Treatment B) Drug Therapy

Teramoto, Tamio; Sasaki, Jun; Ishibashi, Shun; Birou, Sadatoshi; Daida, Hiroyuki; Dohi, Seitaro; Egusa, Genshi; Hiro, Takafumi; Hirobe, Kazuhiko; Iida, Mami; Kihara, Shinji; Kinoshita, Makoto; Maruyama, Chizuko; Ohta, Takao; Okamura, Tomonori; Yamashita, Shizuya; Yokode, Masayuki; Yokote, Koutaro

doi:10.5551/jat.19166

Cited by 13 publications

(6 citation statements)

References 73 publications

(54 reference statements)

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“…Serum LDL-C levels were indirectly estimated using the Friedewald equation, 29 which is considered more precise than direct measurement 30 in accordance with the Japanese guideline 5 . We estimated the non-HDL-C level as the serum total cholesterol level minus the high-density lipoprotein (HDL-C) level.…”

Section: Methodsmentioning

confidence: 99%

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Statin use and all-cause and cancer mortality: BioBank Japan cohort

Yokomichi

Nagai

Hirata

et al. 2017

Journal of Epidemiology

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BackgroundStatins are the first-line agents used to treat patients with high serum low-density lipoprotein cholesterol levels, thus reducing the risk of death from arterial sclerotic cardiovascular disease; however, little is known about the effects of non-statin pharmacological interventions on mortality as well as about the potential protective effects of statin use against cancer death. This work aimed to compare all-cause and cancer mortality among patients with hyperlipidaemia who did and did not receive statin treatment.MethodsBetween 2003 and 2007 fiscal years, we recruited Japanese patients diagnosed with hyperlipidaemia from 66 hospitals. Patients in our cohort were followed up for a maximum of 12 years to observe the causes of death. Kaplan–Meier estimates from the baseline were used to compare the mortality of patients based on the administered medicine. All-cause mortality were compared among patients with/without administration of statins and other agents; any-organ and colorectal cancer mortality were compared between patients with/without administration of statins.ResultsOur cohort included 41,930 patients with mean ages of 64–66 years and mean body mass indices of 24–25 kg/m2. Patients who received statin monotherapy and were treated with lifestyle modification exhibited nearly identical survival curves, whereas statin use represented a non-significant but potentially protective effect against colorectal cancer-related mortality. The lowest mortality in this cohort was associated with resin monotherapy.ConclusionsMortality rate has been similar for patients treated with statin monotherapy and lifestyle modification. Statin monotherapy could potentially reduce any-organ- and colorectal cancer-related mortality.

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Section: Methodsmentioning

confidence: 99%

“…For instance, a recent meta-analysis of statin use reports associated odds ratios of 0.70 for major coronary events, 0.81 for major cerebrovascular events and 0.88 for all-cause mortality 2 . Consequently, statins have achieved the status of first-line agents for the treatment of patients with high serum levels of LDL-C 3, 4, 5…”

Section: Introductionmentioning

confidence: 99%

Statin use and all-cause and cancer mortality: BioBank Japan cohort

Yokomichi

Nagai

Hirata

et al. 2017

Journal of Epidemiology

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“…Whereas concerns regarding an increased risk of statin-associated side effects relative to Western populations appear unfounded [16], many Japanese patients still receive a lower dose of statin [17] and a small percentage are receiving non-statin lipid-lowering therapy (LLT) alone [18]. The choice of LLT is also limited because combination therapy comprising a fibrate and a statin – which is associated with an increased risk of rhabdomyolysis [19, 20] – should be used with caution, and avoided among patients with renal disorders [21]. Epidemiological studies have shown that a substantial proportion of treated high-risk Japanese patients do not achieve the JAS LDL-C therapeutic targets [18, 22, 23].…”

