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Latest IMPROVE-IT commentary

PCSK9 monoclonal antibody therapy: pharmacodynamics, efficacy and safety

Webcast Prof Evan Stein, University of Cincinnati Medical Center, Cincinnati, Ohio, USA overviews the clinical development of PCSK9 monoclonal antibody therapy Report from State-of-the-Art PCSK9 Science: Current understanding and therapeutic perspectives Prof Evan Stein discusses the pharmacodynamics of the two most advanced PCSK9 monoclonal antibody…

TESLA in brief

TESLA was a randomised, double-blind, placebo-controlled trial of the PCSK9 inhibitor, evolocumab, in 50 patients (49 received treatment) with homozygous FH (mean LDL-C at baseline 9.0 mmol/L). All were on statins and 91% also received ezetimibe. LDL receptor mutations were identified in 45 (92%) patients;…

Mechanistic insights from PCSK9 LOF mutations

Mechanistic insights from PCSK9 LOF mutations with a particular focus on data from the Copenhagen studies, were discussed by Professor Anne Tybjaerg-Hansen, Rigshospitalet, Copenhagen University Hospital, and University of Copenhagen, Denmark. Seminal studies showed that carriage of LOF mutations was associated reduction in LDL cholesterol…

How low should LDL cholesterol be lowered – and for how long?

PCSK9 plasma transport and lipoprotein association

Hagai Tavori, PhD, and Sergio Fazio, MD, PhD. Knight Cardiovascular Institute, Center of Preventive Cardiology, Oregon Health and Science University, Portland, OR. PCSK9 and LDL are ligands for the LDL receptor (LDLR). The fate of the ligand-receptor complex is dependent on the ligand, with both…

Overturning the 1%…Bridging the gaps in care

2014 FH Global Summit: 13-14 October, New York, USA: Familial hypercholesterolaemia (FH) is a major clinical challenge for the 21st century. The European Atherosclerosis Society Consensus Panel has already made the case for FH being one of the most common inherited conditions, affecting about one…

RUTHERFORD-2 in brief

RUTHERFORD-2 was a large, randomised, placebo-controlled trial of the PCSK9 inhibitor, evolocumab, in 331 patients with heterozygous familial hypercholesterolaemia (mean LDL-C at baseline 3.9-4.2 mmol/L). All were on statins and 62% were also on ezetimibe. FH-causing mutations were identified in 80% of patients, most were…

Why new NLA guidelines for dyslipidaemia? A view from the authors

The US National Lipid Association (NLA) has just released recommendations for management of dyslipidaemia. Matthew K. Ito, Professor of Pharmacy Practice, Portland, Oregon and one of the lead authors, discusses thinking behind these recommendations, and what are the implications for clinicians. •                Why has the…

Missing FH: How can we improve FH referral and diagnosis?

Heterozygous familial hypercholesterolemia (FH) is neither a rare disease nor a sentence to a life full of complications and early death. Recent evidence shows that even when founder effects are taken into account, heterozygous FH affects around 1/200-300 people instead of the historical estimate of…

Will the PCSK9 monoclonal antibodies replace other lipid lowering treatments currently used with statins?

Where will the new PCSK9 inhibitors fit into the treatment of people whose raised low density lipoprotein cholesterol (LDL-C) puts them at high risk of cardiovascular disease? Leading researcher, Professor Frederick Raal discusses this important question.

In your opinion, what are the optimum patient populations for PCSK9 monoclonal antibody therapy?

PCSK9 monoclonal antibodies offer very important new treatments to lowed low density lipoprotein cholesterol (LDL-C) in patients who cannot tolerate statins or whose LDL-C is inadequately reduced as well as those people with high LDL-C caused by Familial Hypercholesterolemia.

How low should LDL-C be lowered? Thoughts of IMPROVE-IT rekindle debate

Not only lower BUT but SOONER is better

2014 FH Global Summit: 13-14 October, New York, USA FH is highly treatable: lowering LDL-C helps in managing the disease process. Clearly, the focus for FH care needs to move from the acute setting to prevention. Identifying FH sooner rather than later is optimal for…

PCSK9 inhibitors and FH: future for standard of care?

Two recent trials in FH patients – RUTHERFORD-2 and TESLA – have raised the focus of the PCSK9 inhibitors in FH.  In an accompanying Lancet editorial, Profs. Raul Santos (Sao Paulo, Brazil) and Gerald Watts (Perth, Australia) have intimidated that PCSK9 inhibitors might represent the…

How can we optimise PCSK9-targeted therapies?

Highly relevant to these discussions was how to optimise the use of PCSK9-targeted therapies, discussed from both European (Professor Luís Masana, University Rovira and Virgili, Reus-Tarragona, Spain) and North American (Professor Henry Ginsberg, Columbia University, New York, USA) perspectives, from the guidelines perspectives. There are…

RUTHERFORD-2 slide deck now available

What are the gaps in knowledge about the PCSK9 inhibitors

Alirocumab

A 24-Week Study of Alirocumab as Monotherapy versus Ezetimibe: The First Phase 3 Data of a Proprotein Convertase Subtilisin/Kexin Type 9 Inhibitor One Year Open-Label Treatment with Alirocumab 150 mg Every Two Weeks in Heterozygous Familial Hypercholesterolemic Patients Effects of Alirocumab, a Fully Human Monoclonal…

Will PCSK9 monoclonal antibody therapy replace other classes of drug currently used in combination therapy both in FH and non-FH indications?

Frederick J. Raal FRCP, FRCPC, FCP(SA), Cert Endo, MMED, PhD Professor and Head, Division of Endocrinology & Metabolism Director, Carbohydrate and Lipid Metabolism Research Unit University of the Witwatersrand, South Africa Elevated LDL-cholesterol(LDL-C) is considered to be the pivotal causative factor for atherosclerosis and LDL-C…