Vnitr Lek 2018, 64(12):1137-1141
Comments on the most important and recent studies involving PCSK9i
- Centrum preventivní kardiologie III. interní kliniky 1. LF UK a VFN v Praze
The paper provides a brief overview of the key studies focused on PCSK9 inhibitors. It mainly examines positive results of the FOURIER studies on evolocumab, the SPIRE study on boccocizumab and the ODYSSEY Outcomes study on alirocumab. All these studies have not only shown a significant decrease in LDL-cholesterol levels, but also the reduction of cardiovascular events just correlating with these levels. The treatment leading to a dramatic drop in LDL-cholesterol levels was safe and well tolerated by patients. All the studies provided with comments demonstrate a positive impact of biological treatment of hypercholesterolemia on cardiovascular disease and confirm validity of the hypothesis saying "the lower the better", at least for LDL-cholesterol. In conclusion, Professor Braunwald's hypothesis is mentioned saying that this treatment might eventually lead to as much as eradication of atherothrombotic cardiovascular diseases.
Keywords: alirocumab; bococizumab; evolocumab; FOURIER; cardiovascular disease; LDL-cholesterol; ODYSSEY Outcomes; SPIRE
Received: November 4, 2018; Accepted: November 15, 2018; Published: December 1, 2018 Show citation
References
- Sabatine MS, Giugliano RP, Keech AC et al. Evolocumab and clinical outcomes in patients with cardiovascular disease. N Engl J Med 2017; 376(18): 1713-1722. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa1615664>.
Go to original source...
Go to PubMed...
- Catapano AL, Graham I, De Backer G et al. 2016 ESC/EAS Guidelines for the management of dyslipidaemias. Eur Heart J 2016; 37(39): 2999-3058. Dostupné z DOI: <http://dx.doi.org/10.1093/eurheartj/ehw272>.
Go to original source...
Go to PubMed...
- Giugliano RP, Mach F, Zavitz K et al. Evaluation of cognitive function in a randomized trial of evolocumab. N Engl J Med 2017; 377(7): 633-643. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa1701131>.
Go to original source...
Go to PubMed...
- Caswell J. Why Cholesterol Matters. Dostupné z DOI: <http://heartinsight.heart.org/Summer-2017/Why-Cholesterol-Matters>.
- Halcox JP, Tubach F, Lopez-Garcia E et al. Low Rates of Both Lipid-Lowering Therapy Use and Achievement of Low-Density Lipoprotein Cholesterol Targets in Individuals at High-Risk for Cardiovascular Disease across Europe. PLoS One 2015; 10(2): e0115270. Dostupné z DOI: <http://dx.doi.org/10.1371/journal.pone.0115270>.
Go to original source...
Go to PubMed...
- Nordestgaard BG, Chapman MJ, Humphries SE et al. Familial Hypercholesterolaemia is Underdiagnosed and Undertreated in the General Population: Guidance for Clinicians to Prevent Coronary Heart Disease. Eur Heart J 2013; 34(45): 3478-3490. Dostupné z DOI: <http://dx.doi.org/10.1093/eurheartj/eht273>.
Go to original source...
Go to PubMed...
- Sabatine MS, Giugliano RP, Wiviott SD et al. Efficacy and Safety of Evolocumab in Reducing Lipids and Cardiovascular Events. N Engl J Med 2015; 372: 1500-1509. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa1500858>.
Go to original source...
Go to PubMed...
- Koren MJ, Lundqvist P, Bolognese M et al. Anti-PCSK9 monotherapy for hypercholesterolemia: the MENDEL-2 randomized, controlled phase III clinical trial of evolocumab. J Am Coll Cardiol 2014; 63(23): 2531-2540. Dostupné z DOI: <http://dx.doi.org/10.1016/j.jacc.2014.03.018>.
Go to original source...
Go to PubMed...
- Blom DJ, Hala T, Bolognese M et al. A 52-week placebo-controlled trial of evolocumab in hyperlipidemia. N Engl J Med 2014; 370(19): 1809-1819. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa1316222>.
Go to original source...
Go to PubMed...
- Koren MJ, Giugliano RP, Raal FJ et al. Efficacy and Safety of Longer-Term Administration of Evolocumab (AMG 145) in Patients With Hypercholesterolemia: 52-Week Results from the Open-Label Study of Long-Term Evaluation Against LDL-C (OSLER) Randomized Trial. Circulation 2014; 129(2): 234-243. Dostupné z DOI: <http://dx.doi.org/10.1161/CIRCULATIONAHA.113.007012>.
Go to original source...
Go to PubMed...
- Češka R et al. Familiární hypercholesterolémie. Triton: Praha 2015. ISBN 978-80-7387-843-6.
- Robinson JG, Farnier M, Krempf M Efficacy and Safety of Alirocumab in Reducing Lipids and Cardiovascular Events. N Engl J Med 2015; 372(16): 1489-1499. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa1501031>.
Go to original source...
Go to PubMed...
- Lunven C, Paehler T, Poitiers F et al. A randomized study of the relative pharmacokinetics, pharmacodynamics, and safety of alirocumab, a fully human monoclonal antibody to PCSK9, after single subcutaneous administration at three different injection sites in healthy subjects. Cardiovasc Ther 2014; 32(6): 297-301. Dostupné z DOI: <http://dx.doi.org/10.1111/1755-5922.12093>.
Go to original source...
Go to PubMed...
- Kereiakes DJ, Robinson JG, Cannon CP et al. Efficacy and safety of the proprotein convertase subtilisin/kexin type 9 inhibitor alirocumab among high cardiovascular risk patients on maximally tolerated statin therapy: the ODYSSEY COMBO I study. Am Heart J 2015; 169(6): 906-915. Dostupné z DOI: <http://dx.doi.org/10.1016/j.ahj.2015.03.004>.
Go to original source...
Go to PubMed...
- Cannon CP, Cariou B, Blom D et al. Efficacy and safety of alirocumab in high cardiovascular risk patients with inadequately controlled hypercholesterolaemia on maximally tolerated doses of statins: the ODYSSEY COMBO II randomized controlled trial. Eur Heart J 2015; 36(19): 1186-1194. Dostupné z DOI: <http://dx.doi.org/10.1093/eurheartj/ehv028>.
Go to original source...
Go to PubMed...
- Robinson JG, Farnier M, Krempf M et al. Efficacy and safety of alirocumab in reducing lipids and cardiovascular events. N Engl J Med 2015; 372(16): 1489-1499. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa1501031>.
Go to original source...
Go to PubMed...
- Ginsberg HN, Rader DJ, Raal FJ. ODYSSEY HIGH FH: efficacy and safety of alirocumab in patients with severe heterozygous familial hypercholesterolemia. Circulation 2014; 130(23): 2119.