New drugs for persistently high or resistant cholesterol
Posted by Richard Kelly on
New Drugs for resistant cholesterol
New Non-Statin Cholesterol Medication
PCSK9 inhibitors are a new class of cholesterol-lowering drugs that are reserved for persistently high cholesterol not controlled by medication such as statin alone.
PCSK9 inhibitors
PCSK9 inhibitors show excellent results in bringing down non-HDL levels in certain high-risk patients. They work by blocking a protein called PCSK9, which has a role in moderating cholesterol levels in the blood.
In June 2016, NICE recommended two PCSK9 inhibitor drugs for the NHS – Repatha® (evolocumab) and Praluent® (alirocumab) for treating certain patients who cannot tolerate statins or have reached the maximum statin dose without sufficient cholesterol reduction.
Researchers on the FOURIER trial investigating the effectiveness of evolocumab in the UK showed a 59% drop in cholesterol levels compared to placebo and a 15% lower risk of cardiovascular events.
According to NICE, additional lipid lowering therapies should be considered if:
1. If target LDL-C level is not attained on statins alone, add ezetimibe and trial for at least 3 months.
2. If target LDL-C level is still not attained, consider PCSK9 inhibitor, subject to NICE criteria in table 1, in addition to existing lipid lowering therapy.
PCSK9 inhibitors in Ireland
Repatha® (evolocumab) and Praluent® (alirocumab) are both licensed in Ireland. Repatha® (evolocumab) is a 140 mg pre-filled injection pen and is available in Ireland from July 2019. Specific criteria that must be satisfied for a patient to be recommended for reimbursement of Repatha under the High-Tech Arrangement.
The prescribing of Repatha® under the High-Tech Scheme is confined to designated clinicians who have agreed to the terms of the HSE-Managed Access Protocol and have been approved by the HSE-Medicines Management Program. The clinician must submit an online application for individual reimbursement approval for each patient.
For comprehensive and free health advice and information call in to Whelehans, log on to www.whelehans.ie or dial 04493 34591 (Pearse St) or 04493 10266 (Clonmore). Email queries to info@whelehans.ie. Find us on Facebook.