Litsebi tse ling tsa cardiologists li ea liphateng tsa mofuta o mocha oa meriana ea k'holeseterole.
Setsing sa selemo sa March 2015, American College of Cardiology's (ACC's) Seboka sa Scientific se neng se tšoaretsoe motseng o moholo oa motse oa San Diego, moea o ne o le boima ka puo ea PCSK9 inhibitors. Haholo-holo, litsebi tse ngata tsa cardiologists tse neng li le teng li ile tsa khothaletsoa haholo ka liphello tsa liteko tsa nako e telele tsa Amgen's Repatha (evolocumab) . Litsing tsa meriana, lik'hemik'hale tsa PCSK9 tse kang evolocumab le tsa bohlokoa tsa Regeneron / Sanofi (alirocumab) li bontšitsoe ho fokotsa LDL-C ("bad" cholesterol) bonyane le li-statins le mohlomong ho feta .
( Litemana ke lithethefatsi tse kang Zocor le Crestor.
Qetellong, feela ho theola likarolo tsa li-cholesterol tsa LDL feela ho li fokotsa ho ka 'na ha se ke ha fana ka melemo ea sebele ntle le ho fokotsa kotsi ea liketsahalo tsa nakong e tlang ea pelo joaloka ts'oaetso le lefu la pelo. Hape e le hore re fumane hore na ho na le melemo e joalo ea nako e telele e thibelang, re hloka thuto ea nako e telele ... lilemo tse telele ho feta tse khothatsang, leha ho le joalo, liphello tsa selemo se le seng tseo hona joale re li bonang.
Ke eng PCSK9 inhibitors?
Proprotein convertase subtilisin / Kexin mofuta oa 9 kapa PCSK9 ke liphatsa tsa lefutso tse etsang karolo ea k'holeseterole le metabolism ea mafura a mafura. Batho ba nang le mefuta e sa tloaelehang ea liphatsa tsa lefutso tsa PCSK9 ba ne ba nkoa e le ba nang le litekanyetso tsa LDL-C ("cholesterol" e mpe) e bapisoang le ba nang le li-statins tse matla-tekanyo. Ho feta moo, liphetoho liphatseng tsa lefutso li 'nile tsa amahanngoa le li-autosomal tse tloaelehileng tsa hypercholesterolemia , e leng boloetse bo kotsi bo bakang likhahla tse phahameng haholo tsa lipids kapa k'holeseterole le lefu la pelo.
Ka lebaka la litlhaloso tse joalo, lik'hamphani tsa lithethefatsi Amgen le Regeneron / Sanofi li entse li-antibodies tse monoclonal tse lebisang liprotheine tsa PCSK9 (tse ngotsoeng ke liphatsa tsa PCSK9).
Liphello ka mor'a ho phekola ka selemo se le seng (ish) ka PCSK9 Inhibitors
Ka la 17 March, 2015, New England Journal of Medicine e hatisitse lipampiri tse peli tse hlahisang liphetho tsa libeke tse 52 ho tsoa ho liteko tsa evolocumab tsa OSLER-1 le OSLER-2 le liphetho tsa libeke tse 78 ho tsoa litsing tsa meriana tsa Registry / Sanofi tsa ODYSSEY.
Liphetho tse ling tsa bohlokoa tse tsoang litsing tsa OSLER li kenyeletsa tse latelang:
- Ka libeke tse 48 tsa phekolo, evolocumab e ile ea fokotsa litekanyetso tsa LDL-C ka liphesente tse 61 ho barupeluoa ba nang le maemo a sa tšoaneng a kotsi ea pelo.
- Ka libeke tse 52 tsa phekolo, lebelo la likoetliso tsa pelo (ts'oaetso ea pelo, ho otloa ke pelo, TIA le tse ling tse joalo) e ne e le karolo ea 2.18 lekholong ho ba sa keneng evolocumab empa ho latela mokhoa o tloaelehileng oa tlhokomelo (ho nka li-statins) ho fapana le 0,95 lekholong bakeng sa ba nkang evolocumab le kalafo ea tlhokomelo ea boemo bo botle (ho nka statins).
- Liketsahalo tse bohloko tse sa hlokomeleheng tse nang le liphello tse mpe tse akarelletsang arthralgia, hlooho ea matsoho, bohloko ba maoto le mokhathala li ile tsa tlalehoa hangata ho barupeluoa ba nkang evolocumab.
Litholoana tse ling tsa bohlokoa tse tsoang litsing tsa ODYSSEY li kenyeletsa tse latelang:
- Ka libeke tse 78 tsa phekolo, alirocumab e fokolitse lichelete tsa LDL-C ka karolo ea 60 lekholong ho litho tsa sehlopha ho kenyelletsa bakuli ba kotsing haholo (ba nang le hypercholesterolemia kapa malapa a mangata a kotsi a kang ho tsuba, lefu la tsoekere joalo-joalo).
