{"id":"ad7c4ea303b7","type":"article","url":"https://hartvaat.nl/2026/03/30/essence-timi-73b-apoc3-remmer-olezarsen-reduceert-niet-verkalkte-coronairplaque-/","title":"Essence-TIMI 73b: APOC3-remmer olezarsen reduceert niet-verkalkte coronairplaque bij hypertriglyceridemie","title_en":"","category":"algemeen","category_label":"Algemeen","professions":["cardioloog","internist"],"tags":["ezetimibe","lipidenverlaging","niet-statine-therapie"],"journal":"Circulation","doi":"https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.126.080012","source_url":"https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.126.080012","authors":[],"significance":9,"published":"2026-04-23","source_date":"2026-03-30","image":"","kennis":["https://hartvaat.nl/kennis/coronairlijden/esc-richtlijn-chronisch-coronairlijden-2024/","https://hartvaat.nl/kennis/antistolling/doac-versus-vka-keuze/"],"congress":"","summary_en":"This CCTA sub-study of Essence-TIMI 73b showed that olezarsen — an APOC3 antisense oligonucleotide — lowered triglycerides by ~60% and remnant cholesterol by ~70%, with neutral LDL-C and ~15% apoB reduction. Over 12 months in patients with moderate hypertriglyceridemia and non-calcified coronary plaque, olezarsen produced a placebo-adjusted reduction in non-calcified plaque volume. It provides some of the first imaging evidence that triglyceride-directed therapy favorably modifies coronary atherosclerosis.","created":"2026-07-03T10:32:47Z","updated":"2026-07-03T13:31:43Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"In deze CCTA-substudie van Essence-TIMI 73b verlaagde olezarsen — een APOC3-antisense oligonucleotide — triglyceriden met ongeveer 60% en remnant-cholesterol met 70%, met neutraal effect op LDL-C en ~15% apoB-daling. Na 12 maanden trad bij patiënten met gematigde hypertriglyceridemie en bestaande coronairplaque een reductie op van de niet-verkalkte plaquevolume ten opzichte van placebo. Het is een van de eerste imaging-signalen dat triglyceride-gerichte therapie plaque gunstig beïnvloedt.","abstract_original":"Background: Whether lowering triglyceride-rich lipoproteins and remnant cholesterol favorably modifies coronary atherosclerosis is unclear. Olezarsen, an antisense oligonucleotide that targets apolipoprotein C-III, reduces triglycerides by ~60% and remnant cholesterol by ~70%, has a neutral effect on LDL cholesterol (LDL-C), and reduces apolipoprotein B (apoB) by ~15% in moderate hypertriglyceridemia. We investigated the effect of olezarsen on coronary plaque in adults with largely moderate hypertriglyceridemia.Methods: We conducted a coronary computed tomography angiography (CCTA) study within Essence-TIMI 73b, a randomized, placebo-controlled trial of olezarsen vs. placebo that enrolled patients between November 2022 and February 2024. Inclusion criteria were triglycerides ≥150 mg/dL (2.26 mmol/L), presence or high risk for cardiovascular disease, and non-calcified plaque on baseline CCTA. The primary endpoint was percent change from baseline to 12 months in non-calcified plaque volu"}