News
Stroke risk in heterozygous FH
Are individuals with heterozygous familial hypercholesterolaemia (FH, inherited high cholesterol) at higher risk of stroke? And if so, does statin treatment ameliorate this risk? Results from this meta-analysis suggest this may be the case. Heterozygous FH is undoubtedly associated with an increased risk of premature…
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ATVB Council statement on nonstatin LDL therapy
This timely statement, led by Professor Robert Hegele, Robarts Research Institute, Western University, London, Ontario, Canada, considers the place of nonstatin therapy, including PCSK9 inhibitors, in the prevention of cardiovascular disease (CVD). Evidence conclusively establishes LDL cholesterol as causal for atherosclerosis and CVD. Statins are…
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European Union targets familial hypercholesterolemia (FH, inherited high cholesterol)
Patient groups representing up to 4.5 million Europeans with genetic high cholesterol joined MEPs and cardiologists at the European Parliament to raise awareness of Familial Hypercholesterolemia (FH), calling for improved diagnosis, care and management of this life-threatening and under-diagnosed disease which contributes to the annual €196…
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Underutilization of cascade screening for familial hypercholesterolemia
Why cascade screening for familial hypercholesterolemia. Cascade screening in the context of dyslip- idemia refers to cholesterol testing of close relatives of individuals who fulfill genetic or phenotypic criteria for the diagnosis of famil- ial hypercholesterolemia (FH).
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HoFH in the Middle East: Consensus paper
A Consensus Panel from experts in the Middle East, including representation from Oman, Saudi Arabia, United Arab Emirates, Iran and Bahrain, has highlighted issues specific to this region that complicate the diagnosis and management of familial hypercholeterolaemia (FH, inherited high cholesterol). In particular, the epidemic…
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Alirocumab in PCSK9 Gain of Function hypercholesterolaemia
The PCSK9 monoclonal antibody alirocumab is effective and well tolerated in patients with autosomal dominant hypercholesterolaemia caused by PCSK9 gain of function (GOF) mutations. This is the first study indicating the benefit of PCSK9 inhibition in these individuals with a rare but severe hypercholesterolaemia due…
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Missed opportunities for FH detection
Consistent with findings previously reported from the EUROASPIRE IV study (1), this report from Australia also highlighted a high prevalence of likely FH in patients aged less than 60 years admitted to the coronary care unit. In 175 coronary care patients aged less 60 years, about…
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PCSK9 predominant influence on FH phenotype
PCSK9 is an important determinant of the severity of heterozygous familial hypercholesterolaemia (FH, inherited high cholesterol), independent of the functionality of the LDLR mutation, according to this study. LDLR mutations are the predominant type of FH-causing mutation identified on genetic testing. Whether the nature of…
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Universal screening for FH in children
A report from Slovenia makes the case for universal screening for familial hypercholesterolaemia (FH, inherited high cholesterol) incorporating both family history and genetic data. Total cholesterol (TC) was measured in all children at age 5 years as part of the Slovenia national universal screening for…
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IMPROVE-IT: no increased diabetes risk with ezetimibe-statin
A subgroup analysis from IMPROVE-IT showed that there was no excess risk of new-onset diabetes in patients treated with the combination of simvastatin plus ezetimibe. Data were presented by Dr Michael Blazing, Duke University, Durham, USA. The findings provide reassurance after a recent report questioned…
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Statin intolerance: International study
An international survey involving 13 countries in Europe, South America, Asia-Pacific and the USA reinforce recent consensus that statin intolerance is an issue in up to 12% of patients. Importantly, about 10% of these patients receive no lipid lowering therapy after discontinuation of statin. While…
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Sustained lowering of Lp(a) with alirocumab in 4915 patients
In this pooled analysis of 10 clinical trials in the ODYSSEY Clinical trial programme, alirocumab (75/150 mg every 2 weeks) resulted in sustained lowering of lipoprotein(a) [Lp(a)] by 23-29%. In all except two trials (ODYSSEY ALTERNATIVE and ODYSSEY MONO) patients were on background statin therapy….
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PROFICIO: more evolocumab data
Long-term follow-up of GAUSS patients: durable, well tolerated response to evolocumab In statin-intolerant patients who completed GAUSS-1 and GAUSS-2, evolocumab showed sustained LDL cholesterol lowering over a median 11 month follow-up, with no increase in myalgia, compared with the standard of care. This report pooled…
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ODYSSEY 78-week data in heterozygous FH: PCSK9 FORUM Expert view
ESC Congress 2015, 1 September 2015 Familial hypercholesterolaemia (FH, inherited high cholesterol) represents one of the key priorities for PCSK9 monoclonal antibody therapy. This analysis from the ODYSSEY clinical programme with alirocumab, which has the largest group of heterozygous FH patients studied to date, establishes…
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Managing LDL-C: can we redefine targets?
31st August 2015, London, UK Despite all the consternation and debate about the US versus European guidelines for lipid management, it is important to remember that there are a number of important consistencies. Both guidelines agree that patients at high global risk of cardiovascular disease…
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DYSIS reaffirms unmet clinical needs in ACS patients
Comprehensive results from the DYSIS (Dyslipidemia International Study) II study clearly show that attainment of LDL cholesterol goal in high to very high cardiovascular risk patients is still far from optimal. Overall, nearly 70% of patients with stable coronary heart disease (CHD) did not attain…
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Evolocumab and PROFICIO: consistent LDL response across age, sex and risk groups
ESC Congress 2015, London, 30th August 2015 In an analysis of 3,146 patients from four Phase III trials, evolocumab given either 2-weekly or monthly produced similar LDL cholesterol lowering irrespective of age, gender, glycaemic status or cardiovascular risk. The primary endpoint in this analysis was…
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ESC Translational Hotline: is recombinant HSP-27 a possibility for the future?
ESC Congress 2015, London, 30th August 2015 Heat shock protein 27 (HSP-27) is a novel biomarker that has been previously shown to attenuate atherosclerotic lesion progression and enhance lesion remodelling in an experimental model of atherosclerosis. New data presented at this Translational Science Hotline showed…
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What’s next in the PCSK9 field: small interference RNA therapeutics
ESC Congress 2015, London, 30th August 2015 There were promising data with the reformulated small interference RNA (siRNA) therapeutic targeting PCSK9 (ALN-PCSsc). The study results indicate potential for a quarterly or even twice-yearly subcutaneous injection regimen. Previously a proof of concept Phase I study showed the…
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FDA approves evolocumab
Evolocumab was formally approved the US Food and Drugs Administration (FDA) yesterday for use in adult patients with heterozygous familial hypercholesterolemia (FH, inherited high cholesterol), homozygous FH, as well as patients with clinical atherosclerotic cardiovascular disease who require additional lowering of LDL cholesterol. This now…
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