- Liphello tse mpe tse bakoang ke phekolo ea alirocumab li kenyeletsa liketso tsa mokokotlo oa majoe, myalgia, liketsahalo tsa kelello le tsa ophthalmologic.
- Bakuli bohle ba thuto ena ba se ba ntse ba le li-statins-e leng tekanyo e phahameng kapa tekanyo e phahameng e mamelletsoeng. Bakeng sa bakuli ba fumanang alirocumab, tekanyo ea liketsahalo tsa pelo e ne e le karolo ea 1,7 lekholong ho ea ho 3.3 lekholong ho ba ntseng ba nka placebo.
Na PCSK9 Inhibitors ke New Statins?
Litsebi tsa cardiologists joale li botsa boemo ba k'holeseterole e le bofelo ba tsohle-qetellong. Joalokaha re ithutile ho tsoa lipatlisisong tse fetileng, lithethefatsi tse ling tse fokotsang LDL-C, ho eketsa HDL le tse ling tse joalo li ka 'na tsa se ke tsa fana ka melemo ea sebele ea lefatše joaloka ho thibela lefu la pelo kapa tlhaselo ea pelo. Tsela eo k'holeseterole le lipids li kopanelang 'meleng oa rona li rarahaneng haholo ho feta tseo re li utloisisang hona joale.
Ha e le hantle, mokhoa o motle ka ho fetisisa oo re nang le oona oa ho phekola lefu la pelo ke statins, sehlopha se ikhethang sa lithethefatsi se thibelang liketsahalo tsa nako e tlang tsa pelo. Meriana ena e ka 'na ea sebetsa ka ho se fokotsa litele tsa LDL feela empa hape ka ho tsitsisa liphase tse koalang methapo ea rona.
E le hore PCSK9 inhibitors e nkoe e le ea bohlokoa joaloka li-statins, re hloka lilemo tse 'maloa tsa liphello, ke kahoo Amgen a bonang hammoho thuto ea FOURIER. Thuto ea FOURIER e tla ba tlhahlobo ea lilemo tse hlano ea tsamaiso ea evolocumab ho ba nkang li-statins le kotsing e kholo ea liketsahalo tsa pelo le masapo joaloka ho otloa ke lefu le pelo. (Haeba u thahasella, hona joale AMGEN e khothaletsa barupeluoa hore ba ithute.) Ka liphetho tse hlahang ho FOURIER, bafuputsi ba na le tšepo ea ho eketsa ho fokotseha ha liketsahalo tsa lefu la pelo tse hlokometsoeng selemo se seng ho ea ho lilemo tse 'maloa . Ho feta moo, liphello tsa thuto li ka 'na tsa re thusa ho utloisisa hantle hore na metseng ea bakuli e rua molemo ka ho fetisisa ho tsoa ho PCSK9 inhibitors.
Lilemong tse seng kae, ha re bona re fumane melemo ea nako e telele ea pelo, joale re ka sheba katleho e kang ea statin ea Amgen, moetsi oa evolocumab. Katleho e joalo e na le mekhoa e mengata hobane ho phaella ho sa tsebe hantle hore na batho ba nang le mokuli ba ka rua molemo o mokae ka evolocumab, ho na le ntho e bohloko ka ho fetisisa ka PCSK9 inhibitor: Patlisiso e fana ka maikutlo a hore ho batho ba bang, evolocumab le alirocumab li ka senya tsamaiso ea methapo. Ka ho toba, teko ea ODYSSEY e khothalletsa hore alirocumab e ka senya mohopolo ka tsela e itseng, e baka amnesia kapa e baka pherekano.
Lisebelisoa
Article e ngotsoeng "PCSK9 ho thibela bakuli ba nang le hypercholesterolemia" ke NR Desai le MS Sabatine ho tloha Elsevier ka 2015. Ho fumanoa ho tsoa Clinical Key ka 3/15/2015.
Sehlooho se nang le sehlooho se reng "Tlhahlobo le Tšireletseho ea Alirocumab ho Fokotsa Lipilisi le Liketsahalo Tsa Ts'oaetso" ka JG Robinson le bangoli ba mmoho ho tloha NEJM 3/17/2015. E fihliloe ka 3/15/2015.
Article e nang le sehlooho se reng "Tlhahlobo le Tšireletseho ea Evolocumab ka ho Fokotsa Lipids le Liketsahalo Tsa Motsoako" ka MS Sabatine le bangoli ba mmoho ho tloha NEJM 3/17/2015. E fihliloe ka 3/15/2015.
Temana e nang le sehlooho se reng "Ho Fokotsa LDL Cholesterol e Molemo, Empa Joang le ka Bo-mang?" ka NJ Stone le DML James ho tloha NEJM 3/17/2015.