Alirocumab, Praluent® in the light of studies
Authors:
Richard Češka 1; Lucie Votavová 2
Authors place of work:
Centrum preventivní kardiologie, III. interní klinika 1. LF UK a VFN v Praze
1; ScreenProFH, z. s., Praha
2
Published in the journal:
AtheroRev 2016; 1(2): 93-99
Category:
Reviews
Summary
Very promising medicines in the class of brand new hypolipidemic drugs, specifically PCSK9 inhibitors, are now registered on a global scale (alirocumab was the very first medicine of this class in the world registered by an American drug agency FDA) Alirocumab, Praluent is a fully human monoclonal antibody to PCSK-9 enzyme (proprotein convertase subtilisin kexin-9). PCSK-9 enzyme plays an important role in the metabolism of LDL-cholesterol through affecting the breakdown and eventually the amount and activity of LDL-receptors. PCSK9 inhibitors are bringing an important advancement in the treatment of disorders of lipid metabolism and in preventive cardiology. Alirocumab can be administered as monotherapy (mainly to statin-intolerant patients), however it will be primarily administered in combination with the other hypolipidemic drugs (in particular statins) where the effort to reach target values has not succeeded. A very important group of patients indicated for treatment with Praluent will comprise patients with familial hypercholesterolemia (FH). In the modern era of evidence based medicine it is necessary to verify the effects of every new drug in controlled studies. The presented conclusions focus on the results of the studies which verified the effects of alirocumab therapy on lipids and lipoproteins, on safety parameters and selected indicators, which suggest at least preliminary conclusions in favour of cardiovascular efficacy and safety. As our centre has its own extensive experience of conducting studies with alirocumab, the final part also considers a subjective view on the studies with this new hypolipidemic drug.
Key words:
alirocumab – cardiovascular risk – familial hypercholesterolemia – Praluent® – statin intolerance
Zdroje
1. Robinson JG, Farnier M, Krempf M et al. ODYSSEY LONG TERM Investigators. Efficacy and Safety of Alirocumab in Reducing Lipids and Cardiovascular Events. N Engl J Med 2015; 372(16): 1489–1499.
2. Moriarty PM, Jacobson TA, Bruckert E et al. Efficacy and safety of alirocumab, a monoclonal antibody to PCSK9, in statin-intolerant patients: Design and rationale of ODYSSEY ALTERNATIVE, a randomized phase 3 trial. J Clin Lipidol 2014; 8(6): 554–561.
3. Cannon CP, Blazing MA, Giuliano RP et al. IMPROVE-IT Investigators. Ezetimibe Added to Statin Therapy after Acute Coronary Syndromes. N Engl J Med 2015; 372(25): 2387–2397.
4. McKenney J, Swergold G, DiCioccio T et al. Dynamics between the monoclonal antibody alirocumab (SAR236553/REGN727), Proprotein Convertase Subtilisin/Kexin Type 9 (PCSK9) and low-density lipoprotein cholesterol (LDL-C) levels. In: 81st European Atherosclerosis Society Congress. Lyon, France. 2013. [abstract no. 298]. Dostupné z WWW: <http://www2.kenes.com/eas2013/pages/home.aspx>.
5. Lunven C, Paehler T, Poitiers F et al. A randomized study of the relative pharmacokinetics, pharmacodynamics, and safety of alirocumab, a fully human monoclonal antibody to PCSK9, after single subcutaneous administration at three different injection sites in healthy subjects. Cardiovasc Ther 2014; 32(6): 297–301.
6. Regeneron Pharmaceuticals Inc, Sanofi-aventis. PRALUENT (alirocumab): US prescribing Information. 2015. Dostupné z WWW: <http://www.regeneron.com/Praluent/Praluent-fpi.pdf>.
7. Rey J, Poitiers F, Paehler T et al. Randomized, partial blind study of the pharmacodynamics, pharmacokinetics and safety of multiple subcutaneous doses of alirocumab, a fully human monoclonal antibody to proprotein convertase subtilisin/kexin type 9, administered every 4 weeks alone or in combination with ezetimibe or fenofibrate in healthy subjects. J Am Coll Cardiol 2014; 63(12 S). Dostupné z DOI: <http://dx.doi.org/10.1016/S0735–1097(14)61375–9>.
8. Kereiakes DJ, Robinson JG, Cannon CP et al. Efficacy and safety of the proprotein convertase subtilisin/kexin type 9 inhibitor alirocumab among high cardiovascular risk patients on maximally tolerated statin therapy: The ODYSSEY COMBO I study. Am Heart J 2015; 169(6): 906–915.e13. Dostupné z DOI: <http://dx.doi.org/10.1016/j.ahj.2015.03.004>.
