Hot topics
Does PCSK9 inhibition have a role in HIV dyslipidaemia?
With HIV (human immunodeficiency virus) patients in developed countries living longer, appropriate management of cardiovascular risk factors, notably dyslipidaemia, becomes more of an issue. But is this also the same in developing regions? As a consequence of developments in HIV management, HIV patients in developed…
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Are very low LDL-C levels on a PCSK9 inhibitor safe?
One of the key concerns of clinicians is whether the very low LDL cholesterol levels attained on a PCSK9 inhibitor are safe. Such concerns have been sparked by a recent meta-analysis which suggested a signal for adverse neurocognitive effects (1). These concerns were investigated in…
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FOURIER doesn’t disappoint: Amgen announces positive topline results
Amgen has confirmed that the much-awaited FOURIER (Further Cardiovascular OUtcomes Research with PCSK9 Inhibition in Subjects with Elevated Risk) trial showed that treatment with the PCSK9 inhibitor evolocumab significantly reduced the risk of cardiovascular events in patients with clinical atherosclerotic cardiovascular disease on optimized statin…
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Bococizumab exits the PCSK9 stage: A response from PCSK9 Forum Editors
Pfizer announced on Tuesday, 1st November that it was discontinuing development of bococizumab, its PCSK9 inhibitor. According to the press release, the Company stated that: ‘The totality of clinical information now available for bococizumab, taken together with the evolving treatment and market landscape for lipid-lowering…
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Optimal treatment in children with FH urgently needed!
Familial hypercholesterolaemia (FH, inherited high cholesterol) is the most common inherited cause of premature coronary heart disease, affecting about 1 in 200-250 people (1). This means that worldwide, one baby is born with FH every minute. Therefore, diagnosing children with FH earlier, so that lifestyle…
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Insights from Chile: Rodrigo Alonso, Clínica Las Condes, Santiago de Chile
The Healthcare Perspective in South America
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Insights from Brazil: Raul Santos, InCor-University of Sao Paulo
The Healthcare Perspective in South America
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Outcomes data are critical
The Healthcare System Perspective in Europe: Francois Mach, University of Geneva, Switzerland
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Collaboration between patient associations and healthcare professionals is key
The Patient Perspective: Gunnar Karlsson, FH Sverige
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Many key barriers are amenable to change; new strategies are needed
General considerations: David L. Hare, University of Melbourne Australia
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What prevents high risk patients gaining access to treatment with PCSK9 inhibitors?
Roundtable discussion from the Fifth Closed Expert Meeting of PCSK9 Forum focused on identifying barriers to access to treatment with PCSK9 monoclonal antibody therapy, from both the patient and healthcare system perspectives. Access in developing countries is especially problematic, according to insights from South America….
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No effect of PCSK9 inhibitors on new-onset diabetes
Treatment with alirocumab for up to 18 months did not affect the incidence of new-onset diabetes, according to this pooled analysis of Phase III trials from the ODYSSEY programme. These findings are in line with reports with evolocumab which showed no effect on glycaemic measures…
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New debate on lipid screening in children and adolescents
Experts have weighed in following publication of the US Preventive Services Task Force recommendations, which concluded that there was insufficient evidence to assess the balance of benefits and harms of screening for lipid disorders in children and adolescents up to 20 years. To read the…
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News: International Atherosclerosis Society consensus statement on severe familial hypercholesterolaemia
In this new statement, the International Atherosclerosis Society (IAS) has placed phenotype at the heart of management strategies for familial hypercholesterolaemia (FH, inherited high cholesterol). Commenting, lead author Dr. Raul Santos (University of São Paulo Medical School Hospital and Preventive Medicine Centre and Cardiology Program,…
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PCSK9 Inhibitors for Treatment of High Cholesterol levels: Effectiveness and Value
Ciaran Kohli-Lynch, working with Professor Andrew Briggs, University of Glasgow, UK critically appraises the findings and implications of the Institute for Clinical and Economic Review (ICER) report regarding the value of PCSK9 inhibitors in high cardiovascular risk patients. A summary of the report was published as:…
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Lipoprotein-associated PCSK9: Physiological implications?
Professor Sergio Fazio, The Knight Cardiovascular Institute of OHSU, Portland, USA overviews the physiological implications of lipoprotein-associated PCSK9. Studies show that only 40% of total plasma PCSK9 associates with LDL. This raises a key question: Does lipoprotein-bound PCSK9 more accurately reflect PCSK9 activity?
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Legacy effects: Does early intensive LDL lowering treatment modify the atherosclerotic process?
Professor Packard, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK discusses follow-up data from major statin trials and considers the potential mechanism for the legacy effect seen in some trials, such as WOSCOPS. These findings raise a key question: Would phased…
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PCSK9 inhibitors: What is the value of addressing unmet clinical needs in LDL management?
No doubt the PCSK9 monoclonal antibodies are effective in lowering LDL cholesterol across the spectrum of high cardiovascular risk patients. Moreover, data from a recent meta-analysis looking at clinical outcomes with these novel treatments suggested a 50% reduction in all-cause mortality and myocardial infarction (1)….
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Study questions utility of measuring PCSK9 in ACS setting
High PCSK9 levels at angiography were not predictive of 1-year mortality in patients with acute coronary syndrome (ACS), but did predict failure to attain LDL cholesterol goal at 1 year follow-up, independent of lipid-modifying therapy or baseline LDL cholesterol levels. This study measured PCSK9 levels…
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Need to manage lipoprotein(a), blood pressure and renal insufficiency in familial hypercholesterolaemia
This study makes the case for identifying and managing elevated lipoprotein(a), high blood pressure, and renal insufficiency, to reduce the risk of premature coronary artery disease (CAD) in patients with familial hypercholesterolaemia (FH, inherited high cholesterol). Elevated lipoprotein(a) [Lp(a)] is already recognised as causal for…
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