Page 9 - Dyslipidaemia for programming

REFLECTIONS dae mia
Dyslipidaemia Global Newsletter #3
aim ead
Dyslipi

Long-term LDL-C lowering with evolocumab was found to be safe and well-tolerated for over eight years. The clinical benefit oDyfslipi
evolocumab was more evident after 12 months of treatment in the parent FOURIER study. This observation is consistent with the
lag in clinical benefit also observed with LDL-C lowering with statins.

Earlier initiation of evolocumab is associated with
continued accrual of CV benefits, including MACE
and CV mortality, as evidenced by the continued
divergence in the curves in the first several years
after the FOURIER trial when patients were
transitioned from placebo to evolocumab. This
resulted in a 15% reduction in HR for the primary
endpoint of CV death, MI, stroke, unstable angina, or
coronary revascularization in the evolocumab group
that continued with evolocumab, compared to the
placebo group that initiated evolocumab in the open-
label extension period. It also resulted in a 20%
reduction in the HR for the key secondary endpoint
of CV death, MI, or stroke. This reflects the legacy
effect that occurs from aggressive lowering of LDL-C
that continues to be observed through long-term
follow-up.

Large-scale, long-term data were limited for PCSK9
inhibitors. In the Evaluation of Cardiovascular
Outcomes After an Acute Coronary Syndrome During
Treatment With Alirocumab (ODYSSEY OUTCOMES)
trial, the monoclonal PCSK9 antibody alirocumab
reduced the risk of major adverse cardiovascular
events by 15% and nominally reduced mortality in
patients after an acute coronary syndrome over a
median of 2.8 years with greater apparent benefit
for those patients treated longer than three years.

CLINICAL PEARLS FROM THE FACULTY This FOURIER-OLE is the longest follow-up available to date
on a PCSK9 inhibitor. It supports the notion of earlier initiation
of treatment strategies to lower LDL-C and the importance of
adequate follow-up on CV outcomes in trials of lipid-modifying
therapy on the order of five years to fully define the clinical
benefits.

CLICK HERE
FOR THE LINK TO FULL ARTICLE

WATCH
PROF. LAVALLE COBO DISCUSS THE
CLINICAL APPLICATIONS OF THE
RESULTS FROM THE FOURIER OPEN
LABEL EXTENSION STUDY.

TABLE OF CONTENTS