单克隆抗PCSK9抗体:真实世界的数据
Giulia Guidotti1, Viola Liberati1, Andrea Sorrentino1
1Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy.
Journal of clinical medicine
|August 10, 2024
概括
蛋白转化酶亚素/素9型单克隆抗体 (PCSK9mAb) 治疗有助于近60%的高心血管风险患者达到降脂指南. 高剂量的他类药物预测成功,而家族性高胆固醇血症和女性性别与较低的成绩率有关.
科学领域:
- 心脏病学 心脏病学
- 药理学 药理学是指药理学的学科.
- 临床实践研究 临床实践研究
背景情况:
- 许多高心血管风险患者不符合2019年欧洲心脏病学会 (ESC) 指南中的降脂疗法 (LLT) 建议.
- 蛋白转化酶亚素/素9型单克隆抗体 (PCSK9mAb) 提供了一种潜在的解决方案,可以弥合遵守指南的差距.
研究的目的:
- 评估PCSK9mAb在临床实践中的实际利用和有效性.
- 评估在接受PCSK9mAb治疗的患者中实现ESC指南的降脂建议.
主要方法:
- 在2018年4月至2022年12月期间,有256名患者开始PCSK9mAb治疗 (埃沃洛库马布或阿利罗库马布) 的潜在注册.
- 患者按心血管风险 (高或非常高) 分类.
- 评估结果包括低密度脂蛋白胆固醇 (LDL-C) 的降低和一年后实现目标.
主要成果:
- 大约60%的患者在一年的PCSK9mAb治疗后完全遵守ESC指南.
- 完全遵守被定义为≥50%的LDL-C降低和达到目标LDL-C水平 (非常高风险≤55 mg/dL,高风险≤70 mg/dL).
- 高剂量他类药物治疗是实现LDL-C目标的主要预测因素;异构性家族性高胆固醇血清症 (HeFH),他类药物不耐受性和女性性别与较低的成就率有关.
结论:
- PCSK9mAb治疗是安全有效的,使得很大一部分患者能够满足降脂指南.
- 高强度他类药物的使用是PCSK9mAb疗效的关键预测因素.
- 家庭性高胆固醇血症和女性性别在实现治疗目标方面构成挑战,突出了针对性策略的需要,并解决了预防心血管疾病的性别差异.
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