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Pooled analyses confirm benefit of PCSK9 inhibitors on secondary lipid targets

Pooled analyses confirm benefit of PCSK9 inhibitors on secondary lipid targets

Guidelines for managing dyslipidemia have emphasized the use of non-high-density lipoprotein (HDL) cholesterol, apolipoprotein (Apo)B and lipoprotein(a) for risk stratification (1,2). Two new pooled analyses provide information about the effects of evolocumab and alirocumab on these secondary targets. While LDL cholesterol is the primary lipid…

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ODYSSEY OUTCOMES economics study reinforces highest risk-highest benefit premise

ODYSSEY OUTCOMES economics study reinforces highest risk-highest benefit premise

Alirocumab treatment in the acute coronary syndrome (ACS) setting was best-value in statin-treated patients with persistently elevated LDL cholesterol levels (≥100 mg/dL or 2.6 mmol/L), according to this analysis. The ODYSSEY OUTCOMES Investigators used patient-level data to assess the cost-effectiveness of alirocumab treatment over a…

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ODYSSEY ALTERNATIVE follow-up: Sustained LDL lowering in statin-intolerant patients

ODYSSEY ALTERNATIVE follow-up: Sustained LDL lowering in statin-intolerant patients

Follow-up over 3 years after the main ODYSSEY ALTERNATIVE trial showed that alirocumab treatment led to durable LDL cholesterol lowering and was safe in statin-intolerant patients. Before the advent of the PCSK9 inhibitors, attaining LDL cholesterol goal in patients unable to tolerate statin treatment was…

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No adverse effects of very low LDL cholesterol on cognition: further data from FOURIER

No adverse effects of very low LDL cholesterol on cognition: further data from FOURIER

Data from the entire 22,655-patient cohort of the FOURIER study provide further reassurance that the addition of the PCSK9 inhibitor evolocumab to maximally tolerated statin therapy did not impact patient-reported cognition. The safety of very low levels that are attainable with a PCSK9 inhibitor has…

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EVOLVD trial in heart transplant recipients

EVOLVD trial in heart transplant recipients

The Cholesterol lowering with EVOLocumab to prevent cardiac allograft Vasculopathy in De-novo heart transplant recipients (EVOLVD) trial (ClinicalTrials.gov Identifier: NCT03734211) aims to show whether treatment with evolocumab can ameliorate cardiac allograft vasculopathy (CAV) over the first year after heart transplant. Cardiac allograft vasculopathy is an…

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New FOURIER analysis supports aggressive LDL lowering in patients with a recent MI

New FOURIER analysis supports aggressive LDL lowering in patients with a recent MI

In this latest FOURIER analysis, add-on evolocumab treatment in patients with a recent myocardial infarction (MI) produced 3-fold greater absolute reduction in cardiovascular risk.  These findings confirm 2018 US guideline recommendations for adding a PCSK9 inhibitor in very high-risk patients with elevated LDL cholesterol (≥70…

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LDL cholesterol goals go even lower in India

LDL cholesterol goals go even lower in India

A statement from the Lipid Association of India proposes aggressive LDL cholesterol lowering for individuals at high and very high risk of cardiovascular disease. Cardiovascular disease (CVD) is now the leading cause of mortality in India, responsible for one-quarter of all deaths (1). A number…

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Does PCSK9 inhibition reduce the risk of venous thromboembolism?

Does PCSK9 inhibition reduce the risk of venous thromboembolism?

According to a new analysis from the FOURIER trial, a reduced risk of venous thromboembolism (VTE) is an additional benefit from PCSK9 inhibition in very high-risk patients. Lipoprotein(a) may be a key mediator of this effect. There are mixed observational data for a link between…

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ODYSSEY OUTCOMES – Alirocumab reduces risk for peripheral artery disease

ODYSSEY OUTCOMES – Alirocumab reduces risk for peripheral artery disease

A new analysis from ODYSSEY OUTCOMES shows that alirocumab treatment reduces the substantial risk of peripheral artery disease (PAD) in acute coronary syndrome (ACS) patients on intensive statin therapy. Reduction in lipoprotein(a), especially in individuals with high baseline levels, may mediate this benefit. In this…

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ODYSSEY KIDS: Alirocumab in children with heterozygous FH

ODYSSEY KIDS: Alirocumab in children with heterozygous FH

Alirocumab was effective in lowering LDL cholesterol in children and adolescents with heterozygous familial hypercholesterolaemia (FH, inherited high cholesterol) treated with a statin. Heterozygous FH is characterised by elevated levels of LDL cholesterol which, if untreated, lead to premature atherosclerosis and cardiovascular events (1). Yet,…

