Patients with high cardiovascular risk as candidates to bempedoic acid after treatment with statins, ezetimibe and PCSK9 inhibitors. An estimation and cost-effectiveness analysis.

Seijas‐Amigo, José; Cordero, Alberto; Olmo, Rosa Fernández; Quiroga, Gustavo Aníbal Cortez; Fácila, Lorenzo; Salgado-Barreira, Ángel; Reyes-Santías, Francisco; Romero-Menor, César; Murillo, Juan Rondán; Rodríguez‐Mañero, Moisés; Mora, M C Bello; Valle, Alfonso Salguero del; Sandín, Miriam; Freixa-Pamias, Román; Bañeras, Jordi; García, Pedro Blanch; Lorenzo, M. Milagros Clemente; Sánchez‐Álvarez, Sergio; López‐Rodríguez, Luis; González-Juanàtey, José Ramón

doi:10.1097/fjc.0000000000001365

Cited by 4 publications

(2 citation statements)

References 22 publications

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“…The main reduction of LDL-C was 55.6% (from 145.18 mg/dL to 62.11 mg/dL), very similar results to those reported in the pivotal RCT [ 9 , 10 ]. Half of the population achieved the target level recommended by current guidelines [ 3 ], in line with recent registries performed in our environment [ 22 ].…”

Section: Discussionsupporting

confidence: 73%

Cognitive Function with PCSK9 Inhibitors: A 24-Month Follow-Up Observational Prospective Study in the Real World—MEMOGAL Study

Seijas-Amigo,

Mauriz-Montero,

Suarez-Artime

et al. 2023

Am J Cardiovasc Drugs

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Introduction The cognitive safety of monoclonal antibody proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9i) has been established in clinical trials, but not yet in real-world observational studies. We assessed the cognitive function in patients initiating PCSK9i, and differences in cognitive function domains, to analyze subgroups by the low-density lipoprotein cholesterol (LDL-C) achieved, and differences between alirocumab and evolocumab. Methods This has a multicenter, quasi-experimental design carried out in 12 Spanish hospitals from May 2020 to February 2023. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA). Results Among 158 patients followed for a median of 99 weeks, 52% were taking evolocumab and 48% alirocumab; the mean change from baseline in MoCA score at follow-up was + 0.28 [95% CI (− 0.17 to 0.73; p = 0.216)]. There were no significant differences in the secondary endpoints—the visuospatial/executive domain + 0.04 ( p = 0.651), naming domain − 0.01 ( p = 0.671), attention/memory domain + 0.01 ( p = 0.945); language domain − 0.10 ( p = 0.145), abstraction domain + 0.03 ( p = 0.624), and orientation domain − 0.05 ( p = 0.224)—but for delayed recall memory the mean change was statistically significant (improvement) + 0.44 ( p = 0.001). Neither were there any differences in the three stratified subgroups according to lowest attained LDL-C level—0–54 mg/dL, 55–69 mg/dL and ≥ 70 mg/dL; p = 0.454—or between alirocumab and evolocumab arms. Conclusion We did not find effect of monoclonal antibody PCSK9i on neurocognitive function over 24 months of treatment, either in global MoCA score or different cognitive domains. An improvement in delayed recall memory was shown. The study showed no differences in the cognitive function between the prespecified subgroups, even among patients who achieved very low levels of LDL-C. There were no differences between alirocumab and evolocumab. Registration ClinicalTtrials.gov Identifier number NCT04319081. Supplementary Information The online version contains supplementary material available at 10.1007/s40256-023-00604-6.

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Section: Discussionsupporting

confidence: 73%

Cognitive Function with PCSK9 Inhibitors: A 24-Month Follow-Up Observational Prospective Study in the Real World—MEMOGAL Study

Seijas-Amigo,

Mauriz-Montero,

Suarez-Artime

et al. 2023

Am J Cardiovasc Drugs

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“…Moreover, alirocumab in the ODYSSEY OUTCOMES trial reduced the risk of death related to CAD, nonfatal MI, ischemic stroke or hospitalization for unstable angina by 15% and reduced the risk of PAD events by 31% [ 74 ]. Despite the promising results in patients with high CV risk [ 75 , 76 ], the effects of inclisiran and bempedoic acid in PAD remain to be explored.…”

Section: Treatmentmentioning

confidence: 99%

Focus on Prevention: Peripheral Arterial Disease and the Central Role of the Cardiologist

Fioretti

Gerardi

Giugliano

et al. 2023

JCM

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Peripheral artery disease (PAD) is a manifestation of systemic atherosclerotic disease. PAD patients have a poor prognosis with an increased risk of cardiovascular (CV) events, including myocardial infarction (MI), stroke, limb ischemia and CV death; therefore, it is important to detect and treat PAD early. PAD and coronary artery disease (CAD) share a common pathogenesis and risk factors for development; therefore, cardiologists are in a unique position to screen, diagnosis and treat PAD. Moreover, PAD and CAD also share some treatment goals, including an aggressive modification of risk factors to reduce the risk of CV events. However, PAD remains an underdiagnosed and undertreated disease with medico-legal implications. As the role of cardiologists is expanding, the purpose of this review was to awaken the clinicians to the significance of PAD.

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Nuevos fármacos hipolipemiantes

Deibe,

Rodríguez,

García

et al. 2023

FMC - Formación Médica Continuada en Atención Primaria

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Patients with high cardiovascular risk as candidates to bempedoic acid after treatment with statins, ezetimibe and PCSK9 inhibitors. An estimation and cost-effectiveness analysis.

Abstract: Supplemental Digital Content is Available in the Text.

Cited by 4 publications

References 22 publications

Cognitive Function with PCSK9 Inhibitors: A 24-Month Follow-Up Observational Prospective Study in the Real World—MEMOGAL Study

Cognitive Function with PCSK9 Inhibitors: A 24-Month Follow-Up Observational Prospective Study in the Real World—MEMOGAL Study

Focus on Prevention: Peripheral Arterial Disease and the Central Role of the Cardiologist

Nuevos fármacos hipolipemiantes

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