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of alirocumab in patients with hypercholesterolemia not adequately controlled with non-statin lipid-lowering therapy or the lowest strength of statin: ODYSSEY NIPPON study design and rationale

et al. 2017

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BackgroundStatins are generally well-tolerated and serious side effects are infrequent, but some patients experience adverse events and reduce their statin dose or discontinue treatment altogether. Alirocumab is a highly specific, fully human monoclonal antibody to proprotein convertase subtilisin/kexin type 9 (PCSK9), which can produce substantial and sustained reductions of low-density lipoprotein cholesterol (LDL-C).MethodsThe randomized, double-blind, placebo-controlled, parallel-group, phase 3 ODYSSEY NIPPON study will explore alirocumab 150 mg every 4 weeks (Q4W) in 163 Japanese patients with hypercholesterolemia who are on the lowest-strength dose of atorvastatin (5 mg/day) or are receiving a non-statin lipid-lowering therapy (LLT) (fenofibrate, bezafibrate, ezetimibe, or diet therapy alone). Hypercholesterolemia is defined as LDL-C ≥ 100 mg/dL (2.6 mmol/L) in patients with heterozygous familial hypercholesterolemia or non-familial hypercholesterolemia with a history of documented coronary heart disease, or ≥120 mg/dL (3.1 mmol/L) in patients with non-familial hypercholesterolemia classified as primary prevention category III (i.e. high-risk patients). During the 12-week double-blind treatment period, patients will be randomized (1:1:1) to receive alirocumab subcutaneously (SC) 150 mg Q4W alternating with placebo for alirocumab Q4W, or alirocumab 150 mg SC every 2 weeks (Q2W), or SC placebo Q2W. The primary efficacy endpoint is the percentage change in calculated LDL-C from baseline to week 12. The long-term safety and tolerability of alirocumab will also be investigated.DiscussionThe ODYSSEY NIPPON study will provide insights into the efficacy and safety of alirocumab 150 mg Q4W or 150 mg Q2W among Japanese patients with hypercholesterolemia who are on the lowest-strength dose of atorvastatin, or are receiving a non-statin LLT (including diet therapy alone).Trial registration ClinicalTrials.gov number: NCT02584504

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“…Hence, several guidelines stated that lowering LDL cholesterol (LDL-C) represents a therapeutic target (3,4). Among patients with hypercholesterolemia, those with familial hypercholesterolemia (FH) typically exhibit extremely high levels of LDL-C, the rapid progression of atherosclerotic diseases, and a high prevalence of CVD.…”

Section: Introductionmentioning

confidence: 99%

Two Patients with Familial Hypercholesterolemia Who Were Successfully Weaned from Low-density Lipoprotein Apheresis after Treatment with Evolocumab

et al. 2017

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Two elderly patients (a 76-year-old man and a 75-year-old woman), who had been previously diagnosed with familial hypercholesterolemia (at 58 and 48 years of age, respectively) underwent long-term treatment with oral therapy and low-density lipoprotein (LDL) apheresis. As their LDL cholesterol levels remained high (>150 mg/dL and >120 mg/dL, respectively) and their familial hypercholesterolemia was complicated with angina pectoris, we added evolocumab to their prescription. Thereafter, their LDL cholesterol levels decreased rapidly, and the patients were successfully weaned from LDL apheresis. Evolocumab therapy should thus be considered when LDL apheresis cannot achieve the target LDL cholesterol levels, though the prognosis of such treatment remains unclear.

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Treatment B) Drug Therapy

Cited by 13 publications

References 73 publications

Statin use and all-cause and cancer mortality: BioBank Japan cohort

Statin use and all-cause and cancer mortality: BioBank Japan cohort

Efficacy and safety of alirocumab in patients with hypercholesterolemia not adequately controlled with non-statin lipid-lowering therapy or the lowest strength of statin: ODYSSEY NIPPON study design and rationale

Two Patients with Familial Hypercholesterolemia Who Were Successfully Weaned from Low-density Lipoprotein Apheresis after Treatment with Evolocumab

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