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PCSK9 抑制剂的今生未来
CBSMD
PCSK9抑制剂依伏库单抗 (Evolocumab)
最新发表的"Effect of the PCSK9 Inhibitor Evolocumab on Total Cardiovascular Events in Patients With Cardiovascular DiseaseA Prespecified Analysis From the FOURIER Trial"进一步报道了依伏库单抗 (Evolocumab)对动脉粥样硬化患者中期罹患主要临床终点事件总人次的削弱作用,主要预防作用是通过降低心梗、卒中和血运重建发生率而实现的。
现有CBSMD Scientific Library收录的“Evolocumab”与临床事件相关的研究文献可参阅:
“Mortality Differences Associated With Treatment Responses in CANTOS and FOURIER: Insights and Implications”
“Clinical Efficacy and Safety of Evolocumab in High-Risk Patients Receiving a Statin: Secondary Analysis of Patients With Low LDL Cholesterol Levels and in Those Already Receiving a Maximal-Potency Statin in a Randomized Clinical Trial”
“Evolocumab and Clinical Outcomes in Patients with Cardiovascular Disease”
PCSK9抑制剂阿利库单抗(alirocumab)
2018年10月ODYSSEY研究首项证实最大耐受剂量他汀(statins)基础上联合PCSK9抑制剂阿利库单抗(alirocumab)治疗改善ACS患者的预后。ODYSSEY OUTCOMES研究结果显示每2周服用阿利库单抗可有效降低既往1-12个月内发生ACS事件患者未来缺血性事件,包括全因死亡和心梗。试验设计为在经最大耐受剂量他汀治疗后低密度脂蛋白胆固醇(LDL-C)水平仍未达标的患者中加入阿利库单抗,观察其相较于安慰剂对主要心血管事件的降幅,其中LDL-C≥100 mg/dl的ACS患者获益最大。
2019年4月26日FDA(The U.S. Food and Drug Administration)更新了阿利库单抗的药物说明书:
- 可作为降低成年心血管疾病患者发生心肌梗死、卒中和需要住院治疗的不稳定心绞痛的风险的二级预防药物;
- 可作为配合节食、单独或联合其他降脂疗法(如他汀类药物、依扎替米布)治疗成人原发性高脂血症(包括杂合子家族性高胆固醇血症),以降低低密度脂蛋白胆固醇LDL-C的药物。
Cholesterol-Lowering Agents
Circ Res. | Feb 19,2019
2018年, 那些颠覆既往理念、指导未来临床的研究
CBSMD | Dec 29,2018
Systematic Review for the 2018 AHA/ACC/AACVPR/AAPA/ABC/A...
J Am Coll Cardiol. | Nov 19,2018
Alirocumab Reduces Total Nonfatal Cardiovascular and Fatal Events in the...
J Am Coll Cardiol. | Dec 26,2018
Evolocumab and Clinical Outcomes in Patients with Cardiovascular Diseas...
N Engl J Med. | Feb 09,2018
Sequence variations in PCSK9, low LDL, and protection against coronary ...
N Engl J Med. | Feb 19,2019