News
Low LDL-C, PCSK9 and dementia risk?
An ongoing debate among the experts is whether the very low levels of LDL cholesterol with PCSK9 inhibitor treatment might be associated with neurocognitive events. In fact, the debate predates the PCSK9 inhibitors, with statins linked with cognitive impairment (1-4). However, when the statin data…
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TAUSSIG: Does adding evolocumab reduce cardiovascular events in homozygous FH?
84th European Atherosclerosis Society Congress, 29 May- 1 June, Innsbruck, Austria Patients with homozygous familial hypercholesterolaemia (FH, inherited high cholesterol) are at extremely high risk of premature cardiovascular events due to the burden of elevated LDL cholesterol. Indeed, cardiovascular death at an early age is…
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Changing the message on LDL cholesterol: Lifetime exposure is key
84th European Atherosclerosis Society Congress, 29 May – 1 June, Innsbruck, Austria Until recently, the emphasis in clinical care has been to lower LDL cholesterol to the recommended goal, or even below these limits, as investigated with the PCSK9 inhibitors. However, in his Key Note…
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FH Score: new website
About 1 in 200 people have familial hypercholesterolaemia (FH, inherited high cholesterol), yet <1% world-wide are identified (1,2). To address this urgent issue FH Score has been developed for healthcare professionals to support the diagnosis of adult patients at risk of heterozygous FH. FH Score…
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How do PCSK9-inhibitors reduce lipoprotein(a)?
Beyond lowering LDL cholesterol, PCSK9 inhibition also reduces lipoprotein(a). Prof Derick Raal, University of the Witwatersrand, Johannesburg, South Africa discusses the underlying mechanism. Lipoprotein (a) [Lp(a)] is an LDL-like particle consisting of apolipoprotein(a) [apo(a)] that is disulphide-linked to the apoB moiety of LDL (1). Lp(a)…
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6th Joint Task Force Guidelines on CVD Prevention now available
Updated guidelines from the European Society of Cardiology and nine other societies have been published today. The authors argue that modest risk factor reduction could halve cardiovascular disease (CVD) mortality rates. Currently, CVD is the cause of almost half of all deaths each year in…
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New screening tool for FH for primary care
A new electronic tool for screening for familial hypercholesterolaemia (FH, inherited high cholesterol) in primary care shows promise. According to one of the authors, Professor Gerald Watts, University of Western Australia and Royal Perth Hospital, Western Australia: ‘TARB-Ex is a quick and cost-effective extraction tool…
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UK Paediatric FH register: LDL-C and family history drives diagnosis
Preliminary data from this register, including the largest group of UK children with a clinical diagnosis of familial hypercholesterolaemia (FH, inherited high cholesterol), show that a strong family history of coronary heart disease (CHD) and elevated LDL cholesterol levels primarily drive treatment decisions. Professor Gerald…
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FH affects 1 in 5 young STEMI patients
A study from Greece has highlighted the high prevalence of definite/probable familial hypercholesterolaemia (FH, inherited high cholesterol) in patients with ST-segment elevation myocardial infarction (STEMI) aged 35 years or less. This prospective study included 320 consecutive patients who had survived their first STEMI at ≤35…
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NICE approves alirocumab and evolocumab in draft guidance
The UK National Institute for Health and Clinical Excellence (NICE) has now approved both alirocumab (Praluent, Sanofi) and evolocumab (Repatha, Amgen) for adults with primary hypercholesterolaemia or mixed dyslipidaemia to help reduce their risk of cardiovascular disease, in draft guidance. The specific recommendations are for…
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Alirocumab for Autosomal Recessive Hypercholesterolemia
Results from this in vitro study suggest that PCSK9 inhibition with alirocumab on top of statin treatment may have the potential to lower LDL cholesterol in some patients with autosomal recessive hypercholesterolemia (ARH), a phenocopy of homozygous familial hypercholesterolaemia (FH, inherited high cholesterol). ARH is…
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ACC 2016: Late Breaker underscores the value of genetic testing in ascertaining coronary risk in FH
A key paper for the familial hypercholesterolaemia (FH, inherited high cholesterol) community was presented at the clinical Latebreaker session. According to PCSK9 Forum Board member, Professor Gerald Watts, University of Western Australia, Perth, Australia, the paper by Khera and co-workers not only confirms the higher…
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American College of Cardiology updates guidance for non-statin therapies for LDL-C lowering
In a prelude to this year’s Annual Congress, the American College of Cardiology has released a new consensus document to address gaps from the 2013 ACC/American Heart Association (AHA) guidelines (1) regarding the use of non-statin therapies for lowering LDL cholesterol. This important document provides…
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Latebreaker Clinical Trial GAUSS-3: Evolocumab in patients with statin intolerance
While confirming the superior LDL cholesterol lowering efficacy of evolocumab over ezetimibe, GAUSS-3 also highlights the difficulties of diagnosing statin intolerance, according to PCSK9 Forum Co-Editor Professor Henry Ginsberg. In contrast to the other two trials with evolocumab in statin intolerant patients, GAUSS-3 included an…
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Why PCSK9 inhibitors are needed in FH: SAFEHEART highlights poor LDL cholesterol control
Five-year follow-up data from the Spanish SAFEHEART registry of patients with familial hypercholesterolaemia (FH, inherited high cholesterol) show that attainment of LDL cholesterol is still a major issue. Only 11% attained an LDL-C level of <2.5 mmol/L (100 mg/dl). This was despite increasing maximally tolerated…
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Positive results with ODYSSEY ESCAPE in severe FH
Topline results from ODYSSEY ESCAPE showed that in patients with heterozygous familial hypercholesterolaemia (FH, inherited high cholesterol) who required regular lipoprotein apheresis, on top of maximally tolerated lipid lowering therapy, addition of alirocumab significantly reduced the requirement for apheresis. The frequency of apheresis therapy with…
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Finding FH: the USA needs to do better
PCSK9 Forum interviewed Professor Gerald Watts, University of Western Australia, Perth, Australia and Dr Peter Lansberg, Academic Medical Center, Amsterdam, The Netherlands about the implications of the USA study estimating FH prevalence, reported in News (1): Familial hypercholesterolaemia affects 1 in 250 people in USA…
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Familial hypercholesterolaemia affects 1 in 250 people in USA
Familial hypercholesterolaemia (FH, inherited high cholesterol) is as common in the USA as in Europe, according to findings based on the US National Health and Nutrition Examination Surveys (NHANES). In the study, the authors evaluated data from 36,949 adults (aged 20 years or more) in…
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MONICA study: greater LDL cholesterol lowering in high-risk patients in Sweden
Trends in cholesterol levels in Sweden over the last 20 years show greater impact in individuals at high risk of cardiovascular disease, according to this report from the MONICA study. The study evaluated data from 8,941 individuals (4,546 women and 4,349 men aged 25-74 years)…
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Statin response and potential benefit from PCSK9 inhibition
A report from the JUPITER (Justification for the Use of statins in Prevention: an Intervention Trial Evaluating Rosuvastatin) Study Group shows wide variability in the percent LDL cholesterol reduction to high-intensity statin therapy. Moreover, the cardiovascular risk reduction was directly related to percent LDL cholesterol…
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