Atherosclerotic Cardiovascular Disease, Unmet Needs, and Inclisiran
Autor(a) principal: | |
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Data de Publicação: | 2023 |
Outros Autores: | , , , , |
Tipo de documento: | Artigo |
Idioma: | por |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://doi.org/10.24950/rspmi.1603 |
Resumo: | The leading cause of death and disability worldwide aredue to atherosclerotic cardiovascular disease (ASCVD), entailing a heavy economic impact, in Portugal corresponding to 1% of the gross domestic product. The development and progression of ASCVD are closely related to hypercholesterolaemia, with high LDL-C levels being its most important and easily modifiable risk factor. Reducing LDL-C has been shown to decrease the incidence of cardiovascular events and European recommendations advocate LDL-C target values according to the patient's cardiovascular risk. The risk of hypercholesterolaemia is cumulative, making it relevant to reduce LDL-C as early as possible. Despite the efficacy and safety demonstrated by severalexisting lipid-lowering therapies, in the real world most patients do not achieve the recommended lipid values. Several limitations to adequate lipid control have been pointed out, namely the low adherence of patients to treatment. Inclisiran is the first drug to inhibit PCSK9 synthesis throughRNA small interference mechanism. With a subcutaneousadministration every six months after initial and 3-month dose, it allows a LDL-C reduction higher than 50%, with a good safety profile. The advantage of its long duration of action will potentially overcome the low compliance of patients to treatment and increase the effectiveness in reducing LDL-C, which may translate into a reduction in morbidity and mortality from ASCVD and its high economic impact. |
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Atherosclerotic Cardiovascular Disease, Unmet Needs, and InclisiranDoença Cardiovascular Aterosclerótica, Necessidades não Satisfeitas, e InclisiranAnticolesterolémicos/uso terapêuticoAterosclerose/ tratamento farmacológicoDoenças Cardiovasculares/tratamento farmacológicoDoenças cardiovasculares/ prevenção e controloHipercolesterolemia/ tratamento farmacológicoRNA Interferente Pequeno/uso terapêuticoAnticholesteremic Agents/therapeutic useAtherosclerosis/drug therapyCardiovascular Diseases/drug therapyCardiovascular Diseases/prevention & controlHypercholesterolemia/ drug therapyRNA, Small Interfering/therapeutic useThe leading cause of death and disability worldwide aredue to atherosclerotic cardiovascular disease (ASCVD), entailing a heavy economic impact, in Portugal corresponding to 1% of the gross domestic product. The development and progression of ASCVD are closely related to hypercholesterolaemia, with high LDL-C levels being its most important and easily modifiable risk factor. Reducing LDL-C has been shown to decrease the incidence of cardiovascular events and European recommendations advocate LDL-C target values according to the patient's cardiovascular risk. The risk of hypercholesterolaemia is cumulative, making it relevant to reduce LDL-C as early as possible. Despite the efficacy and safety demonstrated by severalexisting lipid-lowering therapies, in the real world most patients do not achieve the recommended lipid values. Several limitations to adequate lipid control have been pointed out, namely the low adherence of patients to treatment. Inclisiran is the first drug to inhibit PCSK9 synthesis throughRNA small interference mechanism. With a subcutaneousadministration every six months after initial and 3-month dose, it allows a LDL-C reduction higher than 50%, with a good safety profile. The advantage of its long duration of action will potentially overcome the low compliance of patients to treatment and increase the effectiveness in reducing LDL-C, which may translate into a reduction in morbidity and mortality from ASCVD and its high economic impact.A doença cardiovascular aterosclerótica (DCVA) lidera asprincipais causas de morte e incapacidade a nível mundial,acarretando um pesado impacto económico, correspondente a 1% do produto interno bruto em Portugal. O desenvolvimento e progressão da DCVA encontra-se em estreita relação com a hipercolesterolemia, sendo que níveis elevados de C-LDL são o seu fator de risco mais importante e facilmente modificável. A redução do C-LDL provou diminuir a incidência de eventos cardiovasculares e as recomendações europeias advogam valores alvo de C-LDL de acordo com o risco cardiovascular do doente. O risco da hipercolesterolemia é cumulativo, tornando-serelevante a redução do C-LDL o mais precocemente possível. Apesar da eficácia e segurança demonstrada pelas diversasterapêuticas hipolipemiantes existentes, no mundo real amaioria dos doentes não atinge os valores lipídicos recomendados. Várias limitações ao adequado controlo lipídico foram apontadas, nomeadamente a baixa adesão dos doentes ao tratamento. Inclisiran é o primeiro fármaco que permite inibir a síntese de PCSK9 através do mecanismo de RNA de interferência. Com uma administração subcutânea semestral, após administração nos dias 1 e 90, possibilita uma redução do C-LDL superior a 50%, com bom perfil de segurança. A vantagem da sua longa duração de ação permitirá potencialmente contornar a baixa adesão dos doentes ao tratamento e aumentar a efetividade na redução do C-LDL, que se poderá traduzir na redução da morbi-mortalidade por DCVA e do seu elevado impacto económico.Sociedade Portuguesa de Medicina Interna2023-12-15info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttps://doi.org/10.24950/rspmi.1603https://doi.org/10.24950/rspmi.1603Internal Medicine; Vol. 30 No. 4 (2023): Outubro/Dezembro; 243-251Medicina Interna; Vol. 30 N.º 4 (2023): Outubro/Dezembro; 243-2512183-99800872-671Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPporhttps://revista.spmi.pt/index.php/rpmi/article/view/1603https://revista.spmi.pt/index.php/rpmi/article/view/1603/1841Direitos de Autor (c) 2023 Medicina Internainfo:eu-repo/semantics/openAccessFerreira, JorgePalma, IsabelPereira de Moura, JoséGouveia, MiguelCorte-Real, AnaMello e Silva, Alberto2023-12-16T06:15:48Zoai:oai.revista.spmi.pt:article/1603Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-20T00:54:37.555152Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Atherosclerotic Cardiovascular Disease, Unmet Needs, and Inclisiran Doença Cardiovascular Aterosclerótica, Necessidades não Satisfeitas, e Inclisiran |
title |
Atherosclerotic Cardiovascular Disease, Unmet Needs, and Inclisiran |
spellingShingle |
Atherosclerotic Cardiovascular Disease, Unmet Needs, and Inclisiran Ferreira, Jorge Anticolesterolémicos/uso terapêutico Aterosclerose/ tratamento farmacológico Doenças Cardiovasculares/tratamento farmacológico Doenças cardiovasculares/ prevenção e controlo Hipercolesterolemia/ tratamento farmacológico RNA Interferente Pequeno/uso terapêutico Anticholesteremic Agents/therapeutic use Atherosclerosis/drug therapy Cardiovascular Diseases/drug therapy Cardiovascular Diseases/prevention & control Hypercholesterolemia/ drug therapy RNA, Small Interfering/therapeutic use |
title_short |
Atherosclerotic Cardiovascular Disease, Unmet Needs, and Inclisiran |
title_full |
Atherosclerotic Cardiovascular Disease, Unmet Needs, and Inclisiran |
title_fullStr |
Atherosclerotic Cardiovascular Disease, Unmet Needs, and Inclisiran |
title_full_unstemmed |
Atherosclerotic Cardiovascular Disease, Unmet Needs, and Inclisiran |
title_sort |
Atherosclerotic Cardiovascular Disease, Unmet Needs, and Inclisiran |
author |
Ferreira, Jorge |
author_facet |
Ferreira, Jorge Palma, Isabel Pereira de Moura, José Gouveia, Miguel Corte-Real, Ana Mello e Silva, Alberto |
author_role |
author |
author2 |
Palma, Isabel Pereira de Moura, José Gouveia, Miguel Corte-Real, Ana Mello e Silva, Alberto |
author2_role |
author author author author author |
dc.contributor.author.fl_str_mv |
