Tag Archives: PCSK9

CVD prevention past and present Dr Shahed Ahmad from NHS England addresses the conference The scale of CVD deaths, currently 136,000 per year in the UK1 and similar in number to the first year of the COVID-19 pandemic, was highlighted by Dr Shahed Ahmad (NHS England) in his role as National Clinical Director for CVD. He emphasised the importance of tackling CVD as if it were a pandemic. Rather than needing to create vaccines, he said we already have the necessary therapeutics to reduce CVD but these need robust application to our populations. He signposted the CVDPREVENT website2 with its wealth of open access primary care data on metrics, su

What’s new in transplantation Are kidney donors worse off? The meeting was opened by Dr Anna Price (Queen Elizabeth University Hospital, Birmingham) who addressed the long-term cardiovascular effects of unilateral nephrectomy in living kidney donors.1 Previous studies have shown a significant prevalence of cardiovascular morbidity and mortality in patients with chronic kidney disease (CKD),2,3 but the effects of reduced renal function in living kidney donors has been unexplored until now. A recent study by Price et al. demonstrated that living kidney donors had a reduction in estimated glomerular filtration rate (eGFR) from 95 to 67 ml/min

Tafamidis – a new treatment for amyloidosis The European Commission (EC) has granted marketing authorisation for tafamidis (Vyndaqel®, Pfizer), a once-daily 61 mg oral capsule, for the treatment of wild-type or hereditary transthyretin amyloidosis in adult patients with cardiomyopathy (ATTR-CM). Tafamidis is the first authorised treatment in the European Union for patients with ATTR-CM. Prior to this authorisation, treatment options for patients with ATTR-CM were restricted to symptom management, and, in rare cases, heart (or heart and liver) transplant. ATTR-CM is a rare, under-diagnosed and life-threatening disease characterised by the b

Genetic disease The benefits of child-parent screening for familial hypercholesterolaemia (FH), were explored by Professor David Wald (Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine and Dentistry, Queen Mary University of London). Detection rates are highest if FH is screened for in children between one to two years of age – a heel prick test, for example, is quick to carry out at routine immunisation appointments and uptake rates of 84% have been achieved. Screening is effective – a rate of four children and four parents are identified for every 1,000 children screened. The child benefits twice: their

The National Institute for Health and Care Excellence (NICE) has published recommendations supporting the use of two new lipid-lowering agents – both PCSK9 inhibitors, which inhibit the body’s natural system for eliminating low-density lipoprotein cholesterol (LDL-C). A Final Appraisal Determination (FAD) has been published for evolocumab (Repatha®, Amgen) recommending it be used alone or in combination with other cholesterol-lowering therapies, for several types of patients at particularly high risk of cardiovascular events with persistently high cholesterol despite maximal tolerated lipid-lowering therapy.  The NICE recommendation is

PCSK9 approvals in Europe Two agents in a new cholesterol-lowering class – the PCSK9 inhibitors, which use human monoclonal antibodies to target PCSK9 (proprotein convertase subtilisin/kexin type 9) – have received European approval for lowering cholesterol. Evolocumab (Repatha®, Amgen) is the first PCSK9 inhibitor to be granted marketing authorisation by the European Commission (EC) for use in people with primary hypercholesterolaemia or mixed dyslipidaemia, or in homozygous familial hypercholesterolaemia, who are unable to reach low-density lipoprotein cholesterol (LDL-C) goals with an optimal dose of statin (or a statin and other lipi

Too much sitting increases coronary artery calcification Sitting for many hours per day is associated with increased coronary artery calcification, a marker of subclinical heart disease, a new study suggests. The study found no association between coronary artery calcification (CAC) and the amount of exercise a person gets, suggesting that too much sitting might have a greater impact than exercise on this particular measure of heart health. The results suggest that exercise may not entirely counteract the negative effects of a mostly sedentary lifestyle on coronary artery calcium. Presenting the study at the ACC meeting, Dr Jacquelyn Kulinski

Managing risk factors – the old offenders Diet An update on diet and cardiovascular disease was given by Professor Kay Tee Khaw (University of Cambridge). A surprise recent finding has been that increased body mass index (BMI) trends do not directly correlate with cardiovascular mortality, particularly in Mediterranean countries (figure 1). Figure 1. Body mass index and associated coronary heart disease in Europe. Panel a) body mass index; panel b) coronary heart disease This gives rise to the question: is diet a key moderating factor in the relationship between BMI and cardiovascular mortality? The PREDIMED (Effects of the Mediterranean Di

Lowering LDL-cholesterol: we need to do better It is essential that high-risk patients attain the recommended low-density lipoprotein (LDL)-cholesterol target. As reported at the first late-breaking session, the choice and dose of statin are key factors influencing LDL-cholesterol lowering. In a meta-analysis of the VOYAGER (Individual Patient Data Meta-analysis of Statin Therapy in At-risk Groups: Effects of Rosuvastatin, Atorvastatin and Simvastatin) database of 37 studies of high-intensity statins, 71% of patients treated with rosuvastatin 40 mg achieved at least 50% reduction in LDL-cholesterol levels, compared with 59% for atorvastatin 8

Dr Gilbert Wagener (Transcrip Partners LLP) Proprotein convertase subtilisin/kexin type 9 (PCSK9) is a new target for the treatment of hyperlipidaemia. PCSK9 is apparently complimentary to 3-hydroxy-3-methyl-glutaryl-CoA (HMG-CoA) reductase inhibition with statins.6,7 Most advanced in the development path are two monoclonal antibodies (mAbs) against PCSK9, alirocumab (SAR236533) and evolocumab (AMG145), both subcutaneous injectable drugs administered at bi-weekly or four-weekly intervals. Both compounds demonstrated solid reductions in LDL-C, however, dose selection for both focused on the most effective dose and did not consider titration ac