatty substance in the blood.

A patient in New Zealand recently become the first in the world to receive an infusion. UK volunteers will join later this year, along with others from America, as part of a 40-strong trial to test if the treatment reduces ‘bad’ LDL cholestero­l in humans – and by how much.

Previous studies in monkeys, which share the same cholestero­l gene, PCSK9, showed remarkable success. LDL fell by almost 70 per cent with the same levels still seen two years later, suggesting the drop could be permanent.

Cardiologi­st and geneticist Dr Sekar Kathiresan, who co-founded Verve Therapeuti­cs, the team behind Verve-101, said: ‘If it works and is safe, this is the answer to heart attacks – this is the cure.’

Each of the 40 patients on the trial will have inherited naturally high cholestero­l levels from a parent – a condition known as familial hyperchole­sterolaemi­a (FH) which affects one in every 250 Britons. Each will also have had a heart attack before.

Studies show that the longer LDL is kept low, the better the chance of preventing heart attacks.

While statins are effective at cutting cholestero­l – typically lowering levels by 30 to 50 per cent – they have to be prescribed by a doctor, and they only work if people take them regularly.

But Dr Kathiresan said a US study showed only half of people who have had a heart attack are on any cholestero­l-lowering drugs, leading to ‘additional heart attacks, strokes and even deaths’.

Verve-101 uses a precision geneeditin­g technique called CRISPR base editing to rub out a single ‘faulty’ letter of DNA code before replacing it with a ‘harmless’ one. The effect is that cells in the liver, where cholestero­l is made, produce much less of the fatty LDL which can block arteries.

Like the Covid vaccines by PfizerBioN­Tech and Moderna, Verve-101 uses messenger RNA (mRNA) to instruct cells.

In the case of the vaccines, the mRNA tells them to mass-produce the Covid virus’s spike protein, so that the immune system can recognise the real thing when it comes along. With Verve-101, the mRNA tells liver cells to make two proteins – one to locate the PCSK9 gene, and another to edit it.

As with the vaccines, the mRNA is wrapped in a tiny bubble of fat called a ‘lipid nanopartic­le’ which helps it enter cells. Dr Kathiresan said he was ‘optimistic’ that UK regulators would allow the trial to begin later this year. If all goes successful­ly, Verve will publish the initial results in 2023 and hopes that the medicine will be available by 2028.

Cholestero­l is made by the liver and carried around the body in the blood. The body needs cholestero­l to build healthy cells but high levels can increase the risk of heart disease.

With FH, there is a fault with one of the genes involved in removing cholestero­l from the blood, which can lead to a build-up.

‘If it works, this is the cure for heart attacks’

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