News
More real-world data with PCSK9 inhibitors
In the light of cardiovascular outcomes data from FOURIER (Further Cardiovascular Outcomes Research With PCSK9 Inhibition in Subjects With Elevated Risk) (1), the Joint Task Force of the European Society of Cardiology and European Atherosclerosis Society recently updated practical guidance for the use of PCSK9…
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Cholesterol variability is a predictor of adverse outcome in the general population
Data from a large Korean cohort highlights visit-to-visit variability in cholesterol levels as an important cardiovascular risk factor in the general population. This adds to previous evidence that variability in cholesterol levels is an independent predictor of major adverse cardiovascular events in patients with coronary…
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New meta-analysis reaffirms benefit of more intensive LDL lowering on cardiovascular outcome
Irrespective of the type of therapy, more intensive lowering of LDL cholesterol was associated with 19% reduction in major vascular endpoints compared with less intensive treatment. This meta-analysis identified 19 trials (15 with statins, 3 with PCSK9 inhibitors, and one with ezetimibe) in 152,507 patients…
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Why the 2017 ESC/EAS practical guidance on PCSK9 inhibition is needed
In the largest US analysis to date, higher LDL cholesterol levels were not associated with higher payer approval rates for PCSK9 inhibitor therapy. These data reaffirm the need for practical guidance, such as that published by a Joint Task Force from the European Society of…
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Alirocumab effective against the spectrum of mutations causative for familial hypercholesterolaemia
Alirocumab treatment was effective in patients heterozygous for mutations in LDLR, APOB, and PCSK9 genes. This analysis investigated the efficacy of alirocumab in 1191 patients with familial hypercholesterolaemia (FH, inherited high cholesterol) included in 6 trials; 758 were treated with alirocumab. One or more specific…
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New network meta-analysis of PCSK9 inhibitor efficacy
This analysis reaffirms the efficacy of PCSK9 monoclonal antibody therapy added to medium- to high-intensity statin therapy in lowering LDL cholesterol. The authors reviewed 69 trials of lipid-lowering therapies that enrolled patients requiring further LDL cholesterol reduction while on maximally tolerated medium- or high-intensity statin…
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Familial hypercholesterolaemia-causing mutations prevalent in ACS
According to this Spanish study, one in 10 patients aged < 65 years with an acute coronary syndrome and elevated LDL cholesterol levels has a mutation causative for familial hypercholesterolaemia (FH, inherited high cholesterol). The study assessed the prevalence of mutations in 7 genes (LDLR,…
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Another CETP hits the dust: anacetrapib terminated
Merck (known as MSD outside the U.S. and Canada) has decided not to submit applications for regulatory approval for the cholesteryl ester transfer protein (CETP) anacetrapib, after a thorough review of the clinical profile of this drug. This follows on from the publication of the…
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More from FOURIER: Evolocumab effective in diabetics, no impact on glucose control
The latest report from the FOURIER (Further cardiovascular Outcomes Research with PCSK9 Inhibition in subjects with Elevated Risk) trial (1) shows that treatment with the PCSK9 inhibitor evolocumab was similarly effective in patients with and without diabetes. Importantly, evolocumab did not increase the risk of…
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New WOSCOPS analysis: Treat – don’t wait – if high LDL-C without heart disease
This important study confirms and supports the benefit of LDL cholesterol lowering with statin therapy for the primary prevention of atherosclerotic cardiovascular disease (ASCVD), especially in individuals with LDL cholesterol levels above 190 mg/dl (~5 mmol/L). ‘We need to start early and to treat more…
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2017 Update of the ACC Expert Consensus Decision Pathway on Non-Statin Therapies for LDL-Cholesterol Lowering to Reduce ASCVD Risk
2017 Update of the ACC Expert Consensus Decision Pathway on Non-Statin Therapies for LDL-Cholesterol Lowering to Reduce Atherosclerotic Cardiovascular Disease Risk Following first publication in 2016, an updated ACC Expert Consensus Decision Pathway on the role of non-statin therapies for LDL-cholesterol lowering to reduce atherosclerotic cardiovascular disease…
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Is a PCSK9 vaccine a possibility for the future?
PCSK9 Forum has previously reported on preliminary experimental data for a PCSK9 vaccine. A recent publication in The European Heart Journal provides more details, albeit in an experimental preclinical model. Researchers used the APOE*3Leiden.CETP mouse model, a well-established, translational mouse model for hyperlipidaemia and atherosclerosis,…
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SAMS and the nocebo effect: more experts weigh in
PCSK9 Forum discussed the findings of the recent Anglo–Scandinavian Cardiac Outcomes Trial–Lipid Lowering Arm or ASCOT–LLA trial (1) with Dr Paul Thompson (Hartford Hospital, and University of Connecticut, USA), a recognized researcher into the effects of statins on skeletal muscle strength. The ASCOT-LLA group evaluated…
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PCSK9 inhibition and ischaemic stroke: genetic and clinical studies differ
PCSK9 variants that confer life-long lower levels of PCSK9 and LDL cholesterol were associated with a lower risk of coronary heart disease (CHD) but not ischaemic stroke. This contrasts with findings from the FOURIER (Further Cardiovascular Outcomes Research With PCSK9 Inhibition in Subjects With Elevated…
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Managing SAMS: Will a clinical index tool aid detection?
The lack of a gold standard measure has been an obstacle to the identification and management of statin-associated muscle symptoms (SAMS). However, promising data indicate that a Statin-Associated Muscle Symptom Clinical Index (SAMS-CI) may prove useful. The National Lipid Association Statin Muscle Safety Task Force…
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Managing SAMS: Most patients will tolerate a statin
Among patients referred to a specialist centre with statin-associated muscle symptoms SAMS, most will subsequently tolerate a statin, according to this Canadian report. The authors analysed retrospective referral data from 118 patients who developed muscle-related symptoms with 2 or more statins. Over a median follow-up…
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Statin intolerance back in the news: ASCOT-LLA report argues for a nocebo effect
Statin-associated muscle symptoms (SAMS) is very much a hot topic amongst clinical experts. The crux of the debate is differences in SAMS prevalence observed in randomized clinical trials (which showed no difference compared with placebo),1 and observational studies, which report a prevalence of up to…
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Is PCSK9 a marker of early vascular disease?
This study suggests that measurement of PCSK9 could be used as a predictor of early vascular disease in the primary prevention setting. Previous reports have suggested the potential of PCSK9 as a possible biomarker of risk for clinical ischaemic events. This study investigated this in…
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Study reinforces the importance of cascade screening in families with familial hypercholesterolaemia
The risk of cardiovascular events was about 2-fold higher in relatives of patients with familial hypercholesterolaemia (FH, inherited high cholesterol) with an LDL receptor mutation identified by cascade screening, compared with the general population. While the high cardiovascular risk associated with FH is well recognized…
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PCSK9 inhibition reduces tendon xanthomas
A short report shows the benefit of LDL cholesterol lowering with a PCSK9 inhibitor in reducing tendon xanthomas in patients with familial hypercholesterolaemia (FH, inherited high cholesterol). Tendon xanthomas are among the clinical signs of FH in some, but not all, patients, resulting from the…
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