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Amarin Corporation plc Message Board

  • jesse.livermore jesse.livermore Oct 18, 2012 9:01 AM Flag HDL-C and ProtectinDX

    Re HDL..AKA "The good Cholesterol"...Recent studies have called into question whether raising HDL-C levels have any significant benefit in atheroscerotic heart disease...Quote...

    "The name alone sounds so encouraging: HDL, the “good cholesterol.” The more of it in your blood, the lower your risk of heart disease. So bringing up HDL levels has got to be good for health.

    Health Guides: HDL Test | Cholesterol
    Or so the theory went.

    Now, a new study that makes use of powerful databases of genetic information has found that raising HDL levels may not make any difference to heart disease risk. People who inherit genes that give them naturally higher HDL levels throughout life have no less heart disease than those who inherit genes that give them slightly lower levels. If HDL were protective, those with genes causing higher levels should have had less heart disease.

    Researchers not associated with the study, published online Wednesday in The Lancet, found the results compelling and disturbing. Companies are actively developing and testing drugs that raise HDL, although three recent studies of such treatments have failed. And patients with low HDL levels are often told to try to raise them by exercising or dieting or even by taking niacin, which raised HDL but failed to lower heart disease risk in a recent clinical trial.

    “I’d say the HDL hypothesis is on the ropes right now,” said Dr. James A. de Lemos"

    Re..ProtectinDX...This is one of the names given to a FFA which is derived from DHA in the neuronal (brain) tissues...It has very potent anti inflammatory properties similar to the Resolvins. These chemicals are largely in the very early research phase...The problem with drugs like these are they have wide ranging effects, eg they effect platelet aggregation and present problems in controlling their negative side effects...The body controls these pathways by using cascade systems which limit the lethal effects to the immediate area of pathology and prevent their effects from spreading into non involved tissues...Medical science has not reached the stage where we have such control..

    Regards...": ) JL

    Sentiment: Strong Buy

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    • I believe the fixation with HDL and heart disease got in high gear about 20 years ago. If I remember correctly there was a heart doctor that moved his practice to a small town in Italy and almost went out of businness because there were very few patients. He decided to investigate why, despite a diet high in fat and cholesterol, the incidence of heart disease was very low and concluded it was due to the very high level of a certain HDL in that population. That started the development of a drug I think was named ApoA-Milano. I'm going back about 15 years so the name could be a little off. Don't know what happened to the drug but anyways after having a quadruple bypass 9 years ago (at age 53) and an HDL of 23 I was told to take 2,000mg of Niaspan daily, which I did for 8 years. My LDL has always been under 100. I've had 3 stents since and my HDL with the high dose of Niaspan only went up to 27. I was taken off the Niaspan last year because it wasn't doing me any good and there has been an increased risk of stroke associated with the drug. According to the Cleveland Clinic website, more than 90% of their patients with early heart disease have a very low HDL. Apparantly raising HDL artificially provides no potection and whatever causes a high HDL naturally also ptotects against heart disease.

      Sentiment: Hold

    • There are no such thing as "simple HDL and LDL".

      It is your TOTAL lipid profile that matters.

      Leave this to real PhD experts, Big Pharma, PRON and so on.

      None of the posters on this board are even qualified to have an opinion about this (a regular MD has no specialized knowledge here either) (least of all the phony surgeon/patient JL/Akanz.)

    • Thanks JL
      Do you know the name of the trial that showed that by raising HDL by diet , exercise or even Niacin failed to reduce risk .....I'll google Dr James Lemos
      I very much appreciate your contributions to this MB
      There seems to be a lot of conflicting opinions in the field , which really raises the stakes for the Reduce It trial

      Sentiment: Buy

      • 2 Replies to akanz2
      • todhale Oct 18, 2012 10:53 AM Flag

        There have been several studies out in the last few years sort of debunking the "Inuits don't get CVD" research. Hard to control for smoking and other bad habits, though. What I get from having read some of these is that, like the old Framingham study, "relatively" healthy individuals get protection from higher HDL but it's starting to look like individuals under system stress...diabetes and other chronic issues that place the body under systemic oxidative stress (and inflammation) ...HDL can actually become pro-inflammatory.
        I think Vascepa will do well in Reduce-It, as I posted earlier the EPA cascade is a strong competitor v. the pro-inflammatory AA (arachidonic acid) cascade.

        Sentiment: Strong Buy

      • Akanz...

        Study was in Lancet.Should be very easy to locate... should stay focused on well known properties of EPA as a competive antagonist of Omega6s for pro inflammatory cell membrane membrane receptors. This is the important thing. Next, both MARINE and ANCHOR demonstrate purified EPA will lower trigs without raising the LDL-C. Finally JELIS showed purified EPA will significantly lower CVD "events" in patients taking statins, and extrapolating from the numbers it is safe to conclude that purified EPA in the dose range of 4gms qd. should increase survival in patients with high trigs..

        What exactly the role of DHA is in all this is unclear at present, but it not significant with regard to the above observations..REDUCE-IT differs from JELIS in terms of population, size of cohort and dosage. But the form and the drug used is close enough to be highly predictive. From our previous conversations it is clear REDUCE-IT is skewed in such a fashion that the results should show increased benefits over those shown in JELIS , and the benefits in JELIS were impressive

        ": ) JL

        Sentiment: Strong Buy

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