Empleo del ácido bempedoico en los pacientes con dislipemia. Una aproximación práctica

Carlos Escobar , Vivencio Barrios , Albert Ariza , Raquel Campuzano , José María Gámez , José María Mostaza
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引用次数: 3

Abstract

The reduction in cholesterol levels obtained with lipid-lowering therapy is associated with a marked decrease in the risk of cardiovascular complications. However, a substantial proportion of patients with hypercholesterolemia do not achieve the recommended target level, irrespective of their cardiovascular risk. Although this is partly due to the intensity of lipid-lowering treatment being inadequate and although combination therapy could be prescribed more frequently, there is still a need for new drugs to help achieve therapeutic goals. Bempedoic acid is a new, first-in-class, oral, lipid-lowering drug that reduces cholesterol levels by inhibiting the enzyme adenosine triphosphate-citrate lyase, which plays a role in the cholesterol synthesis pathway upstream from where statins act. Importantly, bempedoic acid is not activated in skeletal muscle, which reduces the risk of muscle-related side effects. An extensive series of clinical trials has demonstrated the drug’s efficacy in reducing cholesterol levels when given as monotherapy or in combination with other lipid-lowering drugs. Moreover, its safety profile is good. In this document, a simple and easily applied algorithm is proposed for identifying those patients who potentially stand to benefit most from treatment with bempedoic acid. The algorithm takes into account cardiovascular risk, previous lipid-lowering therapy and the low-density lipoprotein cholesterol level. Its purpose is help the majority of patients achieve the treatment goals as soon as possible.

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贝登酸在血脂异常患者中的应用。实用的方法
通过降脂治疗获得的胆固醇水平的降低与心血管并发症风险的显著降低有关。然而,相当一部分高胆固醇血症患者没有达到推荐的目标水平,无论其心血管风险如何。尽管这部分是由于降脂治疗的强度不够,尽管联合治疗可以更频繁地开处方,但仍然需要新的药物来帮助实现治疗目标。苯二甲酸是一种新型的、一流的口服降脂药物,通过抑制三磷酸腺苷-柠檬酸裂解酶来降低胆固醇水平,该酶在他汀类药物作用的上游胆固醇合成途径中起作用。重要的是,苯二甲酸在骨骼肌中不被激活,这降低了与肌肉相关的副作用的风险。一系列广泛的临床试验已经证明,该药物在单独治疗或与其他降脂药物联合使用时具有降低胆固醇水平的功效。此外,它的安全性也很好。在本文中,我们提出了一种简单且易于应用的算法,用于识别那些可能从苯戊二酸治疗中获益最多的患者。该算法考虑了心血管风险、既往降脂治疗和低密度脂蛋白胆固醇水平。其目的是帮助广大患者尽早达到治疗目标。
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来源期刊
Revista Espanola de Cardiologia Suplementos
Revista Espanola de Cardiologia Suplementos Medicine-Cardiology and Cardiovascular Medicine
CiteScore
1.20
自引率
0.00%
发文量
1
期刊介绍: Revista Española de Cardiología, is an international scientific journal dealing with cardiovascular medicine. Revista Española de Cardiología, the official publication of the Spanish Society of Cardiology, publishes research articles related to cardiovascular diseases. Articles are published in Spanish for the paper edition and in both Spanish and English in the electronic edition, which is available on the Internet. Regular sections include original articles reporting clinical or basic research, brief reports, review articles, editorials and letters to the Editor.
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