Rapid Resolution of Life-Threatening Hypertriglyceridemia after Evinacumab Administration in a Pediatric HSCT Recipient: A Case Report

被引:2
作者
Fachin, Alice [1 ]
De Carlo, Chiara [2 ]
Maestro, Alessandra [3 ]
Zanon, Davide [3 ]
Barbi, Egidio [1 ,3 ]
Maximova, Natalia [3 ]
机构
[1] Univ Trieste, Dept Med Surg & Hlth Sci, I-34127 Trieste, Italy
[2] Univ Udine, Dept Med Surg & Hlth Sci, I-33100 Udine, Italy
[3] Inst Maternal & Child Hlth IRCCS Burlo Garofolo, I-34137 Trieste, Italy
关键词
hypertriglyceridemia; dyslipidemia; evinacumab; ANGPTL3-inhibitors; lipid-lowering drugs; ANGPTL3;
D O I
10.3390/ph16081069
中图分类号
R914 [药物化学];
学科分类号
100701 ;
摘要
Evinacumab, a human monoclonal antibody against angiopoietin-like protein 3 (ANGPTL3), has recently been approved by the U.S. Food and Drug Administration as an add-on therapy for homozygous familial hypercholesterolemia (HoFH) in patients of 12 years and older. Its role as a triglyceride-lowering drug is also emerging in the literature. However, it has not been approved for this indication yet, neither in the adult nor in the pediatric population. We describe the case of a 10-year-old boy who underwent an allogeneic hematopoietic stem cell transplant for acute lymphoblastic leukemia complicated by chronic graft-versus-host disease (GVHD) and presented life-threatening refractory hypertriglyceridemia due to the concomitant use of ruxolitinib and sirolimus. After the failure of the insulin treatment and due to the technical impossibility of performing lipid apheresis, the child underwent evinacumab treatment, obtaining a dramatic rapid reduction in triglyceride and cholesterol levels. This is the first report of a pediatric patient younger than 12 years in Europe receiving evinacumab to treat severe hypertriglyceridemia. The therapy with angiopoietin-like proteins inhibitors has been effective, safe, and well-tolerated in our patient, suggesting that evinacumab may be used in the pediatric population when other therapeutic strategies are ineffective or contraindicated.
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