News
ICD10 codes for familial hypercholesterolaemia: An important first step
After more than 3 years in discussion, International Classification of Diseases (ICD) 10TH Edition codes for familial hypercholesterolaemia (FH, inherited high cholesterol) have now been approved. Two codes will come into force on 1st October this year: E78.01: Familial hypercholesterolemia AND Z83.42: Family history of…
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Updated Canadian Consensus on statin intolerance
The availability of non-statin treatments that are effective in lowering LDL cholesterol and (may) also reduce cardiovascular events (ezetimibe, still be tested with the PCSK9 inhibitors) has been a key driver for new consensus on statin intolerance. Use of these nonstatin therapies offers the possibility…
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Phase II studies
ALN-PCSsc ORION programme This programme with the first-in-class RNA interference (RNAi) PCSK9 inhibitor ALN-PCSsc was launched with the ORION-1 study. Trial ORION-1: Trial to Evaluate the Effect of ALN-PCSSC Treatment on Low Density Lipoprotein Cholesterol (LDL-C) ClinicalTrials.gov Identifier: NCT02597127 Aim To evaluate the efficacy, safety,…
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PCSK9 inhibitors in the clinic: New analyses provide clarification on long-term treatment issues
Reports from EAS Congress provide important insights into the long-term use of PCSK9 inhibitors. Statins are the first-line therapy for LDL cholesterol lowering given indisputable evidence that this treatment reduces cardiovascular events in both men and women (1,2). The PCSK9 inhibitors undoubtedly have proven efficacy,…
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News: International Atherosclerosis Society consensus statement on severe familial hypercholesterolaemia
In this new statement, the International Atherosclerosis Society (IAS) has placed phenotype at the heart of management strategies for familial hypercholesterolaemia (FH, inherited high cholesterol). Commenting, lead author Dr. Raul Santos (University of São Paulo Medical School Hospital and Preventive Medicine Centre and Cardiology Program,…
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EAS Congress Innsbruck: Mixed results with novel agents in homozygous FH
The Clinical Late breaker session reported on three agents with potential for the management of homozygous familial hypercholesterolaemia (FH, inherited high cholesterol). One of these – evinacumab (REGN1500), a human monoclonal antibody to angiopoietin-like protein 3 (ANGPTL3) – showed interesting results in a small proof-of-concept study…
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Is lipoprotein(a) a cause of clinical familial hypercholesterolaemia?
Familial hypercholesterolaemia (FH, inherited high cholesterol) is a common autosomal dominant condition which is characterized by raised LDL cholesterol, family history of dyslipidaemia, and early onset of coronary heart disease. Beyond mutations in the LDLR, APOB and PCSK9 genes, a new study from the University…
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Low LDL-C, PCSK9 and dementia risk?
An ongoing debate among the experts is whether the very low levels of LDL cholesterol with PCSK9 inhibitor treatment might be associated with neurocognitive events. In fact, the debate predates the PCSK9 inhibitors, with statins linked with cognitive impairment (1-4). However, when the statin data…
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TAUSSIG: Does adding evolocumab reduce cardiovascular events in homozygous FH?
84th European Atherosclerosis Society Congress, 29 May- 1 June, Innsbruck, Austria Patients with homozygous familial hypercholesterolaemia (FH, inherited high cholesterol) are at extremely high risk of premature cardiovascular events due to the burden of elevated LDL cholesterol. Indeed, cardiovascular death at an early age is…
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Changing the message on LDL cholesterol: Lifetime exposure is key
84th European Atherosclerosis Society Congress, 29 May – 1 June, Innsbruck, Austria Until recently, the emphasis in clinical care has been to lower LDL cholesterol to the recommended goal, or even below these limits, as investigated with the PCSK9 inhibitors. However, in his Key Note…
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FH Score: new website
About 1 in 200 people have familial hypercholesterolaemia (FH, inherited high cholesterol), yet <1% world-wide are identified (1,2). To address this urgent issue FH Score has been developed for healthcare professionals to support the diagnosis of adult patients at risk of heterozygous FH. FH Score…
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How do PCSK9-inhibitors reduce lipoprotein(a)?
Beyond lowering LDL cholesterol, PCSK9 inhibition also reduces lipoprotein(a). Prof Derick Raal, University of the Witwatersrand, Johannesburg, South Africa discusses the underlying mechanism. Lipoprotein (a) [Lp(a)] is an LDL-like particle consisting of apolipoprotein(a) [apo(a)] that is disulphide-linked to the apoB moiety of LDL (1). Lp(a)…
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6th Joint Task Force Guidelines on CVD Prevention now available
Updated guidelines from the European Society of Cardiology and nine other societies have been published today. The authors argue that modest risk factor reduction could halve cardiovascular disease (CVD) mortality rates. Currently, CVD is the cause of almost half of all deaths each year in…
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New screening tool for FH for primary care
A new electronic tool for screening for familial hypercholesterolaemia (FH, inherited high cholesterol) in primary care shows promise. According to one of the authors, Professor Gerald Watts, University of Western Australia and Royal Perth Hospital, Western Australia: ‘TARB-Ex is a quick and cost-effective extraction tool…
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UK Paediatric FH register: LDL-C and family history drives diagnosis
Preliminary data from this register, including the largest group of UK children with a clinical diagnosis of familial hypercholesterolaemia (FH, inherited high cholesterol), show that a strong family history of coronary heart disease (CHD) and elevated LDL cholesterol levels primarily drive treatment decisions. Professor Gerald…
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FH affects 1 in 5 young STEMI patients
A study from Greece has highlighted the high prevalence of definite/probable familial hypercholesterolaemia (FH, inherited high cholesterol) in patients with ST-segment elevation myocardial infarction (STEMI) aged 35 years or less. This prospective study included 320 consecutive patients who had survived their first STEMI at ≤35…
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NICE approves alirocumab and evolocumab in draft guidance
The UK National Institute for Health and Clinical Excellence (NICE) has now approved both alirocumab (Praluent, Sanofi) and evolocumab (Repatha, Amgen) for adults with primary hypercholesterolaemia or mixed dyslipidaemia to help reduce their risk of cardiovascular disease, in draft guidance. The specific recommendations are for…
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Alirocumab for Autosomal Recessive Hypercholesterolemia
Results from this in vitro study suggest that PCSK9 inhibition with alirocumab on top of statin treatment may have the potential to lower LDL cholesterol in some patients with autosomal recessive hypercholesterolemia (ARH), a phenocopy of homozygous familial hypercholesterolaemia (FH, inherited high cholesterol). ARH is…
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ACC 2016: Late Breaker underscores the value of genetic testing in ascertaining coronary risk in FH
A key paper for the familial hypercholesterolaemia (FH, inherited high cholesterol) community was presented at the clinical Latebreaker session. According to PCSK9 Forum Board member, Professor Gerald Watts, University of Western Australia, Perth, Australia, the paper by Khera and co-workers not only confirms the higher…
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American College of Cardiology updates guidance for non-statin therapies for LDL-C lowering
In a prelude to this year’s Annual Congress, the American College of Cardiology has released a new consensus document to address gaps from the 2013 ACC/American Heart Association (AHA) guidelines (1) regarding the use of non-statin therapies for lowering LDL cholesterol. This important document provides…
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