METHODS AND COMPOSITIONS FOR TREATING A PROPROTEIN CONVERTASE SUBTILISIN KEXIN (PCSK9) GENE-ASSOCIATED DISORDER
The invention relates to methods of inhibiting the expression of a PCSK9 gene in a subject, as well as therapeutic and prophylactic methods for treating subjects having a lipid disorder, such as a hyperlipidemia using RNAi agents, e.g., double-stranded RNAi agents, targeting the PCSK9 gene.
1 . A method of inhibiting the expression of a PCSK9 gene in a human subject, comprising administering to the subject a fixed dose of about 25 mg to about 800 mg of a double-stranded ribonucleic acid (RNAi) agent,
wherein the double-stranded RNAi agent comprises a sense strand and an antisense strand forming a double stranded region, the antisense strand comprising a region of complementarity which comprises at least 15 contiguous nucleotides differing by no more than 3 nucleotides from nucleotides 3544-3623 of the nucleotide sequence of SEQ ID NO:1, thereby inhibiting the expression of the PCSK9 gene in the subject.
2 . A method of decreasing the level of low density lipoprotein cholesterol (LDLc) in serum in a human subject, comprising administering to the subject a fixed dose of about 25 mg to about 800 mg of a double-stranded ribonucleic acid (RNAi) agent,
wherein the double-stranded RNAi agent comprises a sense strand and an antisense strand forming a double stranded region, the antisense strand comprising a region of complementarity which comprises at least 15 contiguous nucleotides differing by no more than 3 nucleotides from nucleotides 3544-3623 of the nucleotide sequence of SEQ ID NO:1, thereby decreasing the level of LDLc in the subject.
3 . (canceled)
4 . (canceled)
5 . The method of claim 1 , wherein the fixed dose is administered to the subject at an interval of once a week; once every two weeks; once a month; once a quarter; or bianually.
6 .- 9 . (canceled)
10 . The method of claim 5 , wherein the subject is administered a fixed dose of about 25 mg to about 50 mg once a week; a fixed dose of about 50 mg to about 100 mg once every two weeks; a fixed dose of about 100 mg to about 200 mg once a month; a fixed dose of about 200 mg to about 800 mg once a quarter; or a fixed dose of about 200 mg to about 800 mg biannually.
11 .- 18 . (canceled)
19 . The method of claim 1 , wherein the double stranded RNAi agent is administered to the subject subcutaneously.
20 . The method of claim 19 , wherein the subcutaneous administration is subcutaneous injection.
21 . (canceled)
22 . The method of claim 1 , wherein the antisense strand comprises a nucleotide sequence corresponding to the unmodified sequence of any one of the nucleotide sequences provided in Table 1.
23 . The method of claim 1 , wherein the antisense strand comprises the nucleotide sequence 5′-ACAAAAGCAAAACAGGUCUAGAA-3′(SEQ ID NO: 685).
24 . The method of claim 1 , wherein the sense strand comprises the nucleotide sequence 5′-CUAGACCUGUTUUGCUUUUGU-3′ (SEQ ID NO: 686).
25 .- 27 . (canceled)
28 . The method of claim 1 , wherein all of the nucleotides of the sense strand and all of the nucleotides of the antisense strand comprise a nucleotide modification.
29 .- 62 . (canceled)
63 . The method of claim 1 , wherein the double-stranded ribonucleic acid RNAi agent further comprises a ligand.
64 . The method of claim 63 , wherein the ligand is conjugated to the 3′ end of the sense strand of the double-stranded ribonucleic acid RNAi agent.
65 . The method of claim 63 , wherein the ligand is an N-acetylgalactosamine (GalNAc) derivative.
66 . The method of claim 65 , wherein the ligand is
67 . The method of claim 65 , wherein the double-stranded ribonucleic acid RNAi agent is conjugated to the ligand as shown in the following schematic
and, wherein X is O or S.
68 . The method of claim 67 , wherein the X is O.
69 .- 72 . (canceled)
73 . The method of claim 1 , further comprising administering an additional therapeutic agent to the subject.
74 .- 76 . (canceled)
77 . The method of claim 1 , wherein the RNAi agent is administered as a pharmaceutical composition.
78 .- 82 . (canceled)
83 . A kit for performing the method of claim 1 , comprising
a) the double-stranded RNAi agent, and
b) instructions for use, and
c) optionally, means for administering the double-stranded RNAi agent to the subject.