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Results of FOURIER study – beginning of the new era in cardiovascular disease prevention?


Authors: Daniel Pella
Authors‘ workplace: I. interná klinika UPJŠ LF a UNLP, Košice
Published in: AtheroRev 2017; 2(2): 87-92
Category: clinical studies

Overview

Increased levels of LDL-cholesterol (LDL-C) represent serious risk factor in the pathogenesis of atherosclerosis and its complications. There were no new approaches how to reach target levels of LDL-C easier from the time when statins were discovered (the only exception is ezetimibe) in majority of patients. Despite use of the most potent statins and prescribed in the highest doses (frequently administered in combination with ezetimibe) a large number of patients in high or very high cardiovascular risk will never reach target levels of LDL-C. Discovery of PCSK9 inhibitors (proprotein convertase subtilisin kexin type 9 inhibitors dramatically changed this situation due to their ability to cause additional decrease in LDL-C levels approximately about 60 % (irrespective, whether patients are treated with statins or not). Majority from PCSK9 inhibitors treated patients are able to reach target levels of LDL-C and moreover, like it was shown in GLAGOV trial, this decrease of LDL-C is accompanied usually with atherosclerosis regression. Multicenter, randomized, double-blind study FOURIER confirmed awaiting evidence that evolocumab in comparison to placebo in statin treated patients with documented atherosclerosis significantly reduced predefined primary and secondary key endpoints. Thus, we could consider FOURIER study results for the beginning of the new era in the prevention of cardiovascular disease.

Key words:
cardiovascular disease, PCSK9 inhibitors, statins, FOURIER study


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