Ezinye izazi ze-cardiologists zihamba zasendle ngeklasi entsha yeyeza ye-cholesterol.
E-American College of Cardiology's (I-ACC's) I-Scientific Session Sessional eyayibanjwe kwiidolophu ezikuloo dolophu yedolophu yaseSan Diego phakathi no-Matshi 2015, umoya unzima ngokuthetha nge-PCSK9 inhibitors. Ngokukodwa, abaninzi abaneengcali ze-cardiologists babekhokelela ngokukhawuleza ngeziphumo ezivavanywa kwixesha elide kwi- Amgen's Repatha (evolocumab) . Kwizilingo zeklinikhi, i-PCSK9 inhibitors njenge-evolocumab kunye ne-Regeneron / Sanofi's Value (alirocumab) ziye zaboniswa ukunciphisa i-LDL-C ("okubi" i-cholesterol) ubuncinci kangangoko kwiimimiselo kwaye mhlawumbi ngaphezulu .
( Iimpawu zonyango zifana neZocor kunye neCrestor.
Ekugqibeleni, ukunciphisa i-LDL amazinga e-cholesterol nje ukuba banciphise ukuba bangabanikeli inzuzo ngokwenene ngaphandle kokunciphisa ingozi yemicimbi yeemvakalelo ezinjenge-stroke ne-heart attack. Kwaye ukuze kuqikelelwe ukuba ngaba inzuzo yexesha elide ikhona, sifuna ukufundwa kwexesha elide ... iminyaka engaphezu kokukhuthaza, kodwa, iziphumo zeminyaka esisodwa esishumayelayo ngoku.
Yintoni i-PCSK9 inhibitors?
Iproprotein iguqula i-subtilisin / i-Kexin uhlobo 9 okanye i-PCSK9 yi-gene edlala indima kwi-cholesterol kunye ne-acety acid metabolism. Abantu abaneentlobo ezingabonakaliyo zohlobo lwe-PCSK9 babonwa njengamanqanaba e-LDL-C ("i-cholesterol embi") efana nezo zisezingeni elimodareyitha. Ukongezelela, ukuguqulwa komzimba kudibaniswe kwi-autosomal hypercholesterolemia yentsapho , isifo esiyingozi esibangela amaqondo aphakamileyo kakhulu weepids okanye i-cholesterol kunye nesifo senhliziyo.
Ngenxa yokuqwalasela okunjalo, iinkampani zamachiza i-Amgen kunye ne-Regeneron / Sanofi zenze i-antibodies e-monoclonal ejolise kwiprotheni ye-PCSK9 (ekhowudiweyo yi-PCSK9 gene): Ukuphinda kunye nokuPhezulu ngokulandelanayo.
Iziphumo Emva komnye umnyaka (ish) weNyango kunye ne-PCSK9 Inhibitors
Ngo-Matshi 17, 2015, i-New England Journal of Medicine yanyathelisa amaphepha amabini aveza iziphumo zeveki ezingama-52 kwi-evolocumab ze-OSLER-1 kunye ne-OSLER-2 izilingo kunye neziphumo ezingama-78 zeveki ezivela kwizilingo ze-ODYSSEY ze-Regeneron / Sanofi.
Ezinye iziphumo ezibalulekileyo ezivela kwizilingo ze-OSLER ziquka ezi zilandelayo:
- Ngeeveki ezingama-48 zonyango, i-evolocumab yaqhubeka nokunciphisa amanqanaba e-LDL-C ngamaphesenti angama-61 kubathathi-nxaxheba ngamanqanaba ahlukeneyo engozini yomzimba.
- Ngeeveki ezingama-52 zonyango, isantya seemeko zengqondo (intliziyo yesifo, i-stroke, i- TIA njalonjalo) yayingu-2,18 ekhulwini kulabo bathathi-nxaxheba abangathathi i-evolocumab kodwa kwi -rapy-care-based care (ukuthatha i-statins) ngokumalunga ne-0.95 pesenti kwabo bathatha i-evolocumab kunye ne-standard-care-care-care-treatment (ukuthatha i-statins).
- Iziganeko ezingathandekiyo ze-neurocognitive kunye nemiphumo engathandabuzekiyo echaphazelekayo kuquka i-arthralgia, intloko yesifo, intlungu yesandla, kunye nokukhathala kwabikwa rhoqo kubathathi-nxaxheba bathabatha i-evolocumab.
Ezinye iziphumo ezibalulekileyo ezivela kwiilingo ze-ODYSSEY ziquka ezi zilandelayo:
- Ngeeveki ezingama-78 zonyango, i-alirocumab yanciphisa amazinga e-LDL-C ngamaphesenti angaba ngu-60 kuwo onke amanxaxheba kubandakanye izigulane ezinobungozi obuphezulu (abo abane-hypercholesterolemia okanye iintsapho ezininzi ezinobungozi obufana nokutshaya, isifo sikashukela nokunye).
