心血管领域PCSK9抑制的起伏:一篇综述
Daniel J McClintick1, Robert P Giugliano2
1Department of Medicine.
Current opinion in lipidology
|August 22, 2023
概括
蛋白转化酶亚素/素9型 (PCSK9) 抑制剂是高风险患者有效的降脂疗法. 目前正在进行的试验和新型配方可能会扩大它们在更广泛的人群中的使用范围.
科学领域:
- 心血管医学 心血管医学
- 药理学 药理学是指药理学的学科.
- 生物化学 生物化学
背景情况:
- 动脉样性心血管疾病 (ASCVD) 仍然是全球死亡的主要原因.
- 有效的降脂疗法对于控制ASCVD风险至关重要.
- 蛋白转化酶亚素/素9型 (PCSK9) 在胆固醇代谢中起着关键作用.
研究的目的:
- 审查最近对PCSK9抑制剂 (PCSK9i) 的临床研究.
- 专注于在过去18个月内发表的临床相关数据.
- 探索PCSK9抑制的新兴治疗策略.
主要方法:
- 标志性试验 (FOURIER,ODYSSEY结果) 的审查及其子组分析.
- 分析最近的研究,调查早期PCSK9i在急性冠状动脉综合征 (ACS) 和皮肤穿透后冠状动脉干预 (PCI) 中的使用情况.
- 检查在低风险人群中正在进行的结果试验和新的PCSK9抑制方法.
主要成果:
- 新的数据证实了单克隆PCSK9抗体 (evolcumab,alirocumab) 的安全性和有效性.
- 在ACS和PCI后早期的PCSK9i管理显示了对生物标志物和斑块形态的影响.
- 目前正在进行的低风险患者试验可能会扩大PCSK9i的适应性.
- 新的PCSK9抑制方法 (口服,疫苗,基因疗法) 正在开发中.
结论:
- PCSK9抑制剂对于高风险ASCVD患者来说是耐受良好的,强大的降脂剂.
- 预计PCSK9i在较低风险人群和急性心肌梗塞中会扩大适用范围.
- 替代PCSK9抑制策略可能提供更容易获得和更具成本效益的选择.
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