News
PCSK9 inhibitors in chronic kidney disease – what do we know?
The first reported data for the use of PCSK9 inhibitors in patients with impaired renal function show that this treatment effectively lowers LDL cholesterol with no evidence to suggest deterioration in renal function. These findings justify new trials specifically in this patient group. As recognized…
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Greatest mortality benefit with highest LDL cholesterol above 100 mg/dl
A systematic review and meta-analysis in over 260,000 patients reaffirms that patients with the highest LDL cholesterol levels at baseline derive the greatest reduction in cardiovascular and all-cause death. The association was not evident in patients with LDL cholesterol levels <2.6 mmol/L or 100 mg/dL….
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Hyporesponsiveness to PCSK9 inhibitors or lack of adherence?
A pooled analysis of 10 phase 3 ODYSSEY studies with alirocumab suggests that lack of adherence with lipid lowering therapy may explain a poor response to PCSK9 inhibition. Clinical trials of statins and other lipid-lowering therapies often report large inter-individual variations in low-density lipoprotein (LDL)…
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How low should LDL cholesterol be lowered after stroke?
LDL cholesterol should be lowered to 80 to 100 mg/dl to prevent recurrent stroke, according to data from the J-STARS Study (Japan Statin Treatment Against Recurrent Stroke). J-STARS (1) examined whether low-dose pravastatin reduced the recurrence of strokes and other vascular events in non-cardioembolic stroke…
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FOURIER analysis: consistent benefit with evolocumab across the range of inflammatory risk
While much of the focus in cardiovascular disease prevention has been on LDL cholesterol as the major modifiable driver of cardiovascular risk, other mediators of risk have been debated. A new analysis from FOURIER (Further Cardiovascular Outcomes Research With PCSK9 Inhibition in Subjects With Elevated…
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New Approaches to PCSK9 inhibition
Prof Derick Raal (University of Witwatersrand, Johannesburg, South Africa) discusses what’s in the pipeline for PCSK9 inhibition beyond the monoclonal antibodies. PCSK9 monoclonal antibodies Modulation of PCSK9 can result in much greater lowering of LDL-cholesterol than that achieved with statin therapy or statin therapy in…
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Alirocumab shows efficacy in homozygous FH phenotype
Treatment with alirocumab led to clinically meaningful LDL cholesterol lowering in patients with a clinical phenotype typically associated with homozygous familial hypercholesterolaemia (FH, inherited high cholesterol), including those who were double heterozygous, compound heterozygous, or homozygous for genes that are causative for FH. Homozygous familial…
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ODYSSEY DM-DYSLIPIDEMIA: Alirocumab shows benefit in type 2 diabetes with mixed dyslipidaemia
In the first dedicated study of a PCSK9 inhibitor in individuals with type 2 diabetes and mixed dyslipidaemia (elevated triglyceride-rich lipoproteins and low HDL cholesterol levels), alirocumab provided superior control of non-HDL cholesterol levels compared with usual care (including maximally-tolerated statins). Non-HDL cholesterol comprises the…
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Do PCSK9 inhibitors increase new-onset diabetes? Another meta-analysis
A new meta-analysis involving more than 26,000 patients reports no increase in new-onset diabetes and no impact on glucose metabolism with PCSK9 inhibitor treatment. The authors performed a comprehensive medical literature to identify 18 randomized controlled studies with 26,123 patients without diabetes at study baseline….
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ODYSSEY OUTCOMES to report at ACC.2018
The second completed cardiovascular outcomes study with a PCSK9 inhibitor will be up first at the first latebreaker session at the American College of Cardiology Scientific Sessions this March. ODYSSEY OUTCOMES with alirocumab follows reporting of FOURIER with evolocumab and the terminated SPIRE studies with…
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Highest risk-highest benefit from PCSK9 inhibition
Using a pragmatic approach, experts have recommended a ‘highest risk–highest benefit’ strategy for clinicians considering PCSK9 inhibitor treatment for their patients. This takes into account the clinical need, outcome benefit and cost of the PCSK9 inhibitors. Briefly, ‘highest risk’ refers to patients with the highest…
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Why we need PCSK9 inhibitors: goal attainment too low with statin plus ezetimibe
Guidelines recommend adding ezetimibe if patients fail to attain LDL cholesterol goal on statin alone. However, this study concludes that in a real-world setting, addition of ezetimibe had only a small impact on the number of high risk patients achieving an LDL cholesterol <1.8 mmol/L…
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Identifying and Treating Severe Familial Hypercholesterolaemia: Course Slides online
The International Atherosclerosis Society-mentored course on severe familial hypercholesterolaemia (FH, inherited high cholesterol), held in Dubai, UAE on October 14-15, 2017, has now published slides and abstracts online. Slides are available at: http://www.athero.org/SevereFHCourse20171014/index.asp and Scientific Program & Abstracts at http://www.athero.org/SevereFHCourse20171014/FinalProgramAbstarctsCVsSocieties.pdf
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Alirocumab shows benefit in SAMS with myotonic dystrophy
There are currently few options for patients with statin intolerance and myotonic dystrophy. In this case report, a 74-year-old male with hypercholesterolaemia (serum LDL cholesterol 210 mg/dL), hypogonadism, insulin-controlled type 2 diabetes mellitus, and minimally elevated serum creatine kinase levels (184 U/L, ref. range 38-174),…
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PCSK9 inhibitors: effects on glycaemia and HbA1c
Treatment with a PCSK9 inhibitor for a mean of 1.5 years led to a small albeit significant increase in plasma glucose and HbA1c, according to the results of this meta-analysis of more than 68,000 patients treated in phase 2/3 trials. With this short duration of…
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ODYSSEY-KT: Alirocumab shows benefit in trial in S. Korea and Taiwan
This trial showed the benefit of PCSK9 inhibition in high risk patients from these countries, evidence for which had been lacking to date. The study enrolled 199 individuals from South Korea and Taiwan (mean age 61 years, 82% male) with hypercholesterolaemia and coronary heart disease…
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FDA approves evolocumab to prevent heart attack, stroke, and coronary revascularization
The U.S. Food and Drug Administration (FDA) has approved evolocumab as the first PCSK9 inhibitor to prevent heart attacks, strokes and coronary revascularizations in adults with established cardiovascular disease. The approval was supported by data from the FOURIER (Further Cardiovascular Outcomes Research With PCSK9 Inhibition…
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More poster news: Patient-reported barriers to use of PCSK9 inhibitors
Results from this web-based US survey show that cost was the main reason given by patients for low initial and ongoing use of PCSK9 inhibitors. This survey was completed by 769 patients who signed up for a pharmaceutical company-sponsored patient support program after prescription for…
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More poster news: Adherence to PCSK9 inhibitor therapy
In the ODYSSEY Open-Label Extension Study, adherence to continuation of alirocumab treatment was not an issue. The ODYSSEY Open-Label Extension Study included patients with heterozygous familial hypercholesterolemia (FH, inherited high cholesterol) after completion of 4 Phase 3 placebo-controlled studies (FH I, FH II, LONG TERM,…
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More real-world experience with PCSK9 inhibitors
In this report from Charité Berlin, PCSK9 inhibitor therapy was effective in 499 patients with high and very high cardiovascular risk and substantial LDL cholesterol burden. Patients were either unable to attain guideline defined LDL cholesterol goal with maximally tolerated lipid lowering therapy or were…
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