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Эффективность и безопасность применения алирокумаба в реальной клинической практике
Эффективность и безопасность применения алирокумаба в реальной клинической практике
Корнева В.А., Кузнецова Т.Ю., Скопец И.С., Везикова Н.Н. Эффективность и безопасность применения алирокумаба в реальной клинической практике. Терапевтический архив. 2022;94(12):1401–1406.
DOI: 10.26442/00403660.2022.12.201991
© ООО «КОНСИЛИУМ МЕДИКУМ», 2022 г.
DOI: 10.26442/00403660.2022.12.201991
© ООО «КОНСИЛИУМ МЕДИКУМ», 2022 г.
________________________________________________
Материалы доступны только для специалистов сферы здравоохранения. Авторизуйтесь или зарегистрируйтесь.
Аннотация
Цель. Оценить результаты двухлетнего применения ингибитора PCSK9 алирокумаба.
Материалы и методы. Группу наблюдения составили 27 пациентов (17 человек с семейной гиперхолестеринемией и 10 пациентов, перенесших инфаркт миокарда), средний возраст – 53,4±4,3 года, мужчин – 70,3%, длительность наблюдения – от 1 до 2,5 года, 18 (66,6%) пациентов получали терапию более 2 лет. Так, 19 пациентов получали алирокумаб в дозе 75 мг/мл 1 раз в 2 нед, 8 – в дозе 150 мг/мл 1 раз в 2 нед. До начала терапии большинство получали максимально переносимую терапию статинами, 10 человек – терапию статинами в сочетании с эзетимибом, 3 пациента – монотерапию эзетимибом из-за непереносимости статинов. Целевыми уровнями холестерина (ХС) липопротеидов низкой плотности (ЛНП) считали для пациентов очень высокого риска менее 1,4 ммоль/л, высокого риска – менее 1,8 ммоль/л, экстремального риска – менее 1 ммоль/л.
Результаты. Снижение ХС ЛНП на терапии алирокумабом 58%; целевые уровни ХС ЛНП достигнуты у 77,8%. Уровень снижения ХС ЛНП менее 50%, несмотря на увеличение дозы алирокумаба до 150 мг, отмечен только в 7,4% случаев. Пациенты, потребовавшие перевода на большую дозу препарата, относились к категории очень высокого риска и характеризовались более высоким уровнем ХС и ХС ЛНП, большей частотой встречаемости ишемической болезни сердца, преобладанием мультифокального атеросклеротического поражения. Уровень снижения липопротеидов (а) составил 24,3% к 3-му месяцу терапии, 29,7% – к 6–12-му месяцу. Дестабилизации течения ишемической болезни сердца, новых случаев острого нарушения мозгового кровообращения и транзиторных ишемических атак не зарегистрировано. Для терапии алирокумабом характерны высокая приверженность и хорошая переносимость с отсутствием побочных реакций, в том числе и местного характера.
Заключение. Включение в схему лечения алирокумаба способствовало стабильному течению ИБС, достижению ассоциированных с атеросклерозом целевых показателей ХС ЛНП у 77,8% пациентов, не сопровождалось побочными эффектами в течение двухлетней терапии.
Ключевые слова: гиполипидемическая терапия, алирокумаб, ингибиторы PCSK9, сердечно-сосудистый риск
Materials and methods. The observation group consisted of 27 patients (17 patients with familial hypercholesterolemia, 10 patients with the history of myocardial infarction), mean age 53.4±4.3 years, 70.3% men, follow-up duration from one year to 2.5 years, 18 (66.6%) patients received therapy for more than 2 years. 19 patients received alirocumab at a dose of 75 mg/ml once every 2 weeks, eight – at a dose of 150 mg/ml once every 2 weeks. Before the start of therapy, the majority received maximally tolerated statin therapy, 10 patients received statin therapy in combination with ezetemibe, 3 patients received ezetemibe monotherapy due to statin intolerance. The target levels of LDL cholesterol were considered for very high risk patients less than 1.4 mmol/L, high risk – less than 1.8 mmol/L, extreme risk – less than 1 mmol/L.
