Boccara Franck, Dent Ricardo, Ruilope Luis, Valensi Paul
Cardiology Unit, Hôpital Saint-Antoine, AP-HP, Hôpitaux de l'Est Parisien, Paris, France.
INSERM, UMR_S 938, Faculty of Medicine, Sorbonne Universities, UPMC University Paris 06, Paris, France.
Adv Ther. 2017 Aug;34(8):1876-1896. doi: 10.1007/s12325-017-0586-8. Epub 2017 Jul 17.
Suboptimal drug adherence represents a major challenge to effective primary and secondary prevention of cardiovascular disease. While adherence is influenced by multiple considerations, polypharmacy and dosing frequency appear to be rate-limiting factors in patient satisfaction and subsequent adherence. The cardiovascular and metabolic therapeutic areas have recently benefited from a number of advances in drug therapy, in particular protease proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors and incretin-based therapies, respectively. These drugs are administered subcutaneously and offer efficacious treatment options with reduced dosing frequency. Whilst patients with diabetes and diabetologists are well initiated to injectable therapies, the cardiovascular therapeutic arena has traditionally been dominated by oral agents. It is therefore important to examine the practical aspects of treating patients with these new lipid-lowering agents, to ensure they are optimally deployed in everyday clinical practice.
药物依从性欠佳是心血管疾病一级和二级预防取得成效的一大挑战。虽然依从性受多种因素影响,但联合用药和给药频率似乎是影响患者满意度及后续依从性的限速因素。心血管和代谢治疗领域最近受益于药物治疗方面的多项进展,特别是分别有蛋白酶前蛋白转化酶枯草溶菌素/kexin 9型(PCSK9)抑制剂和基于肠促胰岛素的疗法。这些药物通过皮下给药,提供了给药频率降低的有效治疗选择。虽然糖尿病患者和糖尿病专家对注射疗法已有充分了解,但心血管治疗领域传统上一直以口服药物为主。因此,研究使用这些新型降脂药物治疗患者的实际情况非常重要,以确保它们在日常临床实践中得到最佳应用。