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https://www.readbyqxmd.com/read/28739196/developing-optimized-treatment-plans-for-patients-with-dyslipidemia-in-the-era-of-pcsk9-inhibitor-therapeutics
#1
James A Underberg, Michael J Blaha, Elizabeth J Jackson Msn, Peter H Jones
This educational content was derived from live, satellite symposium at the American College of Physicians (ACP) Internal Medicine Meeting 2017 in San Diego, California (online at http://courses.elseviercme.com/acp/702e). This activity will focus on optimized treatment plans for patients with dyslipidemia in the era of PCSK9 inhibitor therapeutics. LDL-C has been identified as an important therapeutic target to prevent the progression of atherosclerotic disease, however only 1 out of every 3 adults with high LDL-C has the condition under control...
July 21, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28738813/efficacy-and-safety-of-proprotein-convertase-subtilisin-kexin-type-9-pcsk9-inhibitors-alirocumab-and-evolocumab-a-post-commercialization-study
#2
Joshua Choi, Amir M Khan, Michael Jarmin, Naila Goldenberg, Charles J Glueck, Ping Wang
BACKGROUND: Efficacy-safety of proprotein convertase subtilisin-kexin type 9 (PCSK9) inhibitors, alirocumab (ALI) and evolocumab (EVO), have previously been evaluated through controlled clinical trials with selective patient groups. Post-commercially, in 69 patients with heterozygous familial hypercholesterolemia (HeFH) and/or cardiovascular disease (CVD) with suboptimal LDL cholesterol (LDLC) lowering on maximal tolerated LDLC therapy, we assessed efficacy and safety of ALI and EVO. METHODS: Post-commercially, we started 29 patients on ALI 75 mg, 18 on ALI 150 mg, and 22 on EVO 140 mg every 2 weeks added to a maximally tolerated LDLC-lowering regimen...
July 24, 2017: Lipids in Health and Disease
https://www.readbyqxmd.com/read/28738115/inconsistent-guideline-recommendations-for-cardiovascular-prevention-and-the-debate-about-zeroing-in-on-and-zeroing-ldl-c-levels-with-pcsk9-inhibitors
#3
John P A Ioannidis
No abstract text is available yet for this article.
July 24, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28727332/-inhibitors-of-pcsk9
#4
Iveta Petrova-Slater, Andrea Denegri, Elena Pasotti, Maria Grazia Rossi, David Spirk, Walter F Riesen, Tiziano Moccetti, Marco Moccetti
Observational data show a consistent association between elevated low density lipoproteins (LDL-C) and cardiovascular disease (CVD). Reduction of LDL-C reduces the risk of CVD as has been shown by many trials. Statins are currently the most effective drugs for lowering LDL-C, but can present side effects which might limit the prescribed dosage and prevent patients from reaching the recommended LDL levels. Although treated with statins important residual cardiovascular event risk remains in patients in primary and secondary prevention for CVD...
April 12, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28726431/-what-has-the-glagov-clinical-study-shown
#5
Ján Murín
If we want to favorably influence the cardiovascular atherosclerotic disease, it is necessary to significantly lower LDL-C blood levels. PCSK9 inhibitors can significantly reduce LDL-cholesterol levels, being administered together with statins. However we focus on establishing whether this plays a role in influencing coronary atherosclerosis. The GLAGOV study is a multicentric, double-blinded and placebo-controlled study which during a 76-week period followed an impact of the treatment with evolocumab (PCSK9i) together with statin on the status of coronary atherosclerosis in patients with ischemic heart disease, and in comparison with the statin treatment...
2017: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/28721159/pcsk9-inhibitors-from-discovery-of-a-single-mutation-to-a-groundbreaking-therapy-of-lipid-disorders-in-one-decade
#6
Krzysztof Jaworski, Piotr Jankowski, Dariusz A Kosior
Hypercholesterolemia is one of the main risk factors for coronary heart disease and significantly contributes to the high mortality associated with cardiovascular diseases. Statin therapy represents the gold standard in the reduction of low-density lipoprotein cholesterol concentration. Nevertheless, many patients still cannot achieve the recommended target levels, due to either inadequate effectiveness or intolerance of these drugs. Monoclonal antibodies that inhibit proprotein convertase subtilisin/kexin type 9 (PCSK9) have emerged as a promising option in lipid-lowering treatment...
June 2017: Archives of Medical Science: AMS
https://www.readbyqxmd.com/read/28717862/practical-considerations-for-the-use-of-subcutaneous-treatment-in-the-management-of-dyslipidaemia
#7
REVIEW
Franck Boccara, Ricardo Dent, Luis Ruilope, Paul Valensi
Suboptimal drug adherence represents a major challenge to effective primary and secondary prevention of cardiovascular disease. While adherence is influenced by multiple considerations, polypharmacy and dosing frequency appear to be rate-limiting factors in patient satisfaction and subsequent adherence. The cardiovascular and metabolic therapeutic areas have recently benefited from a number of advances in drug therapy, in particular protease proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors and incretin-based therapies, respectively...