9. Cannon CP, Cariou B, Blom D et al. [ODYSSEY COMBO II Investigators]. Efficacy and safety of alirocumab in high cardiovascular risk patients with inadequately controlled hypercholesterolaemia on maximally tolerated doses of statins: the ODYSSEY COMBO II randomized controlled trial. Eur Heart J 2015; 36(19): 1186–1194.
10. Robinson JG, Farnier M, Krempf M et al. [ODYSSEY LONG TERM Investigators]. Efficacy and safety of alirocumab in reducing lipids and cardiovascular events. N Engl J Med 2015; 372(16): 1489–1499.
11. Bays H, Gaudet D, Weiss R et al. Alirocumab as add-on to atorvastatin versus other lipid treatment strategies: ODYSSEY OPTIONS I randomized trial. J Clin Endocrinol Metab 2015; 100(8): 3140–3148.
12. Bays H, Farnier M, Gaudet D et al. Efficacy and safety of combining alirocumab with atorvastatin or rosuvastatin versus statin intensification or adding ezetimibe in high cardiovascular risk patients: ODYSSEY OPTIONS I and II [Late-Breaking Clinical Trial Abstracts]. Circulation 2014; 130(23): 2118–2119.
13. Roth E, Rader DJ, Moriarty P. Phase 3 randomized trial evaluating alirocumab every four weeks dosing as add-on to statin or as monotherapy: ODYSSEY CHOICE I. In: 17th International Symposium on Atherosclerosis. Amsterdam 2015. Dostupné z WWW: <http://www.athero.org/isa2015/ClinicalBreak/Roth.pdf>.
14. McKenney JM, Koren MJ, Kereiakes DJ et al. Safety and efficacy of a monoclonal antibody to proprotein convertase subtilisin/kexin type 9 serine protease, SAR236553/REGN727, in patients with primary hypercholesterolemia receiving ongoing stable atorvastatin therapy. J Am Coll Cardiol 2012; 59(25): 2344–2353.
15. Roth EM, McKenney JM, Hanotin C et al. Atorvastatin with or without an antibody to PCSK9 in primary hypercholesterolemia. N Engl J Med 2012; 367(20): 1891–1900.
16. Teramoto T, Kobayashi M, Uno K et al. Efficacy and safety of alirocumab in Japanese patients with hypercholesterolemia on stable statin therapy: first data with the 75 mg every two weeks dose [abstract no. 13651]. In: 87th Annual Scientific Sessions of the American Heart Association. 2014.
17. Roth EM, Taskinen MR, Ginsberg HN et al. Monotherapy with the PCSK9 inhibitor alirocumab versus ezetimibe in patients with hypercholesterolemia: results of a 24 week, double-blind, randomized phase 3 trial. Int J Cardiol 2014; 176(1): 55–61.
18. Moriarty PM, Thompson PD, Cannon CP et al. [ODYSSEY ALTERNATIVE Investigators]. Efficacy and safety of alirocumab vs ezetimibe in statin-intolerant patients, with a statin rechallenge arm: The ODYSSEY ALTERNATIVE randomized trial. J Clin Lipidol 2015; 9(6): 758–769.
19. Kastelein JJ, Robinson JG, Farnier M. Efficacy and safety of alirocumab in patients with heterozygous familial hypercholesterolaemia not adequately controlled with current lipid-lowering therapy: results of ODYSSEY FH I and FH II studies [abstract no. 2125]. In: European Society of Cardiology. 2015
20. Ginsberg HN, Rader DJ, Raal FJ. ODYSSEY HIGH FH: Efficacy and safety of alirocumab in patients with severe heterozygous familial hypercholesterolemia. Circulation 2014; 130(23): 2119. Dostupné z WWW: <https://my.americanheart.org/idc/groups/ahamah-public/@wcm/@sop/@scon/documents/downloadable/ucm_469616.pdf>.
21. Stein EA, Gipe D, Bergeron J et al. Effect of a monoclonal antibody to PCSK9, REGN727/SAR236553, to reduce low-density lipoprotein cholesterol in patients with heterozygous familial hypercholesterolaemia on stable statin dose with or without ezetimibe therapy: a phase 2 randomised controlled trial. Lancet 2012; 380(9836): 29–36.
Štítky
Angiology Diabetology Internal medicine Cardiology General practitioner for adultsČlánok vyšiel v časopise
Athero Review
2016 Číslo 2
- Advances in the Treatment of Myasthenia Gravis on the Horizon
- Memantine Eases Daily Life for Patients and Caregivers
- Spasmolytic Effect of Metamizole
- Metamizole at a Glance and in Practice – Effective Non-Opioid Analgesic for All Ages
- What Effect Can Be Expected from Limosilactobacillus reuteri in Mucositis and Peri-Implantitis?
Najčítanejšie v tomto čísle
- Monoclonal antibodies in the internal medicine
- Diabetes mellitus and lipid metabolism
- Alirocumab, Praluent® in the light of studies
- LDL-cholesterol – the main risk factor for atherosclerosis