Summary: Roche announced that its Tina-quant lipoprotein Lp(a) RxDx assay received Breakthrough Device Designation from the FDA, aiming to identify patients who may benefit from Lp(a)-lowering therapy.
Takeaways
- Lp(a) is an emerging and under-recognized risk factor for cardiovascular disease, primarily influenced by genetic factors and unaffected by lifestyle changes.
- The Tina-quant Lp(a) RxDx assay received FDA Breakthrough Device Designation, supporting its role in selecting patients for new Lp(a)-lowering treatments.
- Roche’s collaboration with Amgen aims to improve access to standardized Lp(a) testing, enhancing the ability of healthcare providers to assess cardiovascular risk and guide treatment decisions.
Roche announced its Tina-quant lipoprotein Lp(a) RxDx assay has received Breakthrough Device Designation from the U.S. Food and Drug Administration (FDA) to identify patients who may benefit from innovative Lp(a)-lowering therapy currently in development.
Testing for Lp(a)
Lipoprotein (a), or Lp(a), is emerging as an important, yet under-recognized, potential risk factor for cardiovascular disease, a major public health issue.
“While modern lifestyles are a major driver, as much as 30% of mortality associated with cardiovascular disease occurs in individuals without modifiable risk factors,”(1) says Matt Sause, CEO of Roche Diagnostics. “Lp(a) is a critical marker for people at risk of cardiovascular disease, but medicine has had limited solutions to adequately address the problem. Through our collaboration with Amgen, Roche is paving the way to make elevated Lp(a) an actionable biomarker.”
Once approved, the new Tina-quant test is expected to be made available to support the selection of patients who may benefit from an innovative Lp(a)-lowering therapy.
“Lp(a) testing rates are markedly low, and existing lab tests may not consistently and accurately measure Lp(a) levels,”(2) says Jay Bradner, MD, executive vice president of Research and Development and chief scientific officer at Amgen. “By combining Amgen’s deep legacy and expertise in cardiovascular disease with Roche’s diagnostic expertise, we can accelerate access to more standardized testing and equip more patients and healthcare providers with important information to better understand their risk for cardiovascular disease.”
The Scope of Lp(a)
Globally, as many as one in five people have elevated Lp(a),1 in which lifestyle interventions such as diet and exercise have no significant impact. While Lp(a) levels can be influenced by non-genetic factors including menopause, kidney and liver diseases, and hyperthyroidism, they are predominantly (>90%) determined by genetic variations in the lipoprotein (a) (LPA) gene.(3)
Raised Lp(a) is particularly prevalent among women and people of African descent.(4,5)
High levels of Lp(a) have been shown to promote the buildup of lipids in artery walls, leading to the development of plaques, and have been associated with an increased risk of cardiovascular (CV) events.(3) Lp(a) testing is therefore an important tool for clinicians, enabling them to make a more accurate assessment of CV risk, and it is expected to become a part of regular diagnostic testing in the coming years.
Professional bodies around the world, including the National Lipid Association, Canadian Cardiovascular Society, European Atherosclerosis Society, European Society of Cardiology, and the Beijing Heart Society have recommended that Lp(a) measurement should be considered at least once in every adult person’s life.
As Lp(a) has no single, defined molecular weight, there is a consensus in the scientific community that, ideally, Lp(a) levels should be measured in terms of the number of molecules per liter of blood (nmol/L). This contrasts with widely available tests that measure the molecular weight of Lp(a) in the blood (mg/L), according to Roche.
Further reading: Roche’s Early Alzheimer’s Blood Test Gets Breakthrough Device Designation
The Tina-quant Lp(a) RxDx assay
The FDA has granted Breakthrough Device Designation to the Tina quant Lp(a) RxDx assay for use in selecting patients with elevated Lp(a) and a history of atherosclerotic disease for treatment with an Lp(a)-lowering drug. A lipoprotein (a) test involves a routine blood draw, during which a small sample of blood is used for measurement. This test measures the number of Lp(a) molecules per liter in a person’s bloodstream, which paves the way for Lp(a) to serve as an actionable biomarker in future. If approved, it will be available on selected cobas platforms.
Currently, there is no FDA-authorized Lp(a) assay measuring Lp(a) in nmol/L available in the U.S. This assay will be part of Roche’s wider portfolio of tests for cardiovascular diseases. Together, these tests provide healthcare professionals the opportunity to make informed decisions, allowing patients to access new and innovative treatments.
References:
- Beaglehole, R., Reddy, S., Leeder, S.R. (2007). Poverty and human development: the global implications of cardiovascular disease. Circulation 116, 1871–1873.
- Zheng W, Chilazi M, Park J, et al. Assessing the Accuracy of Estimated Lipoprotein(a) Cholesterol and Lipoprotein(a)‐Free Low‐Density Lipoprotein Cholesterol. Journal of the American Heart Association. 2022;11(2). d oi: 10.1161/jaha.121.023136
- Kronenberg F. et al, Lipoprotein(a) in atherosclerotic cardiovascular disease and aortic stenosis: a European Atherosclerosis Society consensus statement, European Heart Journal, Volume 43, Issue 39, 14 October 2022, Pages 3925–3946
- Simony SB, Mortensen MB, Langsted A, Afzal S, Kamstrup PR, Nordestgaard BG. Sex differences of lipoprotein(a) levels and associated risk of morbidity and mortality by age: The Copenhagen General Population Study. Atherosclerosis. 2022 Aug;355:76-82. doi: 10.1016/j.atherosclerosis.2022.06.1023. Epub 2022 Jun 27. PMID: 35803767.
- Mehta A, Jain V, Saeed A, Saseen JJ, Gulati M, Ballantyne CM, Virani SS. Lipoprotein(a) and ethnicities. Atherosclerosis. 2022 May;349:42-52. doi: 10.1016/j.atherosclerosis.2022.04.005. PMID: 35606075.
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