TORNA ALL’ELENCO

Effectiveness in the treatment of hypercholesterolemia with PCSK-9 inhibitors in Giornale Italiano di Farmacia Clinica

2019
ASL Torino 3

Tipo pubblicazione

Article

Autori/Collaboratori (11)Vedi tutti...

Lecis M

Viglione E

Strobino S


et alii...

Abstract

Introduction. Hypercholesterolemia pharmacological therapy aims to reduce circulating low-density lipoproteins (LDL) concentration. Other therapies for patients who fail to achieve the desired targets have been evaluated. The most studied consists of monoclonal antibodies (mAB) that selectively and irreversibly bind the circulating proprotein convertase subtilisin/kexin type 9 (PCSK9) to prevent its binding to the LDL-R (LDL receptor)/LDL complex on the hepatocytes surface. Increased LDL-R liver levels result in a serum LDL cholesterol reduction. This work intends to define the two inhibitors alirocumab and evolocumab effectiveness using the changes in the lipid parameters and ratios of patients during the therapy. Furthermore, an other goal is the calculation of 10-year cardiovascular risk according to Framingham Heart Study. Materials and methods. The study examine the period from May 2017 to September 2018. The enrolled patients had at least a six month re-evaluation. The data were extracted from the registers compiled and updated on the AIFA web platform. Patient data such as age, sex, smoke, diabetes, hypertension were extracted and processed using Microsoft Access®. In the same way, the lipid ratios were calculated and finally the factors and the percentage of cardiovascular risk at 10 years were calculated using an online application on the MSD manuals® platform based on the Framingham Heart Study algorithm. Results. The average age is 63 and the male sex is preponderant (68%). About 60% of examined patients have arterial hypertension and 22% have diabetes mellitus. Concomitant therapy with statins is taken respectively by 42% and 56% of patients, while intolerance is found in 52% and 47% of cases. Adherence to therapy is maximum. The LDL and triglycerides concentrations decreased, while the HDL values remained constant over the period considered. The lipid ratios examined are decreased from the first to the other re-evaluations. The percentage risk

DOI : 10.1721/3124.31052

Keywords

alirocumab; evolocumab; high density lipoprotein; low density lipoprotein; proprotein convertase 9; triacylglycerol; adult; age; algorithm; article; cardiovascular risk; diabetes mellitus; drug efficacy; female; gender; human; hypercholesterolemia; hypertension; male; middle aged; smoking;