title: Individual analysis of patients with HoFH participating in a phase 3 trial with lomitapide: The Italian cohort.
abstract: OBJECTIVE
  The efficacy and safety of lomitapide as adjunct treatment for adults with homozygous familial hypercholesterolaemia (HoFH) have been confirmed in a phase 3 trial. Given the small number of patients (N = 29), and variations in patient characteristics, examining individual cases provides additional details regarding patient management with lomitapide. Here, we examine the details of the Italian patient cohort in the phase 3 trial.
  
  
  RESULTS
  The methodology of the multinational, single-arm, open-label, 78-week, dose-escalation, phase 3 trial has been previously reported. The current report details the Italian cohort of six patients (three males, three females) based on individual patient data, individual patient histories and narratives, and by mean data ± SD. Lomitapide was administered according to the dose-escalation protocol. At Week 78, concentrations of low-density lipoprotein-cholesterol were decreased by a mean of 42.6 ± 21.8% compared with baseline. Lomitapide was similarly well tolerated in the Italian cohort as in the entire study population. The most common adverse events were gastrointestinal symptoms. One patient showed an increase in liver transaminases >5× upper limit of normal that resolved after lomitapide treatment was reduced and maintained at a lower dose.
  
  
  CONCLUSIONS
  The efficacy, safety and tolerability of lomitapide demonstrated in the Italian subgroup of patients are consistent with findings in the entire study population, and illustrate the broad applicability of lomitapide therapy across genotypes and clinical phenotypes. These data also provide an insight into the management of lomitapide use in a cohort of patients within a clinical trial protocol. Clinicaltrials.gov Identifier: NCT00730236.
authors.affiliation: Università di Palermo, Italy. Electronic address: maurizio.averna@unipa.it.
authors.forename: M
authors.initials: M
authors.lastname: Averna
authors.affiliation: Università di Palermo, Italy.
authors.forename: A B
authors.initials: AB
authors.lastname: Cefalù
authors.affiliation: 'Sapienza' University of Rome, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Stefanutti
authors.affiliation: 'Sapienza' University of Rome, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Di Giacomo
authors.affiliation: Università di Milano, Center for Dyslipidemias, Niguarda Hospital, Milano, Italy.
authors.forename: C R
authors.initials: CR
authors.lastname: Sirtori
authors.affiliation: Università di Ferrara, Ferrara, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Vigna
mesh_terms: D000293:Adolescent; D000328:Adult; D000924:Anticholesteremic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001562:Benzimidazoles / Q000009:adverse effects / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D005260:Female; D020022:Genetic Predisposition to Disease; D006579:Heterozygote; D006801:Humans; D006938:Hyperlipoproteinemia Type II / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy* / Q000235:genetics; D007558:Italy; D008297:Male; D008875:Middle Aged; D009154:Mutation; D010641:Phenotype; D011973:Receptors, LDL / Q000235:genetics*; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000924:Anticholesteremic Agents; C473731:BMS201038; D001562:Benzimidazoles; D015415:Biomarkers; D008078:Cholesterol, LDL; C573412:LDLR protein, human; D011973:Receptors, LDL
keywords: FH; Familial hypercholesterolaemia; HoFH; Homozygous familial hypercholesterolaemia; Lomitapide; Therapy