PCSK9 Inhibitors in the Management of Cardiovascular Risk: A Practical Guidance

Jia, Xiaoming; Rifai, Mahmoud Al; Saeed, Anum; Ballantyne, Christie M.; Virani, Salim S.

doi:10.2147/vhrm.s275739

Cited by 17 publications

(6 citation statements)

References 93 publications

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“…Hence, more studies need to be conducted to better understand the drug utilization patterns and optimize therapeutic efficacy. 52…”

Section: Discussionmentioning

confidence: 99%

Comparisons of Proprotein Convertase Subtilisin/Kexin Type 9 Inhibitors (PCSK9I) versus Ezetimibe on Major Adverse Cardiovascular Events Amongst Patients with Dyslipidaemia: A Population-Based Study

Chou,

Li,

Chung

et al. 2023

Preprint

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Background: Proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9I) have potential benefits against cardiovascular disease. The comparative risks of new-onset major adverse cardiovascular events (MACE) between PCSK9I and ezetimibe remain unknown. Objective: This real-world study compared the risks of MACE upon exposure to PCSK9I and ezetimibe. Methods: This was a retrospective population-based cohort study of patients with dyslipidaemia on either PCSK9I or ezetimibe between 1st January 2015 and 30th October 2022 using a territory-wide database from Hong Kong. The primary outcome was new-onset MACE. The secondary outcomes were myocardial infarction, heart failure, stroke/transient ischaemic attack, and all-cause mortality. Propensity score matching (1:3 ratio) using the nearest neighbour search was performed. Multivariable Cox regression was used to identify significant associations. Results: This cohort included 42450 dyslipidaemia patients (median age: 65.0 years old [SD: 11.1]; 64.54 % males). The PCSK9I and ezetimibe groups consisted of 1477 and 40973 patients, respectively. After matching, 67 and 235 patients suffered from MACE in the PCSK9I and ezetimibe groups, respectively, over a total of 14514.5 person-years. PCSK9I was associated with lower risks of MACE (Hazard ratio [HR]: 0.59; 95% Confidence Interval [CI]: 0.37-0.92) compared to ezetimibe use after adjusting for demographics, past comorbidities, other medications, and time-weighted means of lipid and glucose tests. Besides, while both alirocumab and evolocumab were associated with lower risks of MACE, evolocumab was associated with significantly lower risks of myocardial infarction, heart failure, and stroke/transient ischaemic attack. The results remained consistent in the competing risk and sensitivity analyses. Conclusions: PCSK9I use amongst dyslipidaemia patients was associated with lower risks of new-onset MACE and outcomes compared to ezetimibe after adjustments. Evolocumab might perform better than Alirocumab in reducing the risks of cardiovascular diseases.

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“…Hence, more studies need to be conducted to better understand the drug utilization patterns and optimize therapeutic efficacy. 52…”

Section: Discussionmentioning

confidence: 99%

Comparisons of Proprotein Convertase Subtilisin/Kexin Type 9 Inhibitors (PCSK9I) versus Ezetimibe on Major Adverse Cardiovascular Events Amongst Patients with Dyslipidaemia: A Population-Based Study

Chou,

Li,

Chung

et al. 2023

Preprint

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“…This adds to current guidelines recommending them for heterozygous FH patients (HeFH) who cannot achieve therapeutic targets with standard therapy (LDL-C of <70 mg/dl) and homozygous FH (HoFH) patients. However, this depends on the type of mutation present 47 , 48 .…”

Section: Methodsmentioning

confidence: 99%

Hypercholesterolemia: A literature review on management using tafolecimab – a novel member of PCSK9 monoclonal antibodies

