Journal of clinical lipidology最新文献

英文中文

Real-world evaluation of bempedoic acid use in patients with homozygous familial hypercholesterolemia 纯合子家族性高胆固醇血症患者使用苯戊二酸的实际评价。

IF 4.6 3区医学 Q2 PHARMACOLOGY & PHARMACY

Journal of clinical lipidology

Pub Date : 2026-01-01 DOI: 10.1016/j.jacl.2025.10.065

Bruce A. Warden PharmD, BCPS, CLS, FNLA, FASPC , Paul Barton Duell MD, MNLA, FAHA

OBJECTIVE

Evaluate efficacy and tolerability of bempedoic acid in homozygous familial hyper cholesterolemia (HoFH).

METHODS

A single-center retrospective study of HoFH patients prescribed bempedoic acid between February 2020 and May 2025. Patients were managed according to our clinical standard of care, with routine assessments of lipids, medication tolerability, and adherence. The primary endpoint was percent change in low-density lipoprotein cholesterol (LDL-C) from baseline to first follow-up. Secondary endpoints evaluated LDL-C changes at other timepoints, LDL-C goal attainment, medication access, and tolerability.

RESULTS

Of the 14 HoFH patients treated within our clinic, 5 (mean age 41.4 years, 60% female) were initiated on bempedoic acid, and 4 continued treatment. Pre-existing atherosclerotic cardiovascular disease (ASCVD) was present in 4 of 5 patients, and baseline mean ± SD LDL-C was 131 ± 62.4 mg/dL. Patients were managed on a mean of 3.8 lipid-lowering therapies at baseline, all with statins (60% high-intensity). Bempedoic acid reduced LDL-C by a mean ± SD of –33.2% ± 15.1% to an on-treatment LDL-C of 71 ± 30.9 mg/dL at first follow-up (median 2.9 months). LDL-C reduction of –29.4% ± 13.1% to an on-treatment LDL-C of 75 ± 29.6 mg/dL was seen at most recent follow-up (median 25.6 months). Two patients achieved recommended LDL-C goals on bempedoic acid. The medication was well tolerated, with 60% free from adverse events.

CONCLUSION

Bempedoic acid in patients with HoFH was both effective for LDL-C lowering and tolerable in this cohort of patients. This represents a novel treatment approach in a very high-risk patient population requiring multi-drug regimen for lipid optimization and cardiovascular protection.

目的：评价苯甲多酸治疗纯合子家族性高胆固醇血症（HoFH）的疗效和耐受性。方法：对2020年2月至2025年5月期间处方苯戊酸的HoFH患者进行单中心回顾性研究。患者按照我们的临床护理标准进行管理，包括对血脂、药物耐受性和依从性的常规评估。主要终点是低密度脂蛋白胆固醇（LDL-C）从基线到第一次随访的百分比变化。次要终点评估其他时间点LDL-C变化、LDL-C目标实现、药物获取和耐受性。结果：在我院治疗的14例HoFH患者中，5例（平均年龄41.4岁，60%为女性）开始使用苯甲多酸，4例继续治疗。5例患者中有4例存在动脉粥样硬化性心血管疾病（ASCVD），基线平均±SD LDL-C为131±62.4 mg/dL。患者在基线时平均接受3.8种降脂治疗，均使用他汀类药物（60%为高强度）。在第一次随访（中位为2.9个月）时，苯戊多酸降低LDL-C的平均±SD为-33.2%±15.1%，治疗时LDL-C为71±30.9 mg/dL。在最近的随访中（中位25.6个月），LDL-C降低了-29.4%±13.1%，降至治疗时的75±29.6 mg/dL。两名患者在使用苯戊酸后达到了推荐的LDL-C目标。药物耐受性良好，60%无不良事件发生。结论：在这组患者中，本戊多酸对HoFH患者既能有效降低LDL-C，又能耐受。这代表了一种新的治疗方法，在非常高风险的患者群体需要多药物方案的血脂优化和心血管保护。

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引用次数: 0

Sex differences in inflammatory biomarkers during long-term evolocumab therapy 长期evolocumab治疗期间炎症生物标志物的性别差异。

IF 4.6 3区医学 Q2 PHARMACOLOGY & PHARMACY

Journal of clinical lipidology

Pub Date : 2026-01-01 DOI: 10.1016/j.jacl.2025.11.011

Federica Fogacci MDc , Serra İlayda Yerlitaş Taştan MStat, PhD , Marina Giovannini BD , Egidio Imbalzano MD, PhD , Dmitri Mitselman MD , Claudio Borghi MD , Gökmen Zararsız MStat, PhD , Arrigo F.G. Cicero MD, PhD

BACKGROUND

Atherosclerotic cardiovascular disease remains a predominant cause of morbidity and mortality worldwide, driven by complex interactions between lipid metabolism and chronic inflammation. While evolocumab, a proprotein convertase subtilisin/kexin type 9 inhibitor, is established in lowering low-density lipoprotein cholesterol (LDL-C) and cardiovascular risk, its long-term effects on inflammatory biomarkers—and potential sex-specific responses—are not fully understood.

OBJECTIVE

This study aimed to elucidate the impact of prolonged evolocumab therapy on inflammation markers in a routine clinical setting, focusing on sex-related differences.

METHODS

We analyzed data from 202 hypercholesterolemic patients (111 men, 91 women) treated with evolocumab for at least 36 months. Key inflammatory indices, including the monocyte-to-high-density lipoprotein cholesterol ratio (MHR) and platelet-to-monocyte ratio (PMR), were assessed longitudinally alongside traditional lipid parameters.

RESULTS

Significant sex-related differences emerged in inflammatory profiles: men exhibited consistently higher MHR levels at baseline (P = .010) and throughout follow-up (P < .001), whereas women showed persistently elevated PMR values (P < .001). Intriguingly, a strong inverse correlation was observed between lymphocyte count and lipoprotein(a) levels in women (r_s = −0.885, P < .001), a pattern absent in men, suggesting distinct immunometabolic mechanisms.

CONCLUSION

Our findings reveal pronounced biological sex differences in inflammatory responses to long-term evolocumab therapy, highlighting the need to incorporate sex-specific considerations in cardiovascular risk management and treatment monitoring. These novel insights pave the way for personalized therapeutic strategies and call for further investigation into the clinical significance of inflammation in lipid-lowering treatment outcomes.

背景：由于脂质代谢和慢性炎症之间复杂的相互作用，动脉粥样硬化性心血管疾病仍然是世界范围内发病率和死亡率的主要原因。evolocumab是一种蛋白转化酶枯草杆菌素/ keexin 9型抑制剂，被证实可降低低密度脂蛋白胆固醇（LDL-C）和心血管风险，但其对炎症生物标志物的长期影响以及潜在的性别特异性反应尚不完全清楚。目的：本研究旨在阐明在常规临床环境中长期evolocumab治疗对炎症标志物的影响，重点关注性别相关差异。方法：我们分析了202例接受evolocumab治疗至少36个月的高胆固醇血症患者（111名男性，91名女性）的数据。主要炎症指标，包括单核细胞与高密度脂蛋白胆固醇比率（MHR）和血小板与单核细胞比率（PMR），与传统的脂质参数一起进行纵向评估。结果：炎症谱出现了显著的性别相关差异：男性在基线时（P = 0.010）和整个随访期间（P < 0.001）表现出持续较高的MHR水平，而女性则表现出持续升高的PMR值（P < 0.001）。有趣的是，在女性中观察到淋巴细胞计数和脂蛋白(a)水平之间存在强烈的负相关（rs = -0.885, P < .001），而在男性中不存在这种模式，这表明不同的免疫代谢机制。结论：我们的研究结果揭示了对长期evolocumab治疗的炎症反应存在明显的生物学性别差异，强调了在心血管风险管理和治疗监测中纳入性别特异性考虑的必要性。这些新发现为个性化治疗策略铺平了道路，并呼吁进一步研究炎症在降脂治疗结果中的临床意义。

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Enhancing evaluation of the FIND-FH algorithm: Addressing key analytical gaps 加强对FIND-FH算法的评估：解决关键的分析差距

IF 4.6 3区医学 Q2 PHARMACOLOGY & PHARMACY

Journal of clinical lipidology

Pub Date : 2026-01-01 DOI: 10.1016/j.jacl.2025.09.021

Rajeev Gupta DM , Anshul Yadav MBBS , Neelesh Gupta MD

引用次数: 0

IF 4.6 3区医学 Q2 PHARMACOLOGY & PHARMACY

Journal of clinical lipidology

Pub Date : 2026-01-01

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IF 4.6 3区医学 Q2 PHARMACOLOGY & PHARMACY

Journal of clinical lipidology

Pub Date : 2026-01-01

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IF 4.6 3区医学 Q2 PHARMACOLOGY & PHARMACY

Journal of clinical lipidology

Pub Date : 2026-01-01

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IF 4.6 3区医学 Q2 PHARMACOLOGY & PHARMACY

Journal of clinical lipidology

Pub Date : 2026-01-01

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IF 4.6 3区医学 Q2 PHARMACOLOGY & PHARMACY

Journal of clinical lipidology

Pub Date : 2026-01-01

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IF 4.6 3区医学 Q2 PHARMACOLOGY & PHARMACY

Journal of clinical lipidology

Pub Date : 2026-01-01

引用次数: 0

IF 4.6 3区医学 Q2 PHARMACOLOGY & PHARMACY

Journal of clinical lipidology

Pub Date : 2026-01-01

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