Τίτλος:
PCSK9 inhibitors in clinical practice: Novel directions and new experiences
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Background: In randomized clinical trials, proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9i) effectively reduce low-density lipoprotein-cholesterol (LDL-C) with a favorable tolerability and safety profile. Our purpose is to provide real-world data regarding the indications, efficacy and safety of PCSK9i. Methods: The cohort comprised 141 patients who attended the lipid clinic of 3 hospitals in Greece and started using PCSK9i. Patients were requested to attend the lipid clinic at 3 months and at 1 year. Results: Ninety percent of patients had heterozygous familial hypercholesterolaemia (heFH) and 75% had cardiovascular disease (CVD). A PCSK9i [evolocumab 140 mg/2 weeks (n = 82), alirocumab 75 mg/2 weeks (n = 46) and alirocumab 150 mg/2 weeks (n = 13)] was prescribed due to failure to achieve LDL-C targets despite maximum lipid-lowering therapy (LLT) in 75% of patients, while in the remaining cases, the indication was statin intolerance. The mean reduction of LDL-C at 3 months was 56.2% and remained constant at 12 months (55.8% reduction from baseline). LDL-C target was achieved by 68.1% of patients at 3 months. “Totally” intolerant to statins patients (unable to tolerate any statin dose, n = 23) showed the lowest LDL-C reduction (47.7%). Side effects attributed to treatment were reported by 14 patients (10%). The total number of patients who stopped PCSK9i at 1 year was 14 (10%) but only 2 (1.4%) discontinued treatment because of side effects (myalgias). Conclusions: Our real-world results of PCSK9i showed comparable efficacy and tolerability to those reported in clinical trials and highlighted the value of treatment with PCSK9i heFH patients not achieving LDL-C targets despite maximum LLT and high or very high risk statin intolerant patients. © 2019 Hellenic Society of Cardiology
Συγγραφείς:
Rallidis, L.S.
Skoumas, I.
Liberopoulos, E.N.
Vlachopoulos, C.
Kiouri, E.
Koutagiar, I.
Anastasiou, G.
Kosmas, N.
Elisaf, M.S.
Tousoulis, D.
Iliodromitis, E.
Περιοδικό:
Ελληνική καρδιολογική επιθεώρηση
Εκδότης:
Hellenic Cardiological Society
Λέξεις-κλειδιά:
alirocumab; aminotransferase; antilipemic agent; atorvastatin; creatine kinase; evolocumab; ezetimibe; glucose; hemoglobin A1c; high density lipoprotein cholesterol; hydroxymethylglutaryl coenzyme A reductase inhibitor; lipoprotein A; low density lipoprotein cholesterol; rosuvastatin; triacylglycerol; hydroxymethylglutaryl coenzyme A reductase inhibitor; low density lipoprotein cholesterol; PCSK9 protein, human; proprotein convertase 9, adult; algorithm; Article; cardiovascular disease; cerebrovascular accident; clinical practice; cohort analysis; coronary artery disease; drug efficacy; drug hypersensitivity; drug safety; drug withdrawal; familial hypercholesterolemia; female; human; major clinical study; male; middle aged; monotherapy; myalgia; risk assessment; treatment failure; familial hypercholesterolemia; hypercholesterolemia, Cholesterol, LDL; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Hypercholesterolemia; Hyperlipoproteinemia Type II; Proprotein Convertase 9
DOI:
10.1016/j.hjc.2019.10.003
