NEJM:PCSK9抑制剂 InclisiranIII期临床效果显著

2020-03-19 MedSci原创 MedSci原创

每6个月皮下注射一次Inclisiran,可使他汀药物无效的动脉粥样硬化性心血管疾病患者LDL胆固醇水平降低约50%

先前的研究表明,PCSK9抑制剂Inclisiran具有持久的降低低密度脂蛋白(LDL)胆固醇效果,其给药间隔可长达数月。
 
ORION-10和ORION-11试验中,在接受了最大耐受剂量他汀药物治疗后,LDL水平仍较高的动脉粥样硬化性心血管疾病患者随机在第1天,第90天,以及此后每6个月皮下注射Inclisiran (284 mg)或者安慰剂,为期540天。研究的主要终点为,与安慰剂组相比,LDL胆固醇水平变化。
 
在ORION-10和ORION-11试验中,分别有1561名和1617名患者参与研究。基线时平均LDL胆固醇水平分别为104.7mg/分升和105.5/分升。第510天,在ORION-10试验中,Inclisiran组患者LDL胆固醇水平降低了52.3%,在ORION-11试验中降低了49.9%,相应的时间调整后分别降低了53.8%和49.2%。 Inclisran组和安慰剂组的不良事件相似,Inclisran组注射部位的不良事件发生率较高(ORION-10试验中为2.6% vs 0.9%,ORION-11试验中为4.7%vs0.5%);不良反应通常是轻微的,没有严重或持续性不良事件。
 
研究认为,每6个月皮下注射一次Inclisiran,可使他汀药物无效的动脉粥样硬化性心血管疾病患者LDL胆固醇水平降低约50%。
 
原始出处:
 
Kausik K. Ray et al. Two Phase 3 Trials of Inclisiran in Patients with Elevated LDL Cholesterol. N Engl J Med, March 19, 2020.

 

