PCSK9 inhibitors in clinical practice: Novel directions and new experiences
| Autor: | Dimitrios Tousoulis, Loukianos S. Rallidis, Ioannis Skoumas, Moses Elisaf, Nikolaos Kosmas, Iosif Koutagiar, Charalambos Vlachopoulos, E. Kiouri, Efstathios K. Iliodromitis, Evangelos Liberopoulos, Georgia Anastasiou |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
lcsh:Diseases of the circulatory (Cardiovascular) system Statin medicine.drug_class Hypercholesterolemia proprotein convertase subtilisin/kexin type 9 inhibitors 030204 cardiovascular system & hematology law.invention Hyperlipoproteinemia Type II 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law Internal medicine medicine Humans 030212 general & internal medicine PCSK9 Inhibitors Alirocumab business.industry Cholesterol LDL statin intolerant patient Clinical trial Evolocumab Tolerability lcsh:RC666-701 Cohort familial hypercholesterolaemia lipids (amino acids peptides and proteins) Hydroxymethylglutaryl-CoA Reductase Inhibitors Proprotein Convertase 9 Cardiology and Cardiovascular Medicine business |
| Zdroj: | Hellenic Journal of Cardiology, Vol 61, Iss 4, Pp 241-245 (2020) |
| ISSN: | 1109-9666 |
| Popis: | Background In randomized clinical trials, proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9i) effectively reduce low-density lipoprotein-cholesterol (LDL-C) with a favorable tolerability and safety profile. Our purpose is to provide real-world data regarding the indications, efficacy and safety of PCSK9i. Methods The cohort comprised 141 patients who attended the lipid clinic of 3 hospitals in Greece and started using PCSK9i. Patients were requested to attend the lipid clinic at 3 months and at 1 year. Results Ninety percent of patients had heterozygous familial hypercholesterolaemia (heFH) and 75% had cardiovascular disease (CVD). A PCSK9i [evolocumab 140 mg/2 weeks (n = 82), alirocumab 75 mg/2 weeks (n = 46) and alirocumab 150 mg/2 weeks (n = 13)] was prescribed due to failure to achieve LDL-C targets despite maximum lipid-lowering therapy (LLT) in 75% of patients, while in the remaining cases, the indication was statin intolerance. The mean reduction of LDL-C at 3 months was 56.2% and remained constant at 12 months (55.8% reduction from baseline). LDL-C target was achieved by 68.1% of patients at 3 months. “Totally” intolerant to statins patients (unable to tolerate any statin dose, n = 23) showed the lowest LDL-C reduction (47.7%). Side effects attributed to treatment were reported by 14 patients (10%). The total number of patients who stopped PCSK9i at 1 year was 14 (10%) but only 2 (1.4%) discontinued treatment because of side effects (myalgias). Conclusions Our real-world results of PCSK9i showed comparable efficacy and tolerability to those reported in clinical trials and highlighted the value of treatment with PCSK9i heFH patients not achieving LDL-C targets despite maximum LLT and high or very high risk statin intolerant patients. |
| Databáze: | OpenAIRE |
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