Ferreira, Jorge Palma, Isabel Pereira de Moura, José Gouveia, Miguel Corte-Real, Ana Mello e Silva, Alberto |
dc.subject.por.fl_str_mv |
Anticolesterolémicos/uso terapêutico Aterosclerose/ tratamento farmacológico Doenças Cardiovasculares/tratamento farmacológico Doenças cardiovasculares/ prevenção e controlo Hipercolesterolemia/ tratamento farmacológico RNA Interferente Pequeno/uso terapêutico Anticholesteremic Agents/therapeutic use Atherosclerosis/drug therapy Cardiovascular Diseases/drug therapy Cardiovascular Diseases/prevention & control Hypercholesterolemia/ drug therapy RNA, Small Interfering/therapeutic use |
topic |
Anticolesterolémicos/uso terapêutico Aterosclerose/ tratamento farmacológico Doenças Cardiovasculares/tratamento farmacológico Doenças cardiovasculares/ prevenção e controlo Hipercolesterolemia/ tratamento farmacológico RNA Interferente Pequeno/uso terapêutico Anticholesteremic Agents/therapeutic use Atherosclerosis/drug therapy Cardiovascular Diseases/drug therapy Cardiovascular Diseases/prevention & control Hypercholesterolemia/ drug therapy RNA, Small Interfering/therapeutic use |
description |
The leading cause of death and disability worldwide aredue to atherosclerotic cardiovascular disease (ASCVD), entailing a heavy economic impact, in Portugal corresponding to 1% of the gross domestic product. The development and progression of ASCVD are closely related to hypercholesterolaemia, with high LDL-C levels being its most important and easily modifiable risk factor. Reducing LDL-C has been shown to decrease the incidence of cardiovascular events and European recommendations advocate LDL-C target values according to the patient's cardiovascular risk. The risk of hypercholesterolaemia is cumulative, making it relevant to reduce LDL-C as early as possible. Despite the efficacy and safety demonstrated by severalexisting lipid-lowering therapies, in the real world most patients do not achieve the recommended lipid values. Several limitations to adequate lipid control have been pointed out, namely the low adherence of patients to treatment. Inclisiran is the first drug to inhibit PCSK9 synthesis throughRNA small interference mechanism. With a subcutaneousadministration every six months after initial and 3-month dose, it allows a LDL-C reduction higher than 50%, with a good safety profile. The advantage of its long duration of action will potentially overcome the low compliance of patients to treatment and increase the effectiveness in reducing LDL-C, which may translate into a reduction in morbidity and mortality from ASCVD and its high economic impact. |
publishDate |
2023 |
dc.date.none.fl_str_mv |
2023-12-15 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://doi.org/10.24950/rspmi.1603 https://doi.org/10.24950/rspmi.1603 |
url |
https://doi.org/10.24950/rspmi.1603 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.relation.none.fl_str_mv |
https://revista.spmi.pt/index.php/rpmi/article/view/1603 https://revista.spmi.pt/index.php/rpmi/article/view/1603/1841 |
dc.rights.driver.fl_str_mv |
Direitos de Autor (c) 2023 Medicina Interna info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Direitos de Autor (c) 2023 Medicina Interna |
eu_rights_str_mv |
openAccess |
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application/pdf |
dc.publisher.none.fl_str_mv |
Sociedade Portuguesa de Medicina Interna |
publisher.none.fl_str_mv |
Sociedade Portuguesa de Medicina Interna |
dc.source.none.fl_str_mv |
Internal Medicine; Vol. 30 No. 4 (2023): Outubro/Dezembro; 243-251 Medicina Interna; Vol. 30 N.º 4 (2023): Outubro/Dezembro; 243-251 2183-9980 0872-671X reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
instname_str |
Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
instacron_str |
RCAAP |
institution |
RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
collection |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
repository.name.fl_str_mv |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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