PCSK9 inhibitors for treating hypercholesterolemia

Pasta, Andrea; Cremonini, Anna Laura; Pisciotta, Livia; Buscaglia, Angelo; Porto, Italo; Barra, Fabio; Ferrero, Simone; Brunelli, Claudio; Rosa, Gian Marco

doi:10.1080/14656566.2019.1702970

Cited by 55 publications

(37 citation statements)

References 81 publications

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“…Other therapies, including ezetimibe, fibrates, PCSK9 inhibitors, lomitapide, and mipomersen, may be required when statins that are administered at the highest tolerated dose in combination with other medications do not achieve target LDL cholesterol levels 80) . Pasta et al 81) and Raal et al 82) have recently published reviews on the role of PCSK9 inhibitors in the management of hypercholesterolemia. Table 6 provides a summary of findings from clinical trials and meta-analyses for PCSK9 inhibitors.…”

Section: Discussionmentioning

confidence: 99%

Familial Hypercholesterolemia in Asia Pacific: A Review of Epidemiology, Diagnosis, and Management in the Region

Kalra

Chen

Deerochanawong

et al. 2021

JAT

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The official journal of the Japan Atherosclerosis Society and the Asian Pacific Society of Atherosclerosis and Vascular Diseases Review Familial hypercholesterolemia (FH) is a common genetic disease that is estimated to affect at least 15 million people in the Asia Pacific region. Affected individuals are at significantly increased risk of premature atherosclerotic cardiovascular disease. A literature review was undertaken to provide an overview of the epidemiology, diagnosis, and management of FH across the region.Currently, epidemiological data relating to FH are lacking across the Asia Pacific. Of the 15 countries and regions considered, locally conducted studies to determine FH prevalence were only identified for Australia, China, India, and Japan. Although practically all national clinical guidelines for dyslipidemia include some commentary on FH, specific guidelines on the management of FH are available for only one third of the countries and regions evaluated. Estimates of current FH diagnosis rates suggest that most affected individuals remain undiagnosed and untreated. Although innovative medications such as proprotein convertase subtilisin/ kexin type 9 inhibitors have been approved and are available in most countries and regions considered, they are currently reimbursed in only one quarter.Despite these shortcomings, there is cause for optimism. Early experience with cascade screening in Hong Kong, India, and Vietnam has proven an effective means of identifying family members of probands, as has a reverse screening of family members of children with FH in China. FH registries are gaining momentum across the region, with registries now established in almost half of the countries and regions evaluated. This review concludes with a Call to Action on FH for Asia Pacific to engage healthcare professionals, improve public awareness, and form national FH alliances, comprising all relevant healthcare professional organizations, as a platform to expedite national quality improvement programs in the management of FH.(LDL) receptor, apolipoprotein B, or proprotein convertase subtilisin/kexin type 9 (PCSK9) cause FH. FH poses a major threat to public health because affected individuals are at significantly increased risk of premature atherosclerotic cardiovascular disease (ASCVD) 1) . Untreated individuals with homozygous

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Section: Discussionmentioning

confidence: 99%

Familial Hypercholesterolemia in Asia Pacific: A Review of Epidemiology, Diagnosis, and Management in the Region

Kalra

Chen

Deerochanawong

et al. 2021

JAT

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“…Mouse models using dominant-negative AMPK exacerbated myocardial infarction [34]. Modifying lipid profiles can reduce coronary morbidity and mortality [35] and more aggressive therapeutics on lowering LDL-C are emerging, e.g., PCSK9 inhibitors [36]. However, high cost and repeated injection reduced its availability for aged patients.…”

Section: 1mentioning

confidence: 99%

Yanyu Decoction for Aged Patients with Stable Coronary Artery Disease: A Systematic Review and Meta-Analysis

