12 Aug Metabolic Syndrome Can Help Identify Patients Who Benefit Most From PCSK9 Inhibition With Evolocumab – Repatha®
MedicalResearch.com Interview with:
Prakash Deedwania, MD, FACC,FAHA,FASH,FHFSA,FESC
Professor of Medicine, UCSF School of Medicine,
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: This paper describes the findings form the FOURIER study, a very large study evaluating the efficacy of evolocumab, a PCSK9 inhibitor in patients with metabolic syndrome and preexisting atherosclerotic cardiovascular disease (ASCVD) who were already being treated with statins.
In this largest study of its kind of 27,000 patients we found that 60% of patients with ASCVD had metabolic syndrome. We also found that the presence of metabolic syndrome identified a higher risk of future cardiac & coronary events in these patients despite them receiving maximum tolerated doses of statin.
Furthermore, study treatment with evolocumab was efficacious in reducing the increased risk during the median follow up of nearly 3 years . Unlike treatment with statins there was no risk of new-onset diabetes with evolocumab, which was generally well tolerated. What was interesting thatpatients without metabolic syndrome had much less benefit with PCSK9 inhibition. These findings suggest that the presence of metabolic syndrome can help the clinicians identify the ASCVD patients who are most likely to benefit from treatment with PCSK9 inhibitors. This will be of great help for the cost containment of therapeutic strategy as PCSK9 inhibitors as a class are still quite expensive drugs.
MedicalResearch.com: What should readers take away from your report?
Response: The main message from our findings is that the presence of metabolic syndrome can help identify the group of ASCVD patients who are at high risk of major adverse cardiac events which can be effectively reduced by evolocumab. Those without metabolic syndrome are less likely to benefit.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: The future study should evaluate the cost-effectiveness of the therapeutic strategy based on presence or absence of metabolic syndrome in patients with ASCVD.
Deedwania P, Murphy SA, Scheen A, et al. Efficacy and Safety of PCSK9 Inhibition With Evolocumab in Reducing Cardiovascular Events in Patients With Metabolic Syndrome Receiving Statin Therapy: Secondary Analysis From the FOURIER Randomized Clinical Trial. JAMA Cardiol. Published online August 12, 2020. doi:10.1001/jamacardio.2020.3151
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