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status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1035180, encodeId=96931035180bb, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Thu Mar 19 21:48:41 CST 2020, time=2020-03-19, status=1, ipAttribution=)]
    2020-08-28 jklm09
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encryptionId=678d5348a6, topicName=Csk)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=979839152460, createdName=FukaiBao, createdTime=Thu May 21 09:48:41 CST 2020, time=2020-05-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1916247, encodeId=54cc191624e74, content=<a href='/topic/show?id=c5a89550ff' target=_blank style='color:#2F92EE;'>#III#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=9550, encryptionId=c5a89550ff, topicName=III)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e68e415, createdName=juliusluan78, createdTime=Sun Apr 19 21:48:41 CST 2020, time=2020-04-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1685635, encodeId=b28c1685635d4, content=<a href='/topic/show?id=a340138e48a' target=_blank style='color:#2F92EE;'>#PCS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13874, encryptionId=a340138e48a, topicName=PCS)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=173d28230918, createdName=Tamikia, createdTime=Thu Dec 31 04:48:41 CST 2020, time=2020-12-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1484497, encodeId=61aa148449e31, content=<a href='/topic/show?id=889e2284233' target=_blank style='color:#2F92EE;'>#临床效果#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22842, encryptionId=889e2284233, topicName=临床效果)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=9fab7968641, createdName=12498d2fm53(暂无昵称), createdTime=Sat Mar 21 09:48:41 CST 2020, time=2020-03-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1524790, encodeId=19161524e9023, content=<a href='/topic/show?id=4ba395994d' target=_blank style='color:#2F92EE;'>#II期临床#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=9599, encryptionId=4ba395994d, topicName=II期临床)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=139811614978, createdName=guihongzh, createdTime=Sat Mar 21 09:48:41 CST 2020, time=2020-03-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1594720, encodeId=c8091594e20d9, content=<a href='/topic/show?id=b317956200' target=_blank style='color:#2F92EE;'>#III期#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=9562, encryptionId=b317956200, topicName=III期)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=智智灵药, createdTime=Sat Mar 21 09:48:41 CST 2020, time=2020-03-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1035180, encodeId=96931035180bb, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Thu Mar 19 21:48:41 CST 2020, time=2020-03-19, status=1, ipAttribution=)]
    2020-05-21 FukaiBao
  5. [GetPortalCommentsPageByObjectIdResponse(id=1786872, encodeId=95af1e868729a, content=<a href='/topic/show?id=4c5b138824d' target=_blank style='color:#2F92EE;'>#PCSK9抑制#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13882, encryptionId=4c5b138824d, topicName=PCSK9抑制)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1072181, createdName=wjywjy, createdTime=Thu Oct 08 15:48:41 CST 2020, time=2020-10-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1653002, encodeId=a6f31653002e7, content=<a href='/topic/show?id=5b011018e07' target=_blank style='color:#2F92EE;'>#I期临床#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10187, encryptionId=5b011018e07, topicName=I期临床)], attachment=null, authenticateStatus=null, createdAvatar=null, 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channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13874, encryptionId=a340138e48a, topicName=PCS)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=173d28230918, createdName=Tamikia, createdTime=Thu Dec 31 04:48:41 CST 2020, time=2020-12-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1484497, encodeId=61aa148449e31, content=<a href='/topic/show?id=889e2284233' target=_blank style='color:#2F92EE;'>#临床效果#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22842, encryptionId=889e2284233, topicName=临床效果)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=9fab7968641, createdName=12498d2fm53(暂无昵称), createdTime=Sat Mar 21 09:48:41 CST 2020, time=2020-03-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1524790, encodeId=19161524e9023, content=<a href='/topic/show?id=4ba395994d' target=_blank style='color:#2F92EE;'>#II期临床#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=9599, encryptionId=4ba395994d, topicName=II期临床)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=139811614978, createdName=guihongzh, createdTime=Sat Mar 21 09:48:41 CST 2020, time=2020-03-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1594720, encodeId=c8091594e20d9, content=<a href='/topic/show?id=b317956200' target=_blank style='color:#2F92EE;'>#III期#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=9562, encryptionId=b317956200, topicName=III期)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=智智灵药, createdTime=Sat Mar 21 09:48:41 CST 2020, time=2020-03-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1035180, encodeId=96931035180bb, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Thu Mar 19 21:48:41 CST 2020, time=2020-03-19, status=1, ipAttribution=)]
    2020-04-19 juliusluan78
  6. [GetPortalCommentsPageByObjectIdResponse(id=1786872, encodeId=95af1e868729a, content=<a href='/topic/show?id=4c5b138824d' target=_blank style='color:#2F92EE;'>#PCSK9抑制#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13882, encryptionId=4c5b138824d, topicName=PCSK9抑制)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1072181, createdName=wjywjy, createdTime=Thu Oct 08 15:48:41 CST 2020, time=2020-10-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1653002, encodeId=a6f31653002e7, content=<a href='/topic/show?id=5b011018e07' target=_blank style='color:#2F92EE;'>#I期临床#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10187, encryptionId=5b011018e07, topicName=I期临床)], attachment=null, authenticateStatus=null, createdAvatar=null, 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channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13874, encryptionId=a340138e48a, topicName=PCS)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=173d28230918, createdName=Tamikia, createdTime=Thu Dec 31 04:48:41 CST 2020, time=2020-12-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1484497, encodeId=61aa148449e31, content=<a href='/topic/show?id=889e2284233' target=_blank style='color:#2F92EE;'>#临床效果#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22842, encryptionId=889e2284233, topicName=临床效果)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=9fab7968641, createdName=12498d2fm53(暂无昵称), createdTime=Sat Mar 21 09:48:41 CST 2020, time=2020-03-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1524790, encodeId=19161524e9023, content=<a href='/topic/show?id=4ba395994d' target=_blank style='color:#2F92EE;'>#II期临床#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=9599, encryptionId=4ba395994d, topicName=II期临床)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=139811614978, createdName=guihongzh, createdTime=Sat Mar 21 09:48:41 CST 2020, time=2020-03-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1594720, encodeId=c8091594e20d9, content=<a href='/topic/show?id=b317956200' target=_blank style='color:#2F92EE;'>#III期#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=9562, encryptionId=b317956200, topicName=III期)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=智智灵药, createdTime=Sat Mar 21 09:48:41 CST 2020, time=2020-03-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1035180, encodeId=96931035180bb, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Thu Mar 19 21:48:41 CST 2020, time=2020-03-19, status=1, ipAttribution=)]
    2020-12-31 Tamikia
  7. 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status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1035180, encodeId=96931035180bb, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Thu Mar 19 21:48:41 CST 2020, time=2020-03-19, status=1, ipAttribution=)]
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  9. 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  10. 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status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1035180, encodeId=96931035180bb, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Thu Mar 19 21:48:41 CST 2020, time=2020-03-19, status=1, ipAttribution=)]
    2020-03-19 旺医

    顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息

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Circulation:LDL-C降低疗法——老年人心血管事件的一级预防

以低密度脂蛋白胆固醇(LDL-C)降低疗法作为年龄≥75岁的老年人的冠状动脉疾病事件一级预防的证据不足。用依替米贝降低LDL-C的疗法是否可作为老年患者心血管事件的一级预防?研究人员开展一多中心的、前瞻性、随机化、开放性、结点盲评的试验,评估依替米贝预防75岁及以上LDL-C升高的无冠状动脉病史的老年患者的心血管事件的效果。患者被随机(1:1)分至依替米贝组(10mg/日)或常规护理组。主要结点是

CHC2019:LDL-C降到极低水平,也存在一些潜在临床风险

我们都知道,血胆固醇尤其低密度脂蛋白胆固醇(LDL-C,坏胆固醇)升高是导致冠心病、脑卒中等疾病的重要因素。根据目前的研究结果,从减少心血管事件的角度来看,目前业界很多专家倾向于认为,LDL-C“低一点,好一点”。