Naidoo Poobalan, Mothilal Rashem, Blom Dirk Jacobus
Department of Medical Affairs, Sanofi South Africa, Johannesburg, South Africa.
Division of Lipidology and Hatter Institute, Department of Medicine, University of Cape Town, Cape Town, South Africa.
JMIR Res Protoc. 2018 Jun 29;7(6):e163. doi: 10.2196/resprot.9248.
Dyslipidemia is a major modifiable risk factor for atherosclerotic cardiovascular disease. Current South African guidelines recommend titrating lipid-lowering therapy (LLT) to low-density lipoprotein cholesterol (LDL-C) targets stratified by cardiovascular risk. The LDL-C goal for very high-risk patients is <1.8 mmol/L. In international studies, approximately 30% of patients do not achieve this goal despite receiving maximally tolerated statin doses. There is, however, a paucity of data on LDL-C goal achievement in very high-risk South African patients receiving maximal statin doses.
The goal of the research it to assess LDL-C goal achievement in, and clinical characteristics of, very high cardiovascular risk dyslipidemic patients receiving maximal tolerated statin doses with or without ezetimibe.
This is an observational, cross-sectional South African registry study that plans to include up to 30 sites and 500 study participants. Adult patients with very high cardiovascular risk status receiving stable, maximally tolerated statin doses (with or without ezetimibe) will be eligible for inclusion.
Funding has been awarded and enrollment began on November 15, 2017, and was completed on April 13, 2018, with 507 participants. Database lock was done on June 21, 2018. The statistical analysis has commenced and we expect the final clinical study report to be completed by October 2018.
This study will document the adequacy of LLT in those at highest risk and will thus fill an important data gap in South Africa. This data may be useful in assessing the need for novel LLTs like proprotein convertase subtilisin/kexin 9 inhibitors that substantially lower cholesterol levels in addition to optimal statin therapy.
RR1-10.2196/9248.
血脂异常是动脉粥样硬化性心血管疾病的一个主要可改变危险因素。南非现行指南建议根据心血管风险分层,将降脂治疗(LLT)滴定至低密度脂蛋白胆固醇(LDL-C)目标值。极高风险患者的LDL-C目标值为<1.8 mmol/L。在国际研究中,尽管给予了最大耐受剂量的他汀类药物,但仍有大约30%的患者未达到这一目标。然而,关于接受最大剂量他汀类药物治疗的南非极高风险患者LDL-C目标达成情况的数据却很匮乏。
本研究的目的是评估接受最大耐受剂量他汀类药物治疗(无论是否联用依折麦布)的极高心血管风险血脂异常患者的LDL-C目标达成情况及其临床特征。
这是一项观察性横断面南非注册研究,计划纳入多达30个研究点的500名研究参与者。接受稳定的最大耐受剂量他汀类药物治疗(无论是否联用依折麦布)的极高心血管风险成年患者将符合纳入标准。
已获得资金,于2017年11月15日开始入组,并于2018年4月13日完成,共有507名参与者。2018年6月21日完成数据库锁定。统计分析已开始,预计最终临床研究报告将于2018年10月完成。
本研究将记录极高风险人群中LLT的充分性,从而填补南非的一个重要数据空白。这些数据可能有助于评估是否需要新型LLT,如前蛋白转化酶枯草溶菌素/kexin 9抑制剂,这类药物除了优化他汀类药物治疗外,还能大幅降低胆固醇水平。
RR1-10.2196/9248