- Iimiphumo ezimbi ezibangelwa unyango kunye ne-alirocumab zibandakanya iimpendulo ze-injection-sites, i-myalgia, i-neurocognitive kunye ne-ophthalmologic.
- Zonke izigulane ezi zifundo sele zisezikhundleni-nokuba lizinga eliphezulu okanye kwiqondo elixhasayo. Kwizigulane ezifumana i-alirocumab, isantya seziganeko zentliziyo yesifo sasingu-1.7 ekhulwini kunye no-3.3 ekhulwini kulabo bathatha indawo.
Ngaba i-PCSK9 Inhibitors i-Statins entsha?
I-Cardiologists ngoku ibuza isimo se-cholesterol njengesiphelo-sonke-sonke-biomarker. Njengoko sifunde kuphando oludlulileyo, ezinye iziyobisi ezinciphisa i-LDL-C, ukwandisa i-HDL kunye nokunye akunako ukunika inzuzo yehlabathi ngokwenene njengokukhusela ukubetha okanye ukuhlasela kwentliziyo. Indlela i-cholesterol kunye ne-lipids ezisebenzisana ngayo emzimbeni wethu zinzima kunokuba siyazi ngoku.
Kule ndlela, indlela enokukhetha ngayo yokuphatha isifo senhliziyo yi-statins, iklasi ekhethiweyo yezilwanyana ezikhusela iziganeko ezizayo zomsindo. Ezi zi yobisi mhlawumbi zisebenza ngokungagcini nje ukunciphisa amazinga e-LDL kodwa kunye nokuzinzisa iiplati ezivala imithambo yethu.
Ukuze i-PCSK9 inhibitors ithathwa njengeluncedo njengeemimiselo, sidinga iminyaka emininzi yeziphumo, kungenxa yoko u-Amgen okwamanje uhlanganisa i-FOURIER yokufunda. Ucwaningo lwe-FOURIER luya kuba luhlolo lweeminyaka emihlanu lokulawulwa kwe-evolocumab kulabo bathabatha ama-statins kunye nomngcipheko ophezulu kwimicimbi ye-cardiovascular like stroke and attack heart. (Ukuba unomdla, i-AMGEN okwangoku inxusa abathathi-nxaxheba kwisifundo.) Ngeziphumo ezivela kwi-FOURIER yokufunda, abaphandi banethemba lokunyusa ukwehla kweziganeko zentliziyo ye-cardiovascular eyehlolwe ngonyaka omnye ukuya kwiminyaka emininzi . Ngaphezu koko, iziphumo ezivela kwisifundo zingasinceda siqonde kangcono ukuba iziphi izigulane zizuza kakhulu kwi-PCSK9 inhibitors.
Kwiminyaka embalwa, ukuba sibona ukuxhamla kwexesha elide inzuzo ye-cardiovascular, ngoko siyakwazi ukubheka impumelelo efana nemimiselo ka-Amgen, umenzi we-evolocumab. Impumelelo enjalo inemiqathango kuba ngaphezu kokungazi ngokuqinisekileyo ukuba iziphi izigulane zinokuzuza kakhulu kwi-evolocumab, kukho enye into exakekisayo malunga ne-PCSK9 inhibitor: Uphando lubonisa ukuba kwabanye abantu, i-evolocumab kunye ne-alirocumab ingangcolisa inkqubo ye-nervous system. Ngokukodwa, ityala le-ODYSSEY licebise ukuba i-alirocumab ingabangela ukuba ikhumbule imemori, yenze i-amnesia okanye ibangele ukudideka.
Imithombo
Inqaku elibizwa ngokuthi "i-PCSK9 inhibition kwizigulane ezine-hypercholesterolemia" ngu-NR Desai kunye ne-MS Sabatine evela e-Elsevier ngo-2015. Ukufikelela kwi-Keyical Key ngomhla we-3/15/2015.
I-athimba ebizwa ngokuthi "Ukusebenza kunye noKhuseleko lwe-Alirocumab ekunciphiseni i-lipids kunye neziganeko ze-Cardiovascular" ngoJG Robinson kunye nabalobi be-NEJM 3/17/2015. Kufike ngomhla we-3/15/2015.
I-Article ethi "Ukusebenza kunye noKhuseleko lwe-Evolocumab ekunciphiseni iLipids kunye neziganeko ze-Cardiovascular" yi-MS Sabatine kunye nabalobi be-COJ 3/17/2015. Kufike ngomhla we-3/15/2015.
Inqaku elibizwa ngokuthi "Ukunciphisa i-LDL yeCholesterol Yilungile, kodwa Njani?" NJ Stone kunye no-DML James ukusuka ku-NEJM 3/17/2015.