AlHajri Lamia, AlHadhrami Asma, AlMheiri Shama, AlMutawa Yalwah, AlHashimi Zainab
Department of Health Sciences, Higher Colleges of Technology, PO Box 16062, Dubai, UAE Department of Health Research, Lancaster University, UK.
Department of Health Sciences, Higher Colleges of Technology, Dubai, UAE.
Ther Adv Cardiovasc Dis. 2017 May-Jun;11(5-6):155-169. doi: 10.1177/1753944717698925. Epub 2017 Mar 20.
Hyperlipidemia or dyslipidemia has been a concern for a long time, with various guidelines emphasizing the importance of managing the lipid profile to prevent cardiac incidences. Although statins have been found to be highly effective, resistance and intolerability to side effects will continue to be a stumbling block for certain patients. Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors tackle lipid profile via a novel mechanism and therefore provide an additional effective option for managing lipid profile. The overarching aim of this systematic review was to evaluate the efficacy of evolocumab among various populations with hypercholesterolemia.
A comprehensive search was conducted in ProQuest Health & Medical Complete, Google Scholar, ScienceDirect, and PubMed to identify potential records; then titles, abstracts, and full texts were screened using the inclusion criteria to filter out irrelevant studies. Data extraction and quality assessment were undertaken using standardized tools and the results were narratively synthesized and presented in tables.
Eight studies were included in this systematic review after screening 1191 records. All studies demonstrated a statistically significant reduction in low-density lipoprotein cholesterol (LDL-C) values in the groups that received evolocumab compared with the comparator groups ( p < 0.05). The decline in LDL-C levels from baseline in the majority of studies ranged from 40% to 80%, whether used alone or in combination with other agents. Also, high-density lipoprotein cholesterol, lipoprotein (a) and apolipoprotein B were improved with the use of evolocumab.
This study helped to collate evidence from studies that tested the effectiveness of evolocumab in the management of hyperlipidemia. Evolocumab seems to be highly effective in reducing LDL-C and other lipid parameters. Hence, it provides an excellent alternative for patients with refractory disease or patients who develop intolerable side effects, therefore helping to overcome the stumbling block to achieving optimal lipid management.
高脂血症或血脂异常长期以来一直备受关注，各种指南都强调管理血脂水平对预防心脏疾病的重要性。尽管他汀类药物已被证明非常有效，但对某些患者而言，耐药性和副作用不耐受性仍是一大障碍。前蛋白转化酶枯草溶菌素/kexin 9型（PCSK9）抑制剂通过一种新机制调节血脂水平，因此为管理血脂提供了另一种有效选择。本系统评价的总体目的是评估依洛尤单抗在不同高胆固醇血症人群中的疗效。
在ProQuest健康与医学全文数据库、谷歌学术、ScienceDirect和PubMed中进行全面检索，以识别潜在记录；然后使用纳入标准筛选标题、摘要和全文，以排除无关研究。使用标准化工具进行数据提取和质量评估，并对结果进行叙述性综合并以表格形式呈现。
在筛选了1191条记录后，本系统评价纳入了8项研究。所有研究均表明，与对照组相比，接受依洛尤单抗治疗的组低密度脂蛋白胆固醇（LDL-C）值有统计学意义的降低（p < 0.05）。在大多数研究中，无论单独使用还是与其他药物联合使用，LDL-C水平从基线的下降幅度在40%至80%之间。此外，使用依洛尤单抗后，高密度脂蛋白胆固醇、脂蛋白（a）和载脂蛋白B也有所改善。
本研究有助于整理检验依洛尤单抗治疗高脂血症有效性的研究证据。依洛尤单抗似乎在降低LDL-C和其他血脂参数方面非常有效。因此，它为难治性疾病患者或出现不耐受副作用的患者提供了一个极佳的选择，有助于克服实现最佳血脂管理的障碍。
