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From the Editors

PSCK9 inhibitor therapy- after the clinical trials, what can we learn to improve practice?

PSCK9 inhibitor therapy- after the clinical trials, what can we learn to improve practice?

The major cardiovascular disease (CVD) outcomes trials with the antibody-based inhibitors of proprotein convertase subtilisin kexin type 9 (PCSK9) have now been completed. Both ODYSSEY Outcomes with alirocumab in patients with acute coronary syndromes (ACS) and FOURIER with evolocumab in patients with stable CVD, were…

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New Approaches to PCSK9 inhibition

New Approaches to PCSK9 inhibition

Prof Derick Raal (University of Witwatersrand, Johannesburg, South Africa) discusses what’s in the pipeline for PCSK9 inhibition beyond the monoclonal antibodies. PCSK9 monoclonal antibodies Modulation of PCSK9 can result in much greater lowering of LDL-cholesterol than that achieved with statin therapy or statin therapy in…

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Paediatric FH: what do we still need to know?

Paediatric FH: what do we still need to know?

FH is a common inherited hyperlipidaemia, characterized by elevated cholesterol levels from birth which, if untreated, lead to accelerated atherosclerosis and premature coronary artery disease in adulthood. Clearly, there is an urgent need to identify these individuals in childhood so as to instigate treatment as…

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Looking back at 2017 and forward to 2018

Looking back at 2017 and forward to 2018

PCSK9 Forum Editor Professor Anthony Wierzbicki (St Thomas’ Hospital, London UK) discusses the key trials in cardiovascular disease prevention in 2017 and what 2018 offers.

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Evolocumab in lower extremity peripheral artery disease

Evolocumab in lower extremity peripheral artery disease

Lower extremity peripheral artery disease (LEPAD) is associated with an elevated risk of atherosclerotic cardiovascular disease (ASCVD) and mortality1. Classically, risk factors for LEPAD are heavy smoking, diabetes and older age, although dyslipidaemia also predisposes to LEPAD, as shown by a recent study2. Furthermore, Pereira…

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Depression, Cardiovascular Disease and Adherence

Depression, Cardiovascular Disease and Adherence

David Hare & Samia R Toukhsati, University of Melbourne, Australia This editorial discusses the interrelationship between cardiovascular disease and depression and poses the question: Is depression a key modulator of patient adherence and clinical outcome? “Depression” can refer to anything from feeling transiently unhappy through…

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PlayESC/EAS Task Force issues updated clinical guidance for PCSK9 inhibitors

ESC/EAS Task Force issues updated clinical guidance for PCSK9 inhibitors

This Task Force from the European Society of Cardiology (ESC) and European Atherosclerosis Society (EAS) has considered new evidence from cardiovascular outcomes studies with evolocumab (FOURIER) and bococizumab (now terminated), new analyses and genetic studies.t Taking account of the cost of these agents, the Task…

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REVEAL Study. Should we welcome a new lipid lowering drug family?

REVEAL Study. Should we welcome a new lipid lowering drug family?

The significant and positive results obtained by REVEAL (Randomized EValuation of the Effects of Anacetrapib Through Lipid-modification study) (1) are good news. These data show that we have a new lipid modifying drug, that by significantly reducing atherogenic non-high-density lipoprotein (HDL) cholesterol, decreases major cardiovascular…

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PlayWill CANTOS and REVEAL change how we view the clinical use of PCSK9 inhibitors?

Will CANTOS and REVEAL change how we view the clinical use of PCSK9 inhibitors?

Prof Anthony Wierzbicki, New Associate Editor of PCSK9 Forum discusses Atherosclerosis has long been recognised as a chronic inflammatory disease, where low-density lipoproteins (LDL) interact with both innate and adaptive immunity mechanisms. However, while inflammatory infiltration by circulating white blood cells is an important part…

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NLA 2017 recommendations: Who should benefit from PCSK9 inhibition?

NLA 2017 recommendations: Who should benefit from PCSK9 inhibition?