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Inclisiran in heterozygous familial hypercholesterolaemia

Inclisiran in heterozygous familial hypercholesterolaemia

Results from the ORION-9 study in patients with heterozygous familial hypercholesterolaemia (FH, inherited high cholesterol) show that inclisiran lowers LDL cholesterol by nearly 50% and is well tolerated. The advent of monoclonal antibodies directed against PCSK9 has revolutionised the management of FH, with proven efficacy…

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FH in the MENA region: Gulf Registry launched

FH in the MENA region: Gulf Registry launched

Preliminary data from the Gulf Familial Hypercholesterolaemia Registry (Gulf FH) show a high prevalence, with one in 232 people having definite or probable familial hypercholesterolaemia (FH, inherited high cholesterol). Heterozygous FH is largely underdiagnosed and undertreated.1 Information on prevalence is lacking in almost all countries,…

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Monogenic vs polygenic hypercholesterolaemia and cardiovascular risk

Monogenic vs polygenic hypercholesterolaemia and cardiovascular risk

Understanding the genetic cause of familial hypercholesterolaemia (FH, inherited high cholesterol) is imperative to better stratify and manage cardiovascular risk in patients, according to this report from the UK BioBank. FH is the most common inherited metabolic condition, affecting about one in 200-250 people.1 Genetic…

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Alirocumab in diabetes patients with mixed dyslipidaemia

Alirocumab in diabetes patients with mixed dyslipidaemia

Alirocumab shows benefit in patients with type 2 diabetes mellitus (T2DM) and mixed dyslipidaemia, according to this analysis of the ODYSSEY DM-DYSLIPIDEMIA trial. Individuals with T2DM are at increased risk for atherosclerotic cardiovascular disease (ASCVD), in part due to the mixed dyslipidaemia, characterized by elevated…

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BEIJERINCK: Evolocumab in people living with HIV

BEIJERINCK: Evolocumab in people living with HIV

First trial of PCSK9 monoclonal antibody therapy in people living with HIV and at moderate/high cardiovascular risk, with elevated LDL cholesterol levels has closed enrolment, with 464 patients. Due to advances in antiretroviral treatment, HIV is now regarded as a chronic disease. Consequently, attention has…

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DE LAVAL: Evolocumab reduces need for lipoprotein apheresis

DE LAVAL: Evolocumab reduces need for lipoprotein apheresis

Treatment with evolocumab may replace lipoprotein apheresis in patients with high LDL cholesterol levels, refractory to conventional treatment, according to the findings from the DE LAVAL study. Lipoprotein apheresis, which removes LDL cholesterol from the circulation, is indicated in patients with refractory heterozygous familial hypercholesterolemia…

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New FOURIER analysis underlines consistent efficacy of evolocumab

New FOURIER analysis underlines consistent efficacy of evolocumab

A key question posed by all clinicians is whether age or sex impacts the efficacy of a cholesterol-lowering therapy. This is highly pertinent given the ‘greying’ of populations, and the associated increase in risk for cardiovascular events.  A new analysis from the FOURIER study which…

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Inclisiran dose adjustment not necessary in renal impairment

Inclisiran dose adjustment not necessary in renal impairment

Renal impairment does not influence the pharmacodynamics/pharmacokinetics of inclisiran, according to a new analysis. Impaired renal function alters drug pharmacokinetics, potentially changing drug efficacy and increasing the likelihood of unwanted effects, including renal toxicity. This is a key consideration for individuals taking long-term medications, such…

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New EAS Consensus Panel statement: an Opus for LDL-driven mechanisms in atherosclerosis

New EAS Consensus Panel statement: an Opus for LDL-driven mechanisms in atherosclerosis

A new statement from the European Atherosclerosis Society (EAS) consensus panel is set to become THE reference for the role of LDL in driving atherosclerosis. Published in The European Heart Journal, this is an essential follow-up to a previous statement1 which appraised clinical evidence supporting…

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TAUSSIG reports evolocumab treatment up to 5 years in homozygous or severe FH

TAUSSIG reports evolocumab treatment up to 5 years in homozygous or severe FH

TAUSSIG: Evolocumab provides sustained benefit in severe heterozygous or homozygous FH Evolocumab treatment for up to 5 years was effective and well tolerated in patients with homozygous or severe heterozygous familial hypercholesterolaemia (FH, inherited high cholesterol) in this latest follow-up from the TAUSSIG study. Over…

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