<scp>CARotid plaqUe StabilizatiOn</scp> and regression with evolocumab: Rationale and design of the <scp>CARUSO</scp> study

Aranzulla, Tiziana Claudia; Piazza, Salvatore; Ricotti, Andrea; Musumeci, Giuseppe; Gaggiano, Andrea

doi:10.1002/ccd.29743

Cited by 6 publications

(4 citation statements)

References 38 publications

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“…Lepor et al analyzed carotid plaques with MRI after 3, 6 and 12 months of therapy with PCSK9i, founding a regression in plaque composition and neovasculature [ 23 ]. Similar findings of morphological stabilization and reduction of carotid plaques were reported in the CARUSO study after 6 months of treatment with evolocumab on top of ongoing lipid-lowering therapy [ 24 ].…”

Section: Pcsk9 Inhibitorssupporting

confidence: 83%

Current Options and Future Perspectives in the Treatment of Dyslipidemia

Muscoli

Ifrim

Russo

et al. 2022

JCM

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Low-density lipoprotein cholesterol (LDL-C) plays a crucial role in the development of atherosclerosis. Statin therapy is the standard treatment for lowering LDL-C in primary and secondary prevention. However, some patients do not reach optimal LDL-C target levels or do not tolerate statins, especially when taking high doses long-term. Combining statins with different therapeutic approaches and testing other new drugs is the future key to reducing the burden of cardiovascular disease (CVD). Recently, several new cholesterol-lowering drugs have been developed and approved; others are promising results, enriching the pharmacological armamentarium beyond statins. Triglycerides also play an important role in the development of CVD; new therapeutic approaches are also very promising for their treatment. Familial hypercholesterolemia (FH) can lead to CVD early in life. These patients respond poorly to conventional therapies. Recently, however, new and promising pharmacological strategies have become available. This narrative review provides an overview of the new drugs for the treatment of dyslipidemia, their current status, ongoing clinical or preclinical trials, and their prospects. We also discuss the new alternative therapies for the treatment of dyslipidemia and their relevance to practice.

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Section: Pcsk9 Inhibitorssupporting

confidence: 83%

Current Options and Future Perspectives in the Treatment of Dyslipidemia

Muscoli

Ifrim

Russo

et al. 2022

JCM

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“…Additionally, PCSK9 inhibitors were shown to reduce apolipoprotein B and TGs substantially more than the statin monotherapy group [ 50 , 59 , 75 ]. Similar claims have been made by the ongoing CARUSO study, which is currently investigating the effects of evolocumab on carotid plaque regression [ 76 ]. These findings illuminate a need to further investigate PCSK9 inhibitors as an adjunctive medication and possibly as a monotherapy in the treatment and prevention of hyperlipidemia and atherosclerosis.…”

Section: Review Of Non-statin Treatment Optionssupporting

confidence: 60%

Is a PCSK9 Inhibitor Right for Your Patient? A Review of Treatment Data for Individualized Therapy

Beltran

Zemeir

Kimberling

et al. 2022

IJERPH

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Introduction: In the United States, a significant amount of the population is affected by hyperlipidemia, which is associated with increased levels of serum low-density lipoprotein (LDL-C) and risk of cardiovascular disease. As of 2019, the guidelines set by the American College of Cardiology/American Heart Association advocate for the use of statins as the major contributor to lowering serum LDL-C. While proven to be effective, side effects, including muscle-related symptoms and new-onset diabetes mellitus, can make patients unable to tolerate statin therapy. Additionally, there is a subset of the population which does not approach a recommended LDL-C goal on statin treatment. Due to these findings, it was deemed necessary to review the literature of current statin-alternative lipid-lowering therapies. Methods: A systematic review of preclinical and clinical papers, and a current meta-analysis, was performed using PubMed and Google Scholar. Following the literature review, a meta-analysis was conducted using ProMeta 3. Results: Through systematic review and meta-analysis of the current literature, it is suggested that newer lipid-lowering therapies such as proprotein convertase subtilsin-kixen type 9 (PCSK9) inhibitors are a safe and effective statin alternative for the population with statin intolerance. PCSK9 inhibitors were shown to have no significant effect in causing myalgia in patients and showed no increase in adverse cardiovascular outcomes compared to a control of a current antilipemic medication regimen. Discussion: There are many statin-alternative therapies that should be investigated further as a potential replacement for patients with statin intolerance or as an addition for patients with statin resistance.

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“…Their use was associated with a favorable safety profile without increasing risk of neurocognitive adverse events, liver enzyme elevations, rhabdomyolysis, or new-onset diabetes mellitus. According to the GLAGOV data [ 83 ], both molecules have been shown to favor morphological stabilization and reduction of carotid plaques [ 20 , 84 , 85 , 86 , 87 ], delaying ASCVD progression.…”

Section: Lipid-lowering Therapy (Llt)mentioning

confidence: 99%

Appropriateness of Dyslipidemia Management Strategies in Post-Acute Coronary Syndrome: A 2023 Update

et al. 2023

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It has been consistently demonstrated that circulating lipids and particularly low-density lipoprotein cholesterol (LDL-C) play a significant role in the development of coronary artery disease (CAD). Several trials have been focused on the reduction of LDL-C values in order to interfere with atherothrombotic progression. Importantly, for patients who experience acute coronary syndrome (ACS), there is a 20% likelihood of cardiovascular (CV) event recurrence within the two years following the index event. Moreover, the mortality within five years remains considerable, ranging between 19 and 22%. According to the latest guidelines, one of the main goals to achieve in ACS is an early improvement of the lipid profile. The evidence-based lipid pharmacological strategy after ACS has recently been enhanced. Although novel lipid-lowering drugs have different targets, the result is always the overexpression of LDL receptors (LDL-R), increased uptake of LDL-C, and lower LDL-C plasmatic levels. Statins, ezetimibe, and PCSK9 inhibitors have been shown to be safe and effective in the post-ACS setting, providing a consistent decrease in ischemic event recurrence. However, these drugs remain largely underprescribed, and the consistent discrepancy between real-world data and guideline recommendations in terms of achieved LDL-C levels represents a leading issue in secondary prevention. Although the cost-effectiveness of these new therapeutic advancements has been clearly demonstrated, many concerns about the cost of some newer agents continue to limit their use, affecting the outcome of patients who experienced ACS. In spite of the fact that according to the current recommendations, a stepwise lipid-lowering approach should be adopted, several more recent data suggest a "strike early and strike strong" strategy, based on the immediate use of statins and, eventually, a dual lipid-lowering therapy, reducing as much as possible the changes in lipid-lowering drugs after ACS. This review aims to discuss the possible lipid-lowering strategies in post-ACS and to identify those patients who might benefit most from more powerful treatments and up-to-date management.

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CARotid plaqUe StabilizatiOn and regression with evolocumab: Rationale and design of the CARUSO study

Cited by 6 publications

References 38 publications

Current Options and Future Perspectives in the Treatment of Dyslipidemia

Current Options and Future Perspectives in the Treatment of Dyslipidemia

Is a PCSK9 Inhibitor Right for Your Patient? A Review of Treatment Data for Individualized Therapy

Appropriateness of Dyslipidemia Management Strategies in Post-Acute Coronary Syndrome: A 2023 Update

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