Evidence map›Paper›PMID 40052268›Full record

ArticleCirculation. Genomic and precision medicine2025

Evaluating the Cardiometabolic Efficacy and Safety of Lipoprotein Lipase Pathway Targets in Combination With Approved Lipid-Lowering Targets: A Drug Target Mendelian Randomization Study.

Eloi Gagnon, Dipender Gill, Dominique Chabot, Héléne T Cronjé, Shuai Yuan, Stephen Brennan, Sébastien Thériault, Stephen Burgess, Benoit J Arsenault, Marie-Joe Dib

Abstract read
In one paragraph

Article in Circulation. Genomic and precision medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

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0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Eloi GagnonCentre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec, Canada (E.G., S.T., B.J.A.).ORCID 0000-0002-7483-1371
Dipender GillSequoia Genetics, Ltd, Translation and Innovation Hub, London, United Kingdom (D.G.).ORCID 0000-0001-7312-7078
Dominique ChabotDepartment of Medicine, Faculty of Medicine (D.C., B.J.A.), Université Laval, Québec, Canada.ORCID 0009-0005-8223-842X
Héléne T CronjéDepartment of Public Health, Section of Epidemiology, University of Copenhagen, Denmark (H.T.C.).
Shuai YuanUnit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden (S.Y.).ORCID 0000-0001-5055-5627
Stephen BrennanDepartment of Neurology, Mater Misericordiae University Hospital, Dublin, Ireland (S. Brennan).ORCID 0000-0002-3224-1621
Sébastien ThériaultCentre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec, Canada (E.G., S.T., B.J.A.).ORCID 0000-0003-1893-8307
Stephen BurgessMRC Biostatistics Unit (S. Burgess).ORCID 0000-0001-5365-8760
Benoit J ArsenaultCentre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec, Canada (E.G., S.T., B.J.A.).ORCID 0000-0003-2240-8456
Marie-Joe DibCardiovascular Division, Perelman School for Advanced Medicine, University of Pennsylvania, Philadelphia (M.-J.D.).ORCID 0000-0001-7591-5684

Funding

Wellcome Trust 225790
6 · The paper itself

Abstract

backgroundTherapies targeting the LPL (lipoprotein lipase) pathway are under development for cardiometabolic disease. Insights into their efficacy-both alone and in combination with existing lipid-lowering therapies-modes of action, and safety of these agents are essential to inform clinical development. Using Mendelian randomization, we aimed to (1) evaluate efficacy, (2) explore shared mechanisms, (3) assess additive effects with approved lipid-lowering drugs, and (4) identify secondary indications and potential adverse effects.

methodsWe selected triglyceride-lowering genetic variants located in the genes encoding ANGPTL3 (angiopoietin-like 3), ANGPTL4 (angiopoietin-like 4), APOC3 (apolipoprotein C3), and LPL and conducted drug target Mendelian randomization on primary outcomes including coronary artery disease and type 2 diabetes, and secondary outcomes, including apolipoprotein B, waist-to-hip ratio, body mass index, and 233 metabolic biomarkers. We conducted interaction Mendelian randomization analyses in 488 139 UK Biobank participants to test the effect of combination therapy targeting the LPL and LDLR (low-density lipoprotein receptor) pathways. Finally, we investigated potential secondary indications and adverse effects by leveraging genetic association data on 1204 disease end points.

resultsGenetically predicted triglyceride lowering through the perturbation of LPL pathway activation targets ANGPTL4, APOC3, and LPL was associated with a lower risk of coronary artery disease and type 2 diabetes and lower apolipoprotein B. Genetically predicted triglyceride lowering through ANGPTL4 was associated with a lower waist-to-hip ratio, suggestive of a favorable body fat distribution. There was no evidence of a multiplicative interaction between genetically proxied perturbation of ANGPTL4, APOC3, and LPL and that of HMGCR (HMG-CoA reductase) and PCSK9 (proprotein convertase subtilisin/kexin type 9) on coronary artery disease and type 2 diabetes, consistent with additive effects. Finally, associations of genetically predicted LPL pathway targeting were supportive of the broad safety of these targets.

conclusionsOur findings provide genetic evidence supporting the efficacy and safety of LPL pathway activation therapies for the prevention of coronary artery disease and type 2 diabetes, alone or in combination with statins or PCSK9 inhibitors.

Indexed as

Coronary Artery DiseaseDiabetes Mellitus, Type 2Hypolipidemic AgentsLipoprotein LipaseAngiopoietin-Like Protein 3Angiopoietin-Like Protein 4Apolipoprotein C-IIIFemaleHumansMaleMendelian Randomization AnalysisMiddle AgedPolymorphism, Single NucleotideTriglyceridesAngiopoietin-Like Protein 3Angiopoietin-Like Protein 4ANGPTL3 protein, humanANGPTL4 protein, humanAPOC3 protein, humanApolipoprotein C-IIIHypolipidemic AgentsLipoprotein LipaseLPL protein, humanTriglyceridesbiomarkerscholesterol lowering medicationcoronary heart diseaselipoprotein lipaseMendelian randomization analysisPCSK9 inhibitors

Identifiers

PMID40052268
PMCPMC7617573

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.