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前蛋白转化酶枯草溶菌素9(PCSK9)抑制剂治疗的实际疗效和安全性:阿斯图里亚斯三家医院的经验

[Real-life efficacy and safety of PCSK9 inhibitors treatment: Experience in three hospitals in Asturias].

作者信息

Rodríguez Escobedo R, González Martínez S, Díaz Naya L, Suárez Gutiérrez L, Fernández Morera J L, Riestra Fernández M, Martínez Faedo C, Villazón González F, Menéndez Torre E L

机构信息

Hospital Universitario Central de Asturias, Oviedo, Asturias, España; Grupo de investigación en Endocrinología, Nutrición, Diabetes y Obesidad. Instituto de Investigación del Principado de Asturias (ISPA).

Hospital Vital Álvarez Buylla, Mieres, Asturias, España; Grupo de investigación en Endocrinología, Nutrición, Diabetes y Obesidad. Instituto de Investigación del Principado de Asturias (ISPA).

出版信息

Semergen. 2021 Sep;47(6):369-375. doi: 10.1016/j.semerg.2021.03.008. Epub 2021 Jun 8.

Abstract

BACKGROUND

Inhibitors of proprotein convertase subtilisin/kexin type9 (PCSK9 inhibitors) are a treatment option for those patients with familial hypercholesterolemia or in secondary prevention who do not reach the LDL-C target with other therapeutic measures. The aim of this study is to assess the effectiveness and safety of these drugs.

METHODS

Retrospective, multicentric, descriptive study. We collected data from all patients that have started PCSK9 inhibitors treatment in three hospitals in Asturias since the beginning of its use in 2016. We analysed changes in lipid profile with PCSK9 inhibitors and its side effects.

RESULTS

We registered 98 patients, 75 of them affected by familial hypercholesterolemia (FH) and 23 unaffected. Two months after the beginning of PCSK9 inhibitors treatment, a 61% reduction rate in LDL-C in patients with FH and 52% in those without this condition was observed. This statistically significant reduction remained stable during follow-up. A significant decrease in total cholesterol was observed, without significant changes in HDL-C and triglycerides. 96% of patients had no complications.

CONCLUSIONS

PCSK9 inhibitors are safe drugs that rapidly achieve significant reductions in LDL-C after the beginning of treatment, which are maintained over time. Hence, the use of PCSK9 inhibitors is an alternative for the control of LDL-C in those patients in which the LDL-C target is not reached with other therapeutic measures.

摘要

背景

前蛋白转化酶枯草溶菌素9型抑制剂(PCSK9抑制剂)是那些患有家族性高胆固醇血症或在二级预防中采用其他治疗措施仍未达到低密度脂蛋白胆固醇(LDL-C)目标的患者的一种治疗选择。本研究的目的是评估这些药物的有效性和安全性。

方法

回顾性、多中心、描述性研究。我们收集了自2016年开始使用以来在阿斯图里亚斯的三家医院开始使用PCSK9抑制剂治疗的所有患者的数据。我们分析了使用PCSK9抑制剂后的血脂谱变化及其副作用。

结果

我们登记了98例患者,其中75例患有家族性高胆固醇血症(FH),23例未患此病。开始使用PCSK9抑制剂治疗两个月后,观察到FH患者的LDL-C降低率为61%,未患此病的患者降低率为52%。这种具有统计学意义的降低在随访期间保持稳定。观察到总胆固醇显著降低,高密度脂蛋白胆固醇(HDL-C)和甘油三酯无显著变化。96%的患者无并发症。

结论

PCSK9抑制剂是安全的药物,治疗开始后能迅速使LDL-C显著降低,并能长期维持。因此,对于那些采用其他治疗措施仍未达到LDL-C目标的患者,使用PCSK9抑制剂是控制LDL-C的一种选择。

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