Dr Peter Lansberg, PCSK9 Forum News Editor discusses these latest recommendations from the US National Lipid Association. The National Lipid Association has recently published updated guidance for the use of PCSK9 inhibitors (1). This statement has courted controversy with recommendations for using these efficacious agents…

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PlayImplications of very low LDL cholesterol levels

Implications of very low LDL cholesterol levels

One of the key concerns of clinicians in the aftermath of FOURIER is the safety of very low LDL cholesterol levels. This is underlined by the fact that 42% of patients on evolocumab in FOURIER attained LDL cholesterol levels ≤25 mg/dl (0.65 mmol/L).(1) As previously…

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PlayFOURIER in the Hot Seat: What are the Implications for practice and access?

FOURIER in the Hot Seat: What are the Implications for practice and access?

FOURIER was a landmark trial for PCSK9 inhibition, showing significant reduction in cardiovascular events with evolocumab in very high risk patients on maximally tolerated lipid lowering therapy. The results from FOURIER, together with those from SPIRE-2 in patients at higher baseline LDL cholesterol levels, clearly…

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PlayCountdown to FOURIER: What are the implications for patients?

Countdown to FOURIER: What are the implications for patients?

Countdown to FOURIER: What are the implications for patients? PCSK9 Forum Editor Professor Anthony Wierzbicki gives his view.

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Countdown to FOURIER: Are very low levels of LDL cholesterol safe?

Countdown to FOURIER: Are very low levels of LDL cholesterol safe?

A view from PCSK9 Forum Editor Dr Peter Lansberg (Academic Medical Center, Amsterdam, the Netherlands) Comment relates to: Giugliano RP, Wiviott SD, Blazing MA et al. Long-term Safety and Efficacy of Achieving Very Low Levels of Low-Density Lipoprotein Cholesterol A Prespecified Analysis of the IMPROVE-IT…

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PlayLooking to FOURIER: What do the trials tell us about LDL lowering and cardiovascular events?

Looking to FOURIER: What do the trials tell us about LDL lowering and cardiovascular events?

Presentation of full results from the FOURIER cardiovascular outcomes trial with the PCSK9 monoclonal antibody evolocumab is imminent. Here, PCSK9 Forum Editor Professor Anthony Wierzbicki (Guy’s and St Thomas’ NHS Foundation Trust, London UK) looks back over more than 25 years of trials of LDL…

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TAUSSIG: What does it mean for the homozygous FH patient?

TAUSSIG: What does it mean for the homozygous FH patient?

Data from TAUSSIG (Trial Assessing Long-Term Use of PCSK9 Inhibition in Subjects with Genetic LDL Disorders), the largest and longest study of lipid lowering therapy in patients with homozygous FH, indicate a complementary role for evolocumab with lipoprotein apheresis. PCSK9 Forum Editor Dr Peter Lansberg…

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PlayLooking back at 2016: What made the news?

Looking back at 2016: What made the news?

PCSK9 Forum Editor Professor John Chapman reviews the ups and downs of LDL lowering news in 2016. The Highlights GLAGOV (Global Assessment of Plaque Regression with a PCSK9 Antibody as Measured by Intravascular Ultrasound) (1) would have to feature very much in the forefront of…

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Use of PCSK9 inhibitors in developing countries

Use of PCSK9 inhibitors in developing countries

Inhibitors of proprotein convertase subtilisin/kexin type-9 (PCSK9) reduce the concentration of low density lipoprotein cholesterol (LDL-C) by up to 60%, whether given as the only lipid lowering therapy or when used in people already being treated with lipid-lowering agents. The availability of PCSK9 inhibitors thus…

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Premium quality or just over-priced? How affordable are the PCSK9 monoclonal antibodies?

Premium quality or just over-priced? How affordable are the PCSK9 monoclonal antibodies?

Anthony Wierzbicki, Guy’s & St Thomas’ Hospitals, London discusses recent economic analyses from the US and UK. Cardiovascular disease (CVD) remains one of the commonest causes of morbidity and mortality in the world. The epidemiology of CVD is changing as rates of smoking decrease but…

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Screening for Lipid Disorders in Children and Adolescents: A view from PCSK9 Forum Editors

Screening for Lipid Disorders in Children and Adolescents: A view from PCSK9 Forum Editors

Gerald F Watts, University of Western Australia, Perth, Australia Heterozygous familial hypercholesterolaemia (FH, inherited high cholesterol) starts as an asymptomatic disorder characterized by markedly elevated LDL cholesterol levels and untreated leads to accelerated atherosclerosis and cardiovascular disease. Typically, individuals may be only diagnosed in the…

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