July 17, 2017: Advances in Therapy
https://www.readbyqxmd.com/read/28709786/-pcsk-9-inhibitors-effects-on-ldl-c-and-future-implications-what-you-should-know
#8
P Corral, A J Ruiz
The discovery of proprotein convertase subtilisin/kexin type 9 (PCSK9) in 2003 in families with familial hypercholesterolemia (HF) later generated the development of pharmacological strategies in order to inhibit this protein. Twelve years after this discovery, the first two biological compounds (monoclonal antibodies) were approved, which have been shown to substantially decrease LDL-C and other lipid subfractions. The objective of the present article is to review the history of the discovery of PCSK9, its physiology and pathophysiology and subsequent pharmacological development...
July 11, 2017: Hipertensión y Riesgo Vascular
https://www.readbyqxmd.com/read/28695455/pcsk9-inhibitors-for-treating-dyslipidemia-in-patients-at-different-cardiovascular-risk-a-systematic-review-and-a-meta-analysis
#9
Alessandro Squizzato, Matteo Basilio Suter, Marta Nerone, Robert Patrick Giugliano, Francesco Dentali, Andrea Maria Maresca, Leonardo Campiotti, Anna Maria Grandi, Luigina Guasti
Statin-induced lowering of low-density lipoprotein cholesterol (LDL-C) reduces cardiovascular morbidity and mortality, but many patients do not adequately reduce their LDL-C levels. Monoclonal antibodies targeting PCKS9 are currently in the advanced phase of development. We aimed to investigate the efficacy and safety of PCSK9 inhibitors in patients at different cardiovascular risk in a systematic review. Studies were searched on MEDLINE and EMBASE until January 2016. Differences in the outcomes among groups were expressed as mean differences, or pooled odds ratio (OR) and corresponding 95% confidence interval (CI), which were calculated using a fixed-effects and a random-effects model...
July 10, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28689848/from-the-editor-using-pcsk9-inhibitors-in-practice
#10
EDITORIAL
William Virgil Brown
No abstract text is available yet for this article.
June 28, 2017: Journal of Clinical Lipidology
https://www.readbyqxmd.com/read/28683788/successful-treatment-of-a-patient-with-refractory-nephrotic-syndrome-with-pcsk9-inhibitors-a-case-report
#11
Yuki Awanami, Makoto Fukuda, Yasunori Nonaka, Tsuyoshi Takashima, Keiichiro Matsumoto, Masatora Yamasaki, Motoaki Miyazono, Yuji Ikeda
BACKGROUND: The proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor evolocumab is a low-density lipoprotein (LDL)-lowering drug with a new mechanism, which is currently available in Japan. Here, for the first time, we report the successful use of the PCSK9 inhibitor in a patient with refractory nephrotic syndrome. CASE PRESENTATION: A 61-year-old woman was diagnosed with minimal change-type nephrotic syndrome in October 2012. She received prednisolone (PSL) and cyclosporin A (CyA), but she experienced several cycles of relapse and remission and was hospitalized in May 2016 due to relapse...
July 6, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28674132/exploration-into-lipid-management-and-persistent-risk-in-patients-hospitalised-for-acute-coronary-syndrome-in-japan-explore-j-protocol-for-a-prospective-observational-study
#12
Masato Nakamura, Kiyoko Uno, Atsushi Hirayama, Junya Ako, Atsushi Nohara, Hidenori Arai, Mariko Harada-Shiba
INTRODUCTION: The present study is the largest registry study ever conducted in Japan exploring the prevalence of familial hypercholesterolaemia (FH) among patients with acute coronary syndrome (ACS). Our study aims to (1) evaluate the status of lipid management and the subsequent risk of major cardiovascular events following hospitalisation of Japanese patients with ACS in real-world clinical practice; (2) determine the proportion of Japanese patients with ACS who achieve the lipid management goal and have a reduction of event risks with strict lipid management (low-density lipoprotein-cholesterol <1...
July 2, 2017: BMJ Open
https://www.readbyqxmd.com/read/28673045/the-effect-of-pcsk9-loss-of-function-variants-on-the-postprandial-lipid-and-apob-lipoprotein-response
#13
Teik Chye Ooi, Jacqueline A Krysa, Seham Chaker, Hussein Abujrad, Janice Mayne, Kathy Henry, Marion Cousins, Angela Raymond, Colette Favreau, Monica Taljaard, Michel Chrétien, Majambu Mbikay, Spencer D Proctor, Donna F Vine
CONTEXT: PCSK9 mediates the degradation of the low-density lipoprotein receptor (LDLR) thereby increasing plasma low density lipoprotein cholesterol (LDL-C). Variations in the PCSK9 gene that are associated with loss-of-function (LOF) of PCSK9 result in a greater expression of hepatic LDLR, lower concentrations of LDL-C, and protection from cardiovascular disease (CVD). Apolipoprotein-B (apo) remnants also contribute to CVD risk and are similarly cleared by the LDLR. We hypothesized that PCSK9-LOF carriers would have significantly lower fasting and postprandial remnant lipoproteins on top of lower LDL-C...
June 30, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28651464/are-the-pcsk9-inhibitors-the-panacea-of-atherosclerosis-treatment
#14
Evan A Stein, Traci A Turner
No abstract text is available yet for this article.
