News
ODYSSEY KIDS: Alirocumab in children with heterozygous FH
Alirocumab was effective in lowering LDL cholesterol in children and adolescents with heterozygous familial hypercholesterolaemia (FH, inherited high cholesterol) treated with a statin. Heterozygous FH is characterised by elevated levels of LDL cholesterol which, if untreated, lead to premature atherosclerosis and cardiovascular events (1). Yet,…
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Inclisiran in heterozygous familial hypercholesterolaemia
Results from the ORION-9 study in patients with heterozygous familial hypercholesterolaemia (FH, inherited high cholesterol) show that inclisiran lowers LDL cholesterol by nearly 50% and is well tolerated. The advent of monoclonal antibodies directed against PCSK9 has revolutionised the management of FH, with proven efficacy…
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FH in the MENA region: Gulf Registry launched
Preliminary data from the Gulf Familial Hypercholesterolaemia Registry (Gulf FH) show a high prevalence, with one in 232 people having definite or probable familial hypercholesterolaemia (FH, inherited high cholesterol). Heterozygous FH is largely underdiagnosed and undertreated.1 Information on prevalence is lacking in almost all countries,…
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Monogenic vs polygenic hypercholesterolaemia and cardiovascular risk
Understanding the genetic cause of familial hypercholesterolaemia (FH, inherited high cholesterol) is imperative to better stratify and manage cardiovascular risk in patients, according to this report from the UK BioBank. FH is the most common inherited metabolic condition, affecting about one in 200-250 people.1 Genetic…
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Alirocumab in diabetes patients with mixed dyslipidaemia
Alirocumab shows benefit in patients with type 2 diabetes mellitus (T2DM) and mixed dyslipidaemia, according to this analysis of the ODYSSEY DM-DYSLIPIDEMIA trial. Individuals with T2DM are at increased risk for atherosclerotic cardiovascular disease (ASCVD), in part due to the mixed dyslipidaemia, characterized by elevated…
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BEIJERINCK: Evolocumab in people living with HIV
First trial of PCSK9 monoclonal antibody therapy in people living with HIV and at moderate/high cardiovascular risk, with elevated LDL cholesterol levels has closed enrolment, with 464 patients. Due to advances in antiretroviral treatment, HIV is now regarded as a chronic disease. Consequently, attention has…
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DE LAVAL: Evolocumab reduces need for lipoprotein apheresis
Treatment with evolocumab may replace lipoprotein apheresis in patients with high LDL cholesterol levels, refractory to conventional treatment, according to the findings from the DE LAVAL study. Lipoprotein apheresis, which removes LDL cholesterol from the circulation, is indicated in patients with refractory heterozygous familial hypercholesterolemia…
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New FOURIER analysis underlines consistent efficacy of evolocumab
A key question posed by all clinicians is whether age or sex impacts the efficacy of a cholesterol-lowering therapy. This is highly pertinent given the ‘greying’ of populations, and the associated increase in risk for cardiovascular events. A new analysis from the FOURIER study which…
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Inclisiran dose adjustment not necessary in renal impairment
Renal impairment does not influence the pharmacodynamics/pharmacokinetics of inclisiran, according to a new analysis. Impaired renal function alters drug pharmacokinetics, potentially changing drug efficacy and increasing the likelihood of unwanted effects, including renal toxicity. This is a key consideration for individuals taking long-term medications, such…
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New EAS Consensus Panel statement: an Opus for LDL-driven mechanisms in atherosclerosis
A new statement from the European Atherosclerosis Society (EAS) consensus panel is set to become THE reference for the role of LDL in driving atherosclerosis. Published in The European Heart Journal, this is an essential follow-up to a previous statement1 which appraised clinical evidence supporting…
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TAUSSIG reports evolocumab treatment up to 5 years in homozygous or severe FH
TAUSSIG: Evolocumab provides sustained benefit in severe heterozygous or homozygous FH Evolocumab treatment for up to 5 years was effective and well tolerated in patients with homozygous or severe heterozygous familial hypercholesterolaemia (FH, inherited high cholesterol) in this latest follow-up from the TAUSSIG study. Over…
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ODYSSEY OUTCOMES: Lipoprotein(a) analysis
Following much discussion among the clinical community, the lipoprotein(a) analysis from the ODYSSEY OUTCOMES study has been published. This analysis shows that lipoprotein(a) lowering by alirocumab is an independent contributor to the reduction in cardiovascular events observed in this trial, beyond that attributed to LDL…
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Targeting PCSK9 and ANGPTL3 with statin regresses atherosclerosis
In a mouse model of hyperlipidaemia, the combination of the PCSK9 inhibitor alirocumab, a monoclonal antibody to ANGPTL3 (angiopoietin-like 3 protein) evinacumab, and atorvastatin not only reduced LDL cholesterol by 73% but also regressed atherosclerosis. Read the article: Pouwer MG, et al. Alirocumab, evinacumab, and…
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ODYSSEY: alirocumab improves outcomes in older patients post-ACS
A pre-specified analysis from the ODYSSEY OUTCOMES study shows that, in patients with recent acute coronary syndrome (ACS), alirocumab improves outcomes irrespective of age. Increasing absolute benefit but not harm with advancing age suggests that LDL-C lowering is an important preventive intervention for older patients…
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GAUSS-4: Evolocumab superiority over ezetimibe confirmed
Initial results from the GAUSS-4 trial (ClinicalTrials.gov NCT02634580) show that evolocumab was superior to ezetimibe in reducing LDL-C during the 12-week double-blind period in patients with statin intolerance, with efficacy and safety results maintained for 1 year. In patients with hyperlipidaemia, intolerance to statins presents…
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FOURIER: genetic risk score and evolocumab benefit
A new analysis of the FOURIER trial (in patients with clinically evident atherosclerotic cardiovascular disease) shows that those with high genetic risk, regardless of clinical risk, had a high cardiovascular event rate and derived the greatest relative and absolute benefit from evolocumab. Treatment with evolocumab…
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ODYSSEY: predicting alirocumab benefit with genetic risk score
Post hoc analyses of the ODYSSEY OUTCOMES trial reveal that a high polygenic risk score (PRS) for coronary artery disease (CAD) is associated with elevated risk for recurrent major adverse cardiovascular events (MACE) after acute coronary syndrome (ACS), and larger absolute and relative risk reduction…
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TST trial results: lower LDL-C target benefits ASCVD patients
The Treat Stroke to Target trial (ClinicalTrials.gov Identifier: NCT01252875) shows that aggressive LDL-C reduction with a goal of <70 mg/dl is superior to a more modest reduction (LDL-C 90-110 mg/dl) among patients with atherosclerotic cardiovascular disease (ASCVD) and evidence of ischaemic stroke or transient ischaemic…
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ODYSSEY: Alirocumab decreases stroke risk in ACS patients
In patients with recent acute coronary syndrome (ACS) and dyslipidaemia despite intensive statin therapy, alirocumab decreased the risk of ischaemic stroke without increasing haemorrhagic stroke, irrespective of baseline LDL-C and history of cerebrovascular disease, over a median follow-up of 2.8 years. ODYSSEY OUTCOMES (NCT01663402) compared…
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ORION-1: Less frequent dosing potential with inclisiran
A one-year follow up of the ORION-1 study (Clinical Trial NCT02597127: https://clinicaltrials.gov/ct2/show/NCT02597127) suggests that inclisiran may offer a novel approach to LDL-C reduction with the convenience of less frequent dosing. The study involved prespecified analysis of the randomised, double-blind, placebo-controlled multicentre phase 2 clinical trial. Participants,…
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