Results. The reduction of LDL on therapy with alirocumab was 58%; target levels of LDL were achieved in 77.8%. The level of decrease in LDL cholesterol less than 50% was noted only in 7.4% of cases. Patients requiring a large dose of the drug were classified as very high risk, had higher cholesterol and LDL-C levels. The level of Lp(a) decrease on 29.7% by 6–12 months. No destabilization of coronary heart disease, new cases of stroke were registered.
Conclusion. The inclusion of alirocumab in the treatment regimen contributed to the stable course of atherosclerosis-associated diseases, the achievement of LDL cholesterol targets in 77.8% of patients, was not accompanied by side effects during 2.5 years therapy.
Keywords: hypolipidemic therapy, alirocumab, inhibitor PCSK9, high cardiovascular risk
Материалы и методы. Группу наблюдения составили 27 пациентов (17 человек с семейной гиперхолестеринемией и 10 пациентов, перенесших инфаркт миокарда), средний возраст – 53,4±4,3 года, мужчин – 70,3%, длительность наблюдения – от 1 до 2,5 года, 18 (66,6%) пациентов получали терапию более 2 лет. Так, 19 пациентов получали алирокумаб в дозе 75 мг/мл 1 раз в 2 нед, 8 – в дозе 150 мг/мл 1 раз в 2 нед. До начала терапии большинство получали максимально переносимую терапию статинами, 10 человек – терапию статинами в сочетании с эзетимибом, 3 пациента – монотерапию эзетимибом из-за непереносимости статинов. Целевыми уровнями холестерина (ХС) липопротеидов низкой плотности (ЛНП) считали для пациентов очень высокого риска менее 1,4 ммоль/л, высокого риска – менее 1,8 ммоль/л, экстремального риска – менее 1 ммоль/л.
Результаты. Снижение ХС ЛНП на терапии алирокумабом 58%; целевые уровни ХС ЛНП достигнуты у 77,8%. Уровень снижения ХС ЛНП менее 50%, несмотря на увеличение дозы алирокумаба до 150 мг, отмечен только в 7,4% случаев. Пациенты, потребовавшие перевода на большую дозу препарата, относились к категории очень высокого риска и характеризовались более высоким уровнем ХС и ХС ЛНП, большей частотой встречаемости ишемической болезни сердца, преобладанием мультифокального атеросклеротического поражения. Уровень снижения липопротеидов (а) составил 24,3% к 3-му месяцу терапии, 29,7% – к 6–12-му месяцу. Дестабилизации течения ишемической болезни сердца, новых случаев острого нарушения мозгового кровообращения и транзиторных ишемических атак не зарегистрировано. Для терапии алирокумабом характерны высокая приверженность и хорошая переносимость с отсутствием побочных реакций, в том числе и местного характера.
Заключение. Включение в схему лечения алирокумаба способствовало стабильному течению ИБС, достижению ассоциированных с атеросклерозом целевых показателей ХС ЛНП у 77,8% пациентов, не сопровождалось побочными эффектами в течение двухлетней терапии.
Ключевые слова: гиполипидемическая терапия, алирокумаб, ингибиторы PCSK9, сердечно-сосудистый риск
________________________________________________
Materials and methods. The observation group consisted of 27 patients (17 patients with familial hypercholesterolemia, 10 patients with the history of myocardial infarction), mean age 53.4±4.3 years, 70.3% men, follow-up duration from one year to 2.5 years, 18 (66.6%) patients received therapy for more than 2 years. 19 patients received alirocumab at a dose of 75 mg/ml once every 2 weeks, eight – at a dose of 150 mg/ml once every 2 weeks. Before the start of therapy, the majority received maximally tolerated statin therapy, 10 patients received statin therapy in combination with ezetemibe, 3 patients received ezetemibe monotherapy due to statin intolerance. The target levels of LDL cholesterol were considered for very high risk patients less than 1.4 mmol/L, high risk – less than 1.8 mmol/L, extreme risk – less than 1 mmol/L.
Results. The reduction of LDL on therapy with alirocumab was 58%; target levels of LDL were achieved in 77.8%. The level of decrease in LDL cholesterol less than 50% was noted only in 7.4% of cases. Patients requiring a large dose of the drug were classified as very high risk, had higher cholesterol and LDL-C levels. The level of Lp(a) decrease on 29.7% by 6–12 months. No destabilization of coronary heart disease, new cases of stroke were registered.
