Priložnosti in izzivi vezani na novo skupino zdravil (zaviralci PCSK9) za zniževanje holesterola LDL: opportunities and challenges: The PSCK9 inhibitors - a novel therapeutic target for hypercholesterolemia

Autor: Detiček, Andreja, Janežič, Ana, Janžič, Andrej, Kos, Mitja, Locatelli, Igor, Marđetko, Nika
Jazyk: slovinština
Rok vydání: 2016
Zdroj: Farmacevtski vestnik
Popis: PCKS9 inhibitors represent a new therapeutic target for hypercholesterolemia treatment. Monoclonal antibodies have been most extensively studied in clinical trials. Among them evolocumab and alirocumab were approved for use in summer 2015. They can be used as add-on therapy to inefficient standard hypercholesterol treatment or as monotherapy when standard treatment is contraindicated or intolerant. In clinical trials on evolucumab or alirocumab the LDL cholesterol was additionally reduced by approximately 50% in patients with primary hypercholesterolemia. At the moment, there are limited data on clinical impact of these medicines such as the cardiovascular event rate reduction. Patients with the highest risk of cardiovascular event having inefficient standard hypercholesterol treatment will benefit most from these medicines. These patients include patients with familial hypercholesterolemia or patients with cardiovascular disease and additional risk factors (e.g. diabetes) or patients with statin intolerance with elevated LDL cholesterol level. Zaviralci PCSK9 predstavljajo novo terapevtsko skupino zdravil za zdravljenje hiperholesterolemije. Najbolj preučevana iz te skupine so monoklonska protitelesa, kot sta evolokumab in alirokumab, ki sta poleti 2015 pridobila dovoljenje za promet. Predvidena sta kot dodatna terapija za zniževanje holesterola LDL, kadar pri zdravljenju s statini ne dosežemo ciljnih vrednosti ali pa zdravljenje s statini ni mogoče. Omenjeni učinkovini sta pri bolnikih s primarno hiperholesterolemijo dodatno zmanjšali koncentracije holesterola LDL za približno 50 %. Neposrednih dokazov o vplivu na zmanjšanje pojavnosti srčno-žilnih dogodkov trenutno še ni na voljo. Največja potreba po teh zdravilih se izraža pri bolnikih z največjim tveganjem za srčno-žilne zaplete in pri katerih obstoječa terapija ni dovolj učinkovita. V to skupino spadajo predvsem bolniki z družinsko hiperholesterolemijo in bolniki, ki so že doživeli srčno-žilni zaplet ter imajo še dodatne dejavnike tveganja (npr. sladkorno bolezen) ali pa zdravljenja s statini ne prenašajo in imajo hkrati visoke vrednosti holesterola LDL.
Databáze: OpenAIRE