Clinical utility of evolocumab in the management of hyperlipidemia: patient selection and follow-up.

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Term Occurence Count Dictionary
Evolocumab 13 endocrinologydiseasesdrugs
atorvastatin 7 endocrinologydiseasesdrugs
familial hypercholesterolemia 3 endocrinologydiseases
hyperlipidemia 1 endocrinologydiseases
type 2 diabetes mellitus 1 endocrinologydiseases
cortisol 1 endocrinologydiseasesdrugs
diabetes mellitus 1 endocrinologydiseases
ezetimibe 15 endocrinologydiseasesdrugs
metabolic syndrome 1 endocrinologydiseases
rosuvastatin 1 endocrinologydiseasesdrugs
testosterone 1 endocrinologydiseasesdrugs

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Select Drug Character Offset Drug Term Instance
Evolocumab 620 therapeutic strategy aimed at reducing low-density-lipoprotein cholesterol (LDL-C) and cardiovascular risk. Evolocumab is a fully humanized monoclonal antibody that inhibits PCSK9, an enzyme that binds to LDL receptors
Evolocumab 2980 this review, we focus on evolocumab and the current evidence supporting its clinical use.Pharmacology Evolocumab is a fully humanized monoclonal (IgG2) antibody that fills a concave surface on the catalytic site of
Evolocumab 3358 allowing a return to the hepatocyte surface, where it can continue to remove LDL-C from the circulation.[7] Evolocumab is administered via subcutaneous injection, and maximally suppresses circulating unbound PCSK9 within
Evolocumab 3593 concentrations with evolocumab are reached in 3–4 days, and bioavailability is estimated at 72%. Evolocumab is eliminated mostly by saturation of the binding to PCSK9, while at higher concentrations elimination
Evolocumab 4294 or hepatic impairment, individuals with severe renal or hepatic dysfunction have not been studied. Evolocumab does not have any significant drug–drug, drug–food, or drug–disease interactions.Efficacy studiesStudies
Evolocumab 5996 statin therapy, PCSK9 inhibition with evolocumab reduces LDL-C by an additional 34%–39%.[12],[13] Evolocumab has also demonstrated similar LDL-C lowering effects in Japanese patients, suggesting that the utility
Evolocumab 6713 study, 41% and 66% of patients achieved at least one LDL-C <15 mg/dL and <25 mg/dL, respectively.[20]FH Evolocumab has also demonstrated meaningful lipid- lowering efficacy in patients with FH when added to standard-of-care
Evolocumab 9872 durable over 52 weeks of treatment in long-term extension trials and related to LDL-C reductions.[11] Evolocumab -induced reductions in Lp(a) appear unaffected by age, sex, race/ethnicity, diabetes status, or intensity
Evolocumab 19050 cholesterols.However, after adjustment for changes in total cholesterol, the net effects appeared neutral. Evolocumab 140 mg biweekly and 420 mg monthly regimens increased the β-sitosterol:total cholesterol (TC) ratio
Evolocumab 19317 (not significant for either regimen), suggesting a compensatory increase in cholesterol absorption. Evolocumab 420 mg monthly increased desmosterol:TC (P<0.01) but not lathosterol:TC ratio (not significant), and
Evolocumab 19480 not lathosterol:TC ratio (not significant), and thus had unclear effects on cholesterol synthesis. Evolocumab 140 mg biweekly had no significant effect on either campesterol:TC ratio or lathosterol:TC ratio. Given
Evolocumab 26423 not reported, but this reflects a sizeable majority of subjects who demonstrated voluntary adherence. Evolocumab can be administered once monthly by either injecting three doses within 30 minutes from prefilled autoinjector
Evolocumab 28509 be preferred by many patients.ConclusionPCSK9 has proven to be a highly viable therapeutic target. Evolocumab is a monoclonal antibody shown to be safe and effective in significantly reducing LDL-C. Recent evidence
atorvastatin 5472 is maintained on statin background therapy.[15] When evolocumab was added to background therapy with atorvastatin 80 mg or atorvastatin 80 mg plus ezetimibe, 12 weeks of evolocumab therapy reduced LDL-C by 76% and
atorvastatin 5494 background therapy.[15] When evolocumab was added to background therapy with atorvastatin 80 mg or atorvastatin 80 mg plus ezetimibe, 12 weeks of evolocumab therapy reduced LDL-C by 76% and 47%, respectively, for
atorvastatin 8691 A1Increases in nonatherogenic lipoprotein subsets are modest with evolocumab treatment. When added to atorvastatin 10 mg, atorvastatin 80 mg, or atorvastatin 80 mg plus ezetimibe, placebo-adjusted changes in high-density-lipoprotein
atorvastatin 8711 nonatherogenic lipoprotein subsets are modest with evolocumab treatment. When added to atorvastatin 10 mg, atorvastatin 80 mg, or atorvastatin 80 mg plus ezetimibe, placebo-adjusted changes in high-density-lipoprotein (HDL)
atorvastatin 8734 subsets are modest with evolocumab treatment. When added to atorvastatin 10 mg, atorvastatin 80 mg, or atorvastatin 80 mg plus ezetimibe, placebo-adjusted changes in high-density-lipoprotein (HDL) were 5.4% (SE 1.1%)
atorvastatin 10906 sample size (n=2,531 vs n=901) and multiple studies.Statin intoleranceAfter rechallenging patients with atorvastatin to verify statin intolerance, Nissen et al randomized patients to receive ezetimibe 10 mg daily or evolocumab
atorvastatin 22272 (myalgia, myositis, or rhabdomyolysis), confirming their statin intolerance with a placebo-controlled atorvastatin rechallenge. Once true statin intolerance was confirmed, evolocumab therapy showed superior LDL-C reduction
cortisol 18484 levels, LDL vitamin E levels, or red-cell membrane vitamin E levels. Similarly, estrogen, testosterone, cortisol , and adrenocorticotropic hormone were unaffected by extreme LDL lowering with evolocumab.In an 88-patient
ezetimibe 2217 lipid-lowering therapies to use in combination with statins in hopes of reducing this residual risk.[2] While ezetimibe has modest effects in reducing LDL-C and residual risk,[3] the LDL-C hypothesis would suggest that more
ezetimibe 5518 When evolocumab was added to background therapy with atorvastatin 80 mg or atorvastatin 80 mg plus ezetimibe , 12 weeks of evolocumab therapy reduced LDL-C by 76% and 47%, respectively, for the 140 mg biweekly
ezetimibe 5839 evolocumab as add-on therapy has been shown across several statins and statin doses, with or without ezetimibe .[17]When added to background ezetimibe without statin therapy, PCSK9 inhibition with evolocumab reduces
ezetimibe 5878 shown across several statins and statin doses, with or without ezetimibe.[17]When added to background ezetimibe without statin therapy, PCSK9 inhibition with evolocumab reduces LDL-C by an additional 34%–39%.[12],[13]
ezetimibe 8283 added to background statin therapy of any intensity for 1 year of treatment.[28]Adding evolocumab to ezetimibe -containing statin regimens produced a slightly less significant drop in ApoB. In a 12-week study, evolocumab
ezetimibe 8462 in ApoB. In a 12-week study, evolocumab reduced ApoB by 34%–38% when added to statin therapy with ezetimibe compared to 47%–61% when added to statin therapy without ezetimibe.[17]High-density lipoprotein and
ezetimibe 8531 when added to statin therapy with ezetimibe compared to 47%–61% when added to statin therapy without ezetimibe .[17]High-density lipoprotein and apolipoprotein A1Increases in nonatherogenic lipoprotein subsets are
ezetimibe 8758 evolocumab treatment. When added to atorvastatin 10 mg, atorvastatin 80 mg, or atorvastatin 80 mg plus ezetimibe , placebo-adjusted changes in high-density-lipoprotein (HDL) were 5.4% (SE 1.1%) after 52 weeks of treatment.[28]
ezetimibe 10993 patients with atorvastatin to verify statin intolerance, Nissen et al randomized patients to receive ezetimibe 10 mg daily or evolocumab 420 mg once monthly.[36] LDL-C was decreased by 17% (95% CI 13%–21%) and
ezetimibe 11123 evolocumab 420 mg once monthly.[36] LDL-C was decreased by 17% (95% CI 13%–21%) and 53% (50%–56%) in ezetimibe - and evolocumab-treated patients, respectively (P<0.001 for comparison of ezetimibe and evolocumab).
ezetimibe 11207 (50%–56%) in ezetimibe- and evolocumab-treated patients, respectively (P<0.001 for comparison of ezetimibe and evolocumab). Similar effects were seen for evolocumab 140 mg every 2 weeks in comparison with placebo.[37]
ezetimibe 11342 effects were seen for evolocumab 140 mg every 2 weeks in comparison with placebo.[37] When added to ezetimibe background therapy in statin-intolerant patients, evolocumab 420 mg once monthly reduced LDL-C by 47%
ezetimibe 18841 markers (campesterol and β-sitosterol) were evaluated after 12 weeks of treatment with evolocumab or ezetimibe .[45] Both evolocumab 140 mg biweekly and 420 mg monthly reduced absolute levels of all four cholesterols.However,
ezetimibe 21188 patients only if their LDL-C remains elevated after titration to a maximally tolerated statin dose plus ezetimibe . Additional guidance is given regarding the identification of statin-associated myalgia and its management
ezetimibe 22469 superior LDL-C reduction and a comparably low rate of further muscle-related events when compared to ezetimibe , strengthening its emerging role as a statin alternative for this particular group.The use of evolocumab
rosuvastatin 6473 statin therapy are unprecedented. For example, in the Phase II LAPLACE 2 study, patients receiving rosuvastatin 40 mg daily and evolocumab 420 mg monthly achieved a mean LDL-C of 33 mg/dL (SD 28.3 mg/dL).[19] In
testosterone 18470 vitamin E levels, LDL vitamin E levels, or red-cell membrane vitamin E levels. Similarly, estrogen, testosterone , cortisol, and adrenocorticotropic hormone were unaffected by extreme LDL lowering with evolocumab.In
Select Disease Character Offset Disease Term Instance
diabetes mellitus 10381 diabetes, who are at heightened cardiovascular risk.[33] A comparison of patients with and without type 2 diabetes mellitus enrolled in Phase II evolocumab clinical trials revealed no significant differences in changes in LDL-C,
familial hypercholesterolemia 1366 candidates for evolocumab primarily are individuals at high cardiovascular risk, including those with familial hypercholesterolemia and/or established cardiovascular disease, who are already on statin therapy. At this time, the use
familial hypercholesterolemia 4592 patient population. In this section, we highlight the effects of evolocumab in patients with and without familial hypercholesterolemia (FH), statin intolerance, and common comorbidities, such as diabetes. In addition, we review evolocumab’s
familial hypercholesterolemia 31328 low-density-lipoprotein cholesterol; HDL-C, high-density-lipoprotein cholesterol; TGs, triglycerides; FH, familial hypercholesterolemia ; HeFH, heterozygous FH; HoFH, homozygous FH; NR, not reported; Q2W, every two weeks
hyperlipidemia 95 Title: Drug Design, Development and TherapyClinical utility of evolocumab in the management of hyperlipidemia : patient selection and follow-upDave L DixonLeo F BuckleyCory R TrankleDinesh KadariyaAntonio Abbate1Department
metabolic syndrome 10692 lowering was significantly greater in patients without type 2 diabetes or with impaired fasting glucose or metabolic syndrome compared to those with type 2 diabetes.[35] Notably, the former analysis included a larger sample size
type 2 diabetes mellitus 10374 diabetes, who are at heightened cardiovascular risk.[33] A comparison of patients with and without type 2 diabetes mellitus enrolled in Phase II evolocumab clinical trials revealed no significant differences in changes in LDL-C,

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