July 4, 2017: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/28644091/prevention-of-cardiovascular-disease-in-patients-with-familial-hypercholesterolaemia-the-role-of-pcsk9-inhibitors
#15
Ivan Pećin, Merel L Hartgers, G Kees Hovingh, Ricardo Dent, Željko Reiner
Familial hypercholesterolaemia is an autosomal dominant inherited disorder characterised by elevated low-density lipoprotein cholesterol levels and consequently an increased risk of atherosclerotic cardiovascular disease (ASCVD). Familial hypercholesterolaemia is relatively common, but is often underdiagnosed and undertreated. Cardiologists are likely to encounter many individuals with familial hypercholesterolaemia; however, patients presenting with premature ASCVD are rarely screened for familial hypercholesterolaemia and fasting lipid levels are infrequently documented...
January 1, 2017: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/28643240/pcsk9-inhibitors-treating-the-right-patients-in-daily-practice
#16
REVIEW
Peta King, Stephen J Nicholls
PURPOSE OF REVIEW: Monoclonal antibodies that inhibit proprotein convertase subtilisin/kexin type 9 (PCSK9) have emerged as a novel approach to low-density lipoprotein cholesterol (LDL-C) lowering. The potential role of PCSK9 inhibitors in clinical practice will be reviewed. RECENT FINDINGS: Clinical trials have demonstrated that PCSK9 inhibitors produce robust LDL-C lowering when administered either as monotherapy or in combination with statins. This provides the opportunity to achieve effective lipid lowering in familial hypercholesterolemia, patients with either established atherosclerotic cardiovascular disease or high risk primary prevention and an important opportunity to treat patients with statin intolerance...
August 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/28639183/proprotein-convertase-subtilisin-kexin-type-9-pcsk9-and-its-inhibitors-a-review-of-physiology-biology-and-clinical-data
#17
REVIEW
Ashwin Durairaj, Alberto Sabates, Jonathan Nieves, Brian Moraes, Seth Baum
Atherosclerotic cardiovascular disease (ASCVD) remains the number one killer in the western world. Low-density lipoprotein cholesterol (LDL-C) reduction with statins and ezetimibe has been shown to reduce the risk of cardiovascular events. Now, proprotein convertase subtilisin/kexin type 9 (PCSK9) monoclonal antibodies (mabs) are available for high-risk individuals with ASCVD or familial hypercholesterolemia on maximally tolerated statin therapy but requiring greater LDL-C reduction. PCSK9 mab outcome trial results from the Further Cardiovascular Outcomes Research with PCSK9 Inhibitions in Subjects with Elevated Risk (FOURIER) study, which was presented at the American College of Cardiology in March 2017, which demonstrated a decrease of 15% in primary and 20% secondary end points over a 2-year period [1••]...
August 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28623742/effect-of-intensive-ldl-cholesterol-lowering-with-pcsk9-monoclonal-antibodies-on-tendon-xanthoma-regression-in-familial-hypercholesterolemia
#18
Ana M Bea, Sofia Perez-Calahorra, Victoria Marco-Benedi, Itziar Lamiquiz-Moneo, Estibaliz Jarauta, Rocio Mateo-Gallego, Fernando Civeira
BACKGROUND AND AIMS: The effect of LDLc lowering with PCSK9 antibodies on tendon xanthomas (TX) is unknown. METHODS: TX was measured in 24 heterozygous familial hypercholesterolemia (HeFH) cases and in 24 HeFH controls with or without PCSK9 inhibitors for at least one year. RESULTS: Exposure to PCSK9 inhibitors in cases was 2.96 ± 1.33 years. LDLc decreased 80.8 ± 7.66% in cases and 56.9 ± 11.1% in controls. There was a decrease in maximum (-5...
June 8, 2017: Atherosclerosis
https://www.readbyqxmd.com/read/28618915/coronary-artery-disease-risk-stratification-and-patient-selection-for-more-aggressive-secondary-prevention
#19
François Schiele, Fiona Ecarnot, Romain Chopard
In patients with stable coronary artery disease, clinical outcomes are predominantly characterized by the consequences of atherosclerosis on the myocardium, but also by complications of atherosclerosis, notably recurrent acute coronary syndrome or stroke. Secondary prevention therapy is therefore key in this patient population. Intensification of secondary prevention therapy is possible, at the price of a therapeutic risk or a high cost, therefore justifying careful selection of patients with a high residual risk and low therapeutic risk...
June 2017: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/28618905/effective-low-density-lipoprotein-lowering-therapy-implementation-in-clinical-practice
#20
David Sinning, Ulf Landmesser
Although age-adjusted mortality of coronary heart disease has been successfully reduced over recent years, coronary heart disease still represents a leading cause of death and morbidity, in particular in patients at very high cardiovascular risk. Dyslipidaemia plays a major and causal role in the development and clinical progression of coronary heart disease. At present, low-density lipoprotein cholesterol represents the primary target of lipid-directed therapies for the prevention of cardiovascular disease and events...
June 2017: European Journal of Preventive Cardiology
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