Synonyms: RVX208, RVX000222
Therapy Type: Small Molecule (timeline)
Target Type: Other (timeline)
U.S. FDA Status: MCI-VaD (Phase 3)
Company: Resverlogix Corporation
Apabetalone binds and inhibits bromodomain and extra-terminal domain (BET) proteins, preventing them from binding acetylated lysines in histones to activate gene transcription. In published papers, apabetalone is reported to increase expression of ApoA-1 and suppress genes associated with kidney disease and vascular calcification (McLure et al., 2013; Wasiak et al., 2018; Gilham et al., 2019).
Apabetalone also reportedly suppresses expression of complement proteins (Wasiak et al., 2017). In wild-type mice challenged with lipopolysaccharide, apabetalone suppressed pro-inflammatory cytokines, complement proteins, and endothelial cell adhesion markers (May 2019 conference news).
Resverlogix’s Phase 3 BETonMACE trial evaluates apabetalone in people with Type 2 diabetes and coronary artery disease. The trial includes a cognitive substudy of 467 participants age 70 or older (Ray et al., 2019). They take the Montreal Cognitive Assessment (MoCA) at baseline, annually thereafter, and when the study ends. Outcomes include whether apabetalone slows cognitive decline over a two-year period. This substudy is expected to read out in June 2019.
For all trials of apabetalone, see clinicaltrials.gov.
Last Updated: 12 Jun 2019
- Ray KK, Nicholls SJ, Ginsberg HD, Johansson JO, Kalantar-Zadeh K, Kulikowski E, Toth PP, Wong N, Cummings JL, Sweeney M, Schwartz GG. Effect of selective BET protein inhibitor apabetalone on cardiovascular outcomes in patients with acute coronary syndrome and diabetes: Rationale, design, and baseline characteristics of the BETonMACE trial. Am Heart J. 2019 Nov;217:72-83. Epub 2019 Aug 9 PubMed.
- McLure KG, Gesner EM, Tsujikawa L, Kharenko OA, Attwell S, Campeau E, Wasiak S, Stein A, White A, Fontano E, Suto RK, Wong NC, Wagner GS, Hansen HC, Young PR. RVX-208, an inducer of ApoA-I in humans, is a BET bromodomain antagonist. PLoS One. 2013;8(12):e83190. Epub 2013 Dec 31 PubMed.
- Wasiak S, Tsujikawa LM, Halliday C, Stotz SC, Gilham D, Jahagirdar R, Kalantar-Zadeh K, Robson R, Sweeney M, Johansson JO, Wong NC, Kulikowski E. Benefit of Apabetalone on Plasma Proteins in Renal Disease. Kidney Int Rep. 2018 May;3(3):711-721. Epub 2017 Dec 8 PubMed.
- Gilham D, Tsujikawa LM, Sarsons CD, Halliday C, Wasiak S, Stotz SC, Jahagirdar R, Sweeney M, Johansson JO, Wong NC, Kalantar-Zadeh K, Kulikowski E. Apabetalone downregulates factors and pathways associated with vascular calcification. Atherosclerosis. 2019 Jan;280:75-84. Epub 2018 Nov 14 PubMed.
- Wasiak S, Gilham D, Tsujikawa LM, Halliday C, Calosing C, Jahagirdar R, Johansson J, Sweeney M, Wong NC, Kulikowski E. Downregulation of the Complement Cascade In Vitro, in Mice and in Patients with Cardiovascular Disease by the BET Protein Inhibitor Apabetalone (RVX-208). J Cardiovasc Transl Res. 2017 Aug;10(4):337-347. Epub 2017 May 31 PubMed.
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