Currently Viewing:
European Society of Cardiology (ESC) 2017
Dr Christi Deaton on the Most Important Steps for Cardiovascular Prevention
November 12, 2017
Dr John Rumsfeld: We're Just at the Beginning of the Digital Health Transformation
November 09, 2017
Dr Jeanette Stingone on Environmental Factors That Impact Public Health
November 07, 2017
Christi Deaton: Challenges of Motivating Patients to Participate in CVD Prevention Strategies
November 04, 2017
Dr John Rumsfeld on the Digital Transformation of Cardiovascular Medicine
October 24, 2017
Dr Deepak Bhatt on the Impact of the COMPASS Trial on Standard of Care
October 19, 2017
Dr Jeanette Stingone: Air Pollution Is an Issue Everywhere in the US
October 12, 2017
Dr John Rumsfeld Outlines ACC's Main Goals for the Future of Cardiology
October 07, 2017
Dr Simon Gibbs Discusses the Future of Pulmonary Hypertension Treatments
October 03, 2017
Dr Steven Nissen Argues for Aggressively Lowering LDL Cholesterol
October 01, 2017
Dr John Eikelboom on the COMPASS Trial Findings
September 28, 2017
Dr John Eikelboom on the Surprising Results of the COMPASS Trial
September 15, 2017
Dr Simon Gibbs Outlines Monotherapy vs Combination Therapy in Pulmonary Hypertension
September 14, 2017
Dr Christi Deaton: Ask Cardiac Patients About Their Diet and Exercise
September 12, 2017
Currently Reading
Dr Steven Nissen on Which Patients Should Be Treated With PCSK9 Inhibitors
September 11, 2017
Dr Christi Deaton on Promoting Better Self-Management for Patients With CVD
August 29, 2017
Dr John Eikelboom: COMPASS' Rivaroxaban Plus Aspirin Will Become Standard for CAD, PAD
August 29, 2017
Comorbidities in Patients With Heart Failure: Treating the Whole Patient
August 29, 2017
Dr Simon Gibbs on Daily Management of Patients With Pulmonary Hypertension
August 28, 2017

Dr Steven Nissen on Which Patients Should Be Treated With PCSK9 Inhibitors

Two recent trials have demonstrate which types of patients are benefit the most from being treated with PCSK9 inhibitors, explained Steven Nissen, MD, of Cleveland Clinic.


Steven Nissen, MD, of Cleveland Clinic discusses two trials that demonstrate what types of patients are eligible to be treated with PCSK9 inhibitors.

Transcript (slightly modified)

What does the latest data show about who should be treated with PCSK9 inhibitors?

Of course it's controversial, and the FDA has not acted yet, but there were 2 recent trials—one that we did known as the GLAGOV trial, published last December in JAMA, and then the FOURIER trial, published in the spring in The New England Journal of Medicine. In GLAGOV, we took people that had known coronary disease, that were coming for left heart catheterization, for symptoms. The group that got a statin alone had a low-density lipoprotein (LDL) of about 90—they were well treated, mostly with high-intensity statins. The group that got combination therapy with the PCSK9 inhibitor got to an LDL, a median LDL of 36. They had marked regression of coronary disease. So, clearly people that have a lot of coronary plaque, that have come to the catheterization laboratory for symptoms, appear to benefit. 

FOURIER, I think was a very good trial—very large, some 27,000 patients. They had very similar baseline LDLs of about 90 and their on-treatment LDLs averaged about 30 and there was a reduction in death, stroke, myocardial infarction; there was a very clear benefit across a broad range of patient types. So, I think that sicker patients in the secondary prevention world are good candidates for LDL lowering to these very low levels.

Now, FDA will have to evaluate FOURIER and whether they choose to give a label or not remains to be seen. Although, I frankly think it’s pretty clear that the data is robust and that there will be a label—how they write the label will be a bit nuanced. My advice to people is that the higher the risk of the patient and the higher the LDL, the more reasonable it is to add a PCSK9 inhibitor to a statin.

 
Copyright AJMC 2006-2017 Clinical Care Targeted Communications Group, LLC. All Rights Reserved.
x
Welcome the the new and improved AJMC.com, the premier managed market network. Tell us about yourself so that we can serve you better.
Sign Up
×

Sign In

Not a member? Sign up now!