Shi

Wang

et al. 2021

Evidence-Based Complementary and Alternative Medicine

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Background. There was limited evidence of treatments aiming at aged coronary artery disease (CAD) patients. Yanyu decoction (YD) has been used as adjuvant therapy in aged patients with stable CAD and might be a new treatment worthy of recommendation for CAD patients. This study was to evaluate the combined effects of YD plus conventional pharmaceutical treatment (CPT) on senile patients with stable CAD. Methods. This review was designed according to the PRISMA (Preferred Reported Items for Systematic Reviews and Meta-Analysis) recommendations. A literature search was conducted in seven electronic databases from their inception until August 2020. Primary outcomes of interest were adverse cardiovascular events, including cardiac mortality, acute myocardial infarction (AMI), and unstable angina (UA). The secondary outcomes were blood lipids and hemorheology. Studies were pooled to calculate the risk ratio or weighted mean difference and corresponding 95% confidence interval. Results. Five studies recruiting 848 aged patients with stable CAD were included. Patients receiving YD as an adjuvant have fewer adverse cardiovascular events, including cardiac mortality, AMI, and UA. Besides, YD plus CPT has a better effect on reducing triglycerides, low-density lipoprotein cholesterol, and improving high-density lipoprotein cholesterol. Moreover, significant effects of YD plus CPT for reducing blood viscosity, plasma viscosity, and platelet aggregation rate were found compared with CPT alone. Conclusion. YD plus CPT showed better efficacy than CPT on reducing adverse cardiovascular events and improving hemorheology and blood lipids for aged patients with stable CAD. Our findings may suggest YD as an adjuvant natural-based treatment for CAD. However, more rigorous and larger trials are essential to validate our results, and further consideration of CAD studies specific to aged patients is needed.

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“…However, very low rates of immunogenicity were observed in clinical trials of evolocumab and alirocumab (the two approved PCSK9 inhibitors). 20,24 In a study, which analyzed data from 10 trials involving 4747 patients, 5.1% of patients being treated with alirocumab developed anti-drug antibodies. However, even in those patients, the LDL-C-lowering effect of alirocumab was not adversely affected.…”

Section: Adverse Events Of Pcsk9 Inhibitorsmentioning

confidence: 99%

“…However, even in those patients, the LDL-C-lowering effect of alirocumab was not adversely affected. 24,25 Below, we will address more specifically the effects of PCSK9 inhibitors on the risk of DM, on the incidence of myalgias, especially in statin-intolerant patients, on…”

Section: Adverse Events Of Pcsk9 Inhibitorsmentioning

confidence: 99%

<p>Safety and Tolerability of PCSK9 Inhibitors: Current Insights</p>

Kosmas¹,

Skavdis²,

Sourlas³

et al. 2020

CPAA

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The current era of preventive cardiology continues to emphasize on low-density lipoprotein cholesterol (LDL-C) reduction to alleviate the burden of atherosclerotic cardiovascular disease (ASCVD). In this regard, the pharmacological inhibition of proprotein convertase subtilisin/kexin type 9 (PCSK9) enzyme via monoclonal antibodies has emerged as a novel lipid-lowering therapy, leading to a marked reduction in circulating LDL-C levels and subsequent improvement of cardiovascular outcomes. As these agents are increasingly used in current clinical practice, mounting scientific and clinical evidence supports that PCSK9 inhibitors offer an excellent safety and tolerability profile with a low incidence of adverse events. Notably, the most frequently reported side effects are injection-site reactions. In contrast to statins, PCSK9 inhibitors do not appear to exert a detrimental effect on glycemic control or to increase the incidence of new-onset diabetes mellitus. Accumulating evidence also indicates that PCSK9 inhibitors are a safe, well-tolerated and effective therapeutic strategy for patients with statin intolerance. On the other hand, as PCSK9 inhibitors reduce LDL-C to unprecedented low levels, a large body of current research has examined the effects of their long-term administration on neurocognition and on levels of vitamin E and other fat-soluble vitamins, providing encouraging results. This review aims to present and discuss the current clinical and scientific evidence pertaining to the safety and tolerability of PCSK9 inhibitors.

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PCSK9 inhibitors for treating hypercholesterolemia

Cited by 55 publications

References 81 publications

Familial Hypercholesterolemia in Asia Pacific: A Review of Epidemiology, Diagnosis, and Management in the Region

Familial Hypercholesterolemia in Asia Pacific: A Review of Epidemiology, Diagnosis, and Management in the Region

Yanyu Decoction for Aged Patients with Stable Coronary Artery Disease: A Systematic Review and Meta-Analysis

<p>Safety and Tolerability of PCSK9 Inhibitors: Current Insights</p>

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