Qureshi,

Khanzada,

Safi

et al. 2024

Annals of Medicine &Amp; Surgery

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Background: Cardiovascular diseases (CVD) persist as the leading cause of mortality globally, with atherosclerotic cardiovascular disease (ASCVD), including hypercholesterolemia, being a significant contributor. Hyperlipidemia management includes various lipid-lowering drugs, including statins, Bempedoic acid, inclisiran, Lomitapide, ANGPTL3 inhibitors, and PCSK9 inhibitors. Statins have traditionally dominated lipid management therapies; however, a subset of patients remains unresponsive or intolerant to this therapy, necessitating novel therapeutic approaches. Tafolecimab, a promising and novel PCSK9 monoclonal antibody, demonstrated significant LDL-C reduction and a favorable safety profile in clinical trials. Objective: This review aimed to discuss the role and efficacy of Tafolecimab in the management of hypercholesterolemia. Methods: We searched online databases, including PubMed, Scopus, and Embase, for articles related to talofecimab. Discussion: The efficacy of Tafolecimab in diverse patient populations, including those with comorbid conditions and various lipid disorders, has been explored. Ongoing trials, such as CREDIT-1, CREDIT-2, and CREDIT-4, have provided valuable insights into Tafolecimab’s potential as a lipid-lowering agent. Moreover, the drug’s extended dosing interval may enhance patient compliance and reduce treatment costs. It has also been found that Tafolecimab has more affinity for PCSK9 and a longer duration of LDL-C reduction than other monoclonal antibody drugs such as evolocumab. Thus, this review focuses on Tafolecimab, a novel PCSK9 monoclonal antibody, its mechanism of action, clinical trial outcomes, safety profile, and potential role in hypercholesterolemia management. Despite its assuring potential, the long-term impact of Tafolecimab on cardiovascular outcomes remains to be fully elucidated, necessitating further research. Regulatory authorities like the FDA and EMA should also evaluate Tafolecimab’s risks and benefits. Conclusion: In conclusion, Tafolecimab shows potential as an innovative therapeutic option for hypercholesterolemia, particularly in patients with specific risk factors, but warrants additional research.

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“…PCSK9 inhibitors function by modulating LDL-C receptor expression on hepatocytes’ surfaces; thus, they may decrease LDL-C and, subsequently, significant CVD [ 121 ]. The primary indication for PCSK9 is secondary prevention among patients with a very high risk of ASCVD events [ 122 ]. It has been shown that PCSK9 inhibitors are potent agents for the lowering of LDL-C.…”

Section: Reviewmentioning

confidence: 99%

Towards Optimal Cardiovascular Health: A Comprehensive Review of Preventive Strategies

Branigan,

Duong,

Abdulfattah

et al. 2024

Cureus

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Heart disease remains a prominent global health concern, with cardiovascular disease (CVD) standing as a leading cause of death worldwide. Preventing heart disease not only decreases the risk of premature death but also mitigates complications like heart attacks, strokes, and arrhythmias, thereby enhancing overall health and quality of life. The economic burden of heart disease treatment highlights the importance of implementing preventive measures, such as lifestyle changes and early interventions, which can alleviate healthcare costs. These strategies, targeting risk factors like hypertension (HTN), diabetes mellitus (DM), dyslipidemia, and obesity, not only prevent heart disease but also reduce the risk of other health issues. Herein, this review covers various preventive measures, including dietary interventions, exercise, controlling HTN, DM, cholesterol, and weight, smoking cessation, and pharmacological interventions. By critically analyzing the guidelines and leveraging robust data alongside variations in recommendations, this review aims to elucidate effective primary prevention strategies for CVD.

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PCSK9 Inhibitors in the Management of Cardiovascular Risk: A Practical Guidance

Cited by 17 publications

References 93 publications

Comparisons of Proprotein Convertase Subtilisin/Kexin Type 9 Inhibitors (PCSK9I) versus Ezetimibe on Major Adverse Cardiovascular Events Amongst Patients with Dyslipidaemia: A Population-Based Study

Comparisons of Proprotein Convertase Subtilisin/Kexin Type 9 Inhibitors (PCSK9I) versus Ezetimibe on Major Adverse Cardiovascular Events Amongst Patients with Dyslipidaemia: A Population-Based Study

Hypercholesterolemia: A literature review on management using tafolecimab – a novel member of PCSK9 monoclonal antibodies

Towards Optimal Cardiovascular Health: A Comprehensive Review of Preventive Strategies

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