News, literature and expert perspectives on PCSK9 inhibition
Several lipid-lowering treatments have been shown to exert CV benefits. Prof. Deepak Bhatt discusses how to integrate PCSK9 inhibitors into these therapies for primary and secondary CV prevention.
Dr. Robert Giugliano summarizes what we have learned over the past decades about the effectiveness and safety of reducing LDL-c to very low values.
Ex vivo LDL-receptor expression is inversely associated with the plasma levels of LDL-c and apoB in HoFH patients before and after treatment with evolocumab.
Following FDA Priority Review, evolocumab is the only PCSK9 inhibitor approved to reduce risk of myocardial infarction, stroke and coronary revascularization in adults with established CVD.
The need for additional therapies to lower LDL-c levels was discussed and subsequently the effect of PCSK9 inhibitors in different studies was explained in several patient populations.
Prof. Chapman briefly introduced the outcome trials on the two PCSK9 inhibitors evolocumab and alirocumab and explained in more detail the pathophysiology of atherosclerotic CVD.
Data of large prospective cohort of African-Americans suggest that life-long exposure to low PCSK9 levels and the resulting low levels of LDL-C do not have major effects on neurocognitive outcomes.
AHA 2017 New FOURIER analyses show benefit of treatment with evolocumab both in patiënts with PAD, and clinical factors in high-risk post-MI patients can predict extra high risk.
AHA 2017 Dr. Giugliano summarises findings of 2 additional clinical trial updates and studies into infarct size, TIMI stable IHD risk and total events in the FOURIER trial.
AHA 2017 PAD patients enrolled in the FOURIER trial who were treated with PCKS9 inhibitor evolocumab showed a higher absolute and relative CV event reduction, and a large reduction in limb events.
AHA 2017 Subanalysis of FOURIER shows that within the subgroup of patients with prior MI, a subgroup at extra high risk has greater benefit of LDL-c lowering with PCSK9 inhibitor evolocumab.
This lecture was part of a CME accredited symposium: PCSK9 inhibition & Cardiovascular Outcomes: Review of lipid targets and treatment strategies held at ESC 2017 in Barcelona on August 26, 2017.