Conclusion. The inclusion of alirocumab in the treatment regimen contributed to the stable course of atherosclerosis-associated diseases, the achievement of LDL cholesterol targets in 77.8% of patients, was not accompanied by side effects during 2.5 years therapy.
Keywords: hypolipidemic therapy, alirocumab, inhibitor PCSK9, high cardiovascular risk
Полный текст
Список литературы
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DOI:10.34687/2219-8202.JAD.2020.01.0002
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4. Sabatine MS, Giugliano RP, Keech AC, et al. Further Cardiovascular Outcomes Research with PCSK9 Inhibition in Subjects with Elevated Risk (FOURIER) Evolocumab and Clinical Outcomes in Patients with Cardiovascular Disease. N Engl J Med. 2017;376:1713-22. DOI:10.1056/NEJMoa1615664
5. Schwartz GG, Steg PG, Szarek M, et al. ODYSSEY OUTCOMES Committees and Investigators. Alirocumab and Cardiovascular Outcomes after Acute Coronary Syndrome. N Engl J Med. 2018;379:2097-107. DOI:10.1056/NEJMoa1801174
6. Stock JK. Da Vinchi study: change in approach to cholesterol management will be needed to reduce the implementation gap between guidlines and clinical practice in Europe. Atherosclerosis. 2020;314:74-6. DOI:10.1016/j.atherosclerosis.2020.09.023
7. Farnier M, Gaudet D, Valcheva V, et al. Efficacy of alirocumab in high cardiovascular risk populations with or without heterozygous familial hypercholesterolemia: pooled analysis of eight ODYSSEY Phase 3 clinical program trials. Int J Cardiol. 2016;223:750-7. DOI:10.1016/j.ijcard.2016.08.273
8. Kastelein JJ, Hovingh GK, Langslet G, et al. Efficacy and safety of the proprotein convertase subtilisin/kexin type 9 monoclonal antibody alirocumab vs placebo in patients with heterozygous familial hypercholesterolemia. J Clin Lipidol. 2017;11:195-203. DOI:10.1016/j.jacl.2016.12.004
9. Goldberg AC, Dunbar RL, Hemphill L, et al. A retrospective analysis of clinical use of alirocumab in lipoprotein apheresis patients. J Clin Lipidol. 2020;14:818-24. DOI:10.1016/j.jacl.2020.08.005
10. Schwartz GG, Szarek MM, Bhatt DL, et al. Alirocumab Reduces Risk of Death after Acute Coronary Syndrome in Patients with Persistently Elevated Atherogenic Lipoproteins on Intensive Statin Treatment. Presentation at American Heart Association Scientific Session (November 11, 2018), Chicago (Illinois), USA. Available at: http://abstractsonline.com/pp8/#!/ 4682/presentation/59973. Accessed: 10.11.2018.
11. Tunon J, Steg PJ, Bhatt DL, et al. Effect of alirocumab onmajor adverse cardiovascular events according to renal function in patients with a recent acute coronary syndrome: prespecified analysis from the ODYSSEY OUTCOMES randomized clinical trial. Eur Heart J. 2020;41:4114-23. DOI:10.1093/eurheartj/ehaa498
12. Cholesterol Treatment Trialists’ (CTT) Collaboration. Impact of renal function on the effects of LDL cholesterol lowering with statin-based regimens: a meta-analysis of individual participant data from 28 randomised trials. Lancet Diabetes Endocrinol. 2016;4:829-39. DOI:10.1016/S2213-8587(16)30156-5
13. Sagris D, Ntaios G, Georgiopoulos G, et al. Proprotein Convertase Subtilisin-Kexin Type 9 inhibitors and stroke prevention: A meta-analysis. Eur J Intern Med. 2021;85:130-2. DOI:10.1016/j.ejim.2020.11.021
14. Diaz R, Li QH, Bhatt DL. Intensity of statin treatment after acute coronary syndrome, residual risk, and its modification by alirocumab: insights from the ODYSSEY OUTCOMES trial. Eur J Prev Cardiol. 2021;28:33-43. DOI:10.1177/2047487320941987
15. Benhuria B, Ueyamaa H, Takagib H, et al. PCSK9 Inhibitors and Ezetimibe Monotherapy in Patients Not Receiving Statins: A Meta-Analysis of Randomized Trials. Curr Vasc Pharmacol. 2020;18:1-8. DOI:10.2174/1570161118666200807114559
16. Bittner VA, Szarek M, Aylward PE, et al. Effect of Alirocumab on Lipoprotein(a) and Cardiovascular Risk After Acute Coronary Syndrome. J Am Col Cardiol. 2020;75(2):133-44. DOI:10.1016/j.jacc.2019.10.057
17. Карпов Ю.А. Ингибиторы PCSK9 в улучшении прогноза у пациентов после острого коронарного синдрома: данные исследования ODYSSEY OUTCOMES. Рациональная фармакотерапия в кардиологии. 2018;14(6):922-34 [Karpov YuA. The Role of PCSK9 Inhibitors in the Improvement of Outcomes in Patients after Acute Coronary Syndrome: Results of ODYSSEY OUTCOMES Trial. Rational Pharmacotherapy in Cardiology. 2018;14(6):922-34 (in Russian)]. DOI:10.20996/1819-6446-2018-14-6-922-934
18. Szarek M, Bittner VA, Aylward P. Lipoprotein(a) lowering by alirocumab reduces the total burden of cardiovascular events independent of low-density lipoprotein cholesterol lowering: ODYSSEY OUTCOMES trial. Eur Heart J. 2020(41):4245-55. DOI:10.1093/eurheartj/ehaa649
19. Brandts J, Ray K, Hons B. Low Density Lipoprotein Cholesterol – Lowering Strategies and Population Health Time to Move to a Cumulative Exposure Model. Circulation. 2020;141:873-6. DOI:10.1161/CIRCULATIONAHA.119.043406
2. Mach F, Baigent C, Catapano AL, et al. 2019ESC/EAS Guidelines for the management of dyslipidemias: lipid modification to reduce cardiovascular risk. Eur Heart J. 2020;41(1):111-88. DOI:10.1093/eurheartj/ehz455
3. Kukharchuk VV. About the new version of recommendations for the correction of dyslipidemia in order to prevent atherosclerosis and its complications. Atherosclerosis and Dyslipidemia. 2020;1:5-6 (in Russian). DOI:10.34687/2219-8202.JAD.2020.01.0001
4. Sabatine MS, Giugliano RP, Keech AC, et al. Further Cardiovascular Outcomes Research with PCSK9 Inhibition in Subjects with Elevated Risk (FOURIER) Evolocumab and Clinical Outcomes in Patients with Cardiovascular Disease. N Engl J Med. 2017;376:1713-22. DOI:10.1056/NEJMoa1615664
5. Schwartz GG, Steg PG, Szarek M, et al. ODYSSEY OUTCOMES Committees and Investigators. Alirocumab and Cardiovascular Outcomes after Acute Coronary Syndrome. N Engl J Med. 2018;379:2097-107. DOI:10.1056/NEJMoa1801174
6. Stock JK. Da Vinchi study: change in approach to cholesterol management will be needed to reduce the implementation gap between guidlines and clinical practice in Europe. Atherosclerosis. 2020;314:74-6. DOI:10.1016/j.atherosclerosis.2020.09.023
7. Farnier M, Gaudet D, Valcheva V, et al. Efficacy of alirocumab in high cardiovascular risk populations with or without heterozygous familial hypercholesterolemia: pooled analysis of eight ODYSSEY Phase 3 clinical program trials. Int J Cardiol. 2016;223:750-7. DOI:10.1016/j.ijcard.2016.08.273
8. Kastelein JJ, Hovingh GK, Langslet G, et al. Efficacy and safety of the proprotein convertase subtilisin/kexin type 9 monoclonal antibody alirocumab vs placebo in patients with heterozygous familial hypercholesterolemia. J Clin Lipidol. 2017;11:195-203. DOI:10.1016/j.jacl.2016.12.004
9. Goldberg AC, Dunbar RL, Hemphill L, et al. A retrospective analysis of clinical use of alirocumab in lipoprotein apheresis patients. J Clin Lipidol. 2020;14:818-24. DOI:10.1016/j.jacl.2020.08.005
10. Schwartz GG, Szarek MM, Bhatt DL, et al. Alirocumab Reduces Risk of Death after Acute Coronary Syndrome in Patients with Persistently Elevated Atherogenic Lipoproteins on Intensive Statin Treatment. Presentation at American Heart Association Scientific Session (November 11, 2018), Chicago (Illinois), USA. Available at: http://abstractsonline.com/pp8/#!/ 4682/presentation/59973. Accessed: 10.11.2018.
11. Tunon J, Steg PJ, Bhatt DL, et al. Effect of alirocumab onmajor adverse cardiovascular events according to renal function in patients with a recent acute coronary syndrome: prespecified analysis from the ODYSSEY OUTCOMES randomized clinical trial. Eur Heart J. 2020;41:4114-23. DOI:10.1093/eurheartj/ehaa498
12. Cholesterol Treatment Trialists’ (CTT) Collaboration. Impact of renal function on the effects of LDL cholesterol lowering with statin-based regimens: a meta-analysis of individual participant data from 28 randomised trials. Lancet Diabetes Endocrinol. 2016;4:829-39. DOI:10.1016/S2213-8587(16)30156-5
13. Sagris D, Ntaios G, Georgiopoulos G, et al. Proprotein Convertase Subtilisin-Kexin Type 9 inhibitors and stroke prevention: A meta-analysis. Eur J Intern Med. 2021;85:130-2. DOI:10.1016/j.ejim.2020.11.021
14. Diaz R, Li QH, Bhatt DL. Intensity of statin treatment after acute coronary syndrome, residual risk, and its modification by alirocumab: insights from the ODYSSEY OUTCOMES trial. Eur J Prev Cardiol. 2021;28:33-43. DOI:10.1177/2047487320941987
15. Benhuria B, Ueyamaa H, Takagib H, et al. PCSK9 Inhibitors and Ezetimibe Monotherapy in Patients Not Receiving Statins: A Meta-Analysis of Randomized Trials. Curr Vasc Pharmacol. 2020;18:1-8. DOI:10.2174/1570161118666200807114559
16. Bittner VA, Szarek M, Aylward PE, et al. Effect of Alirocumab on Lipoprotein(a) and Cardiovascular Risk After Acute Coronary Syndrome. J Am Col Cardiol. 2020;75(2):133-44. DOI:10.1016/j.jacc.2019.10.057
17. Karpov YuA. The Role of PCSK9 Inhibitors in the Improvement of Outcomes in Patients after Acute Coronary Syndrome: Results of ODYSSEY OUTCOMES Trial. Rational Pharmacotherapy in Cardiology. 2018;14(6):922-34 (in Russian). DOI:10.20996/1819-6446-2018-14-6-922-934
18. Szarek M, Bittner VA, Aylward P. Lipoprotein(a) lowering by alirocumab reduces the total burden of cardiovascular events independent of low-density lipoprotein cholesterol lowering: ODYSSEY OUTCOMES trial. Eur Heart J. 2020(41):4245-55. DOI:10.1093/eurheartj/ehaa649
19. Brandts J, Ray K, Hons B. Low Density Lipoprotein Cholesterol – Lowering Strategies and Population Health Time to Move to a Cumulative Exposure Model. Circulation. 2020;141:873-6. DOI:10.1161/CIRCULATIONAHA.119.043406
DOI:10.34687/2219-8202.JAD.2020.01.0002
2. Mach F, Baigent C, Catapano AL, et al. 2019ESC/EAS Guidelines for the management of dyslipidemias: lipid modification to reduce cardiovascular risk. Eur Heart J. 2020;41(1):111-88. DOI:10.1093/eurheartj/ehz455
3. Кухарчук В.В. О новой версии рекомендаций по коррекции дислипидемии с целью профилактики атеросклероза и его осложнений. Атеросклероз и дислипидемии. 2020;1:5-6 [Kukharchuk VV. About the new version of recommendations for the correction of dyslipidemia in order to prevent atherosclerosis and its complications. Atherosclerosis and Dyslipidemia. 2020;1:5-6 (in Russian)]. DOI:10.34687/2219-8202.JAD.2020.01.0001
4. Sabatine MS, Giugliano RP, Keech AC, et al. Further Cardiovascular Outcomes Research with PCSK9 Inhibition in Subjects with Elevated Risk (FOURIER) Evolocumab and Clinical Outcomes in Patients with Cardiovascular Disease. N Engl J Med. 2017;376:1713-22. DOI:10.1056/NEJMoa1615664
5. Schwartz GG, Steg PG, Szarek M, et al. ODYSSEY OUTCOMES Committees and Investigators. Alirocumab and Cardiovascular Outcomes after Acute Coronary Syndrome. N Engl J Med. 2018;379:2097-107. DOI:10.1056/NEJMoa1801174
6. Stock JK. Da Vinchi study: change in approach to cholesterol management will be needed to reduce the implementation gap between guidlines and clinical practice in Europe. Atherosclerosis. 2020;314:74-6. DOI:10.1016/j.atherosclerosis.2020.09.023
7. Farnier M, Gaudet D, Valcheva V, et al. Efficacy of alirocumab in high cardiovascular risk populations with or without heterozygous familial hypercholesterolemia: pooled analysis of eight ODYSSEY Phase 3 clinical program trials. Int J Cardiol. 2016;223:750-7. DOI:10.1016/j.ijcard.2016.08.273
8. Kastelein JJ, Hovingh GK, Langslet G, et al. Efficacy and safety of the proprotein convertase subtilisin/kexin type 9 monoclonal antibody alirocumab vs placebo in patients with heterozygous familial hypercholesterolemia. J Clin Lipidol. 2017;11:195-203. DOI:10.1016/j.jacl.2016.12.004
9. Goldberg AC, Dunbar RL, Hemphill L, et al. A retrospective analysis of clinical use of alirocumab in lipoprotein apheresis patients. J Clin Lipidol. 2020;14:818-24. DOI:10.1016/j.jacl.2020.08.005
10. Schwartz GG, Szarek MM, Bhatt DL, et al. Alirocumab Reduces Risk of Death after Acute Coronary Syndrome in Patients with Persistently Elevated Atherogenic Lipoproteins on Intensive Statin Treatment. Presentation at American Heart Association Scientific Session (November 11, 2018), Chicago (Illinois), USA. Available at: http://abstractsonline.com/pp8/#!/ 4682/presentation/59973. Accessed: 10.11.2018.
11. Tunon J, Steg PJ, Bhatt DL, et al. Effect of alirocumab onmajor adverse cardiovascular events according to renal function in patients with a recent acute coronary syndrome: prespecified analysis from the ODYSSEY OUTCOMES randomized clinical trial. Eur Heart J. 2020;41:4114-23. DOI:10.1093/eurheartj/ehaa498
12. Cholesterol Treatment Trialists’ (CTT) Collaboration. Impact of renal function on the effects of LDL cholesterol lowering with statin-based regimens: a meta-analysis of individual participant data from 28 randomised trials. Lancet Diabetes Endocrinol. 2016;4:829-39. DOI:10.1016/S2213-8587(16)30156-5
13. Sagris D, Ntaios G, Georgiopoulos G, et al. Proprotein Convertase Subtilisin-Kexin Type 9 inhibitors and stroke prevention: A meta-analysis. Eur J Intern Med. 2021;85:130-2. DOI:10.1016/j.ejim.2020.11.021
14. Diaz R, Li QH, Bhatt DL. Intensity of statin treatment after acute coronary syndrome, residual risk, and its modification by alirocumab: insights from the ODYSSEY OUTCOMES trial. Eur J Prev Cardiol. 2021;28:33-43. DOI:10.1177/2047487320941987
15. Benhuria B, Ueyamaa H, Takagib H, et al. PCSK9 Inhibitors and Ezetimibe Monotherapy in Patients Not Receiving Statins: A Meta-Analysis of Randomized Trials. Curr Vasc Pharmacol. 2020;18:1-8. DOI:10.2174/1570161118666200807114559
16. Bittner VA, Szarek M, Aylward PE, et al. Effect of Alirocumab on Lipoprotein(a) and Cardiovascular Risk After Acute Coronary Syndrome. J Am Col Cardiol. 2020;75(2):133-44. DOI:10.1016/j.jacc.2019.10.057
17. Карпов Ю.А. Ингибиторы PCSK9 в улучшении прогноза у пациентов после острого коронарного синдрома: данные исследования ODYSSEY OUTCOMES. Рациональная фармакотерапия в кардиологии. 2018;14(6):922-34 [Karpov YuA. The Role of PCSK9 Inhibitors in the Improvement of Outcomes in Patients after Acute Coronary Syndrome: Results of ODYSSEY OUTCOMES Trial. Rational Pharmacotherapy in Cardiology. 2018;14(6):922-34 (in Russian)]. DOI:10.20996/1819-6446-2018-14-6-922-934
18. Szarek M, Bittner VA, Aylward P. Lipoprotein(a) lowering by alirocumab reduces the total burden of cardiovascular events independent of low-density lipoprotein cholesterol lowering: ODYSSEY OUTCOMES trial. Eur Heart J. 2020(41):4245-55. DOI:10.1093/eurheartj/ehaa649
19. Brandts J, Ray K, Hons B. Low Density Lipoprotein Cholesterol – Lowering Strategies and Population Health Time to Move to a Cumulative Exposure Model. Circulation. 2020;141:873-6. DOI:10.1161/CIRCULATIONAHA.119.043406
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13. Sagris D, Ntaios G, Georgiopoulos G, et al. Proprotein Convertase Subtilisin-Kexin Type 9 inhibitors and stroke prevention: A meta-analysis. Eur J Intern Med. 2021;85:130-2. DOI:10.1016/j.ejim.2020.11.021
14. Diaz R, Li QH, Bhatt DL. Intensity of statin treatment after acute coronary syndrome, residual risk, and its modification by alirocumab: insights from the ODYSSEY OUTCOMES trial. Eur J Prev Cardiol. 2021;28:33-43. DOI:10.1177/2047487320941987
15. Benhuria B, Ueyamaa H, Takagib H, et al. PCSK9 Inhibitors and Ezetimibe Monotherapy in Patients Not Receiving Statins: A Meta-Analysis of Randomized Trials. Curr Vasc Pharmacol. 2020;18:1-8. DOI:10.2174/1570161118666200807114559
16. Bittner VA, Szarek M, Aylward PE, et al. Effect of Alirocumab on Lipoprotein(a) and Cardiovascular Risk After Acute Coronary Syndrome. J Am Col Cardiol. 2020;75(2):133-44. DOI:10.1016/j.jacc.2019.10.057
17. Karpov YuA. The Role of PCSK9 Inhibitors in the Improvement of Outcomes in Patients after Acute Coronary Syndrome: Results of ODYSSEY OUTCOMES Trial. Rational Pharmacotherapy in Cardiology. 2018;14(6):922-34 (in Russian). DOI:10.20996/1819-6446-2018-14-6-922-934
18. Szarek M, Bittner VA, Aylward P. Lipoprotein(a) lowering by alirocumab reduces the total burden of cardiovascular events independent of low-density lipoprotein cholesterol lowering: ODYSSEY OUTCOMES trial. Eur Heart J. 2020(41):4245-55. DOI:10.1093/eurheartj/ehaa649
19. Brandts J, Ray K, Hons B. Low Density Lipoprotein Cholesterol – Lowering Strategies and Population Health Time to Move to a Cumulative Exposure Model. Circulation. 2020;141:873-6. DOI:10.1161/CIRCULATIONAHA.119.043406
Авторы
В.А. Корнева*, Т.Ю. Кузнецова, И.С. Скопец, Н.Н. Везикова
ФГБОУ ВО «Петрозаводский государственный университет», Петрозаводск, Россия
*vikkorneva@mail.ru
Petrozavodsk State University, Petrozavodsk, Russia
*vikkorneva@mail.ru
ФГБОУ ВО «Петрозаводский государственный университет», Петрозаводск, Россия
*vikkorneva@mail.ru
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Petrozavodsk State University, Petrozavodsk, Russia
*vikkorneva@mail.ru
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