JOURNAL ASMAC No 5 - octobre 2018

PERSPECTIVES
rin oder Dextran-Sulfat enthalten, extrakorporal
entfernt. Das Verfahren wird für
gewöhnlich einmal in der Woche durchgeführt.
Parallel wird die Hypercholesterinämie
weiterhin mit Medikamenten
behandelt. Die klinische Wirksamkeit
dieser Therapie lässt sich nur schlecht
durch klassische randomisierte, plazebokontrollierte
und doppelblinde Studien
evaluieren. Ergebnisse relativ grosser Register-Studien
sprechen dafür, dass durch
diese Therapie kardiovaskuläre Ereignisraten
gesenkt werden. Die Therapie wird
schon heute sehr selten eingesetzt und
ihre Indikation wird durch die PCSK9-
Hemmer noch stärker reduziert [38, 39].
MTP-Hemmer
Ziel des Einsatzes von MTP-Hemmern
(Lomitapid, Juxtapid ® ) ist die Senkung
der Produktion von Lipoproteinen in
Darm und Leber. Obwohl MTP-Hemmer
das LDL-Cholesterin bis ca. 50 % senken,
ist der Einsatz dieser Therapie durch deutliche
Erhöhung der Leberwerte und Leberverfettung
limitiert [40]. ■
Manuskript angenommen: 24.5.2017
Interessenskonflikt: Die Autoren erklären,
dass kein Interessenskonflikt besteht.
PD Dr. med. Isabella Sudano,
PhD
Kardiologie
Universitäres Herzzentrum
Universitätsspital Zürich
Rämistrasse 100
8091 Zürich
isabella.sudano@usz.ch
Bibliografie
1. Cholesterol Treatment Trialists C, Baigent C,
Blackwell L, et al.: Efficacy and safety of
more intensive lowering of LDL cholesterol:
a meta-analysis of data from 170 000 participants
in 26 randomised trials. Lancet 2010;
376: 1670–1681.
2. Cholesterol Treatment Trialists C, Fulcher J,
O›Connell R, et al.: Efficacy and safety of
LDL-lowering therapy among men and women:
meta-analysis of individual data from
174 000 participants in 27 randomised trials.
Lancet 2015; 385: 1397–1405.
3. Karmali KN, Lloyd-Jones DM, Berendsen MA,
et al.: Drugs for primary prevention of atherosclerotic
cardiovascular disease: An overview
of systematic reviews. JAMA Cardiol
2016; 1: 341–349.
4. Taylor F, Huffman MD, Macedo AF, et al.:
Statins for the primary prevention of cardiovascular
disease. Cochrane Database Syst
Rev 2013; 1: CD004816.
5. Stroes ES, Thompson PD, Corsini A, et al.:
Statin-associated muscle symptoms: impact
on statin therapy - European Atherosclerosis
Society Consensus Panel Statement on Assessment,
Aetiology and Management. Eur
Heart J 2015; 36: 1012–1022.
6. Catapano AL, Graham I, De Backer G, et al.:
2016 ESC/EAS Guidelines for the Management
of Dyslipidaemias. Eur Heart J 2016;
37: 2999–3058.
7. Selby K, Nanchen D, Auer R, et al.: Low statin
use in adults hospitalized with acute coronary
syndrome. Prev Med 2015; 77: 131–136.
8. Javed U, Deedwania PC, Bhatt DL, et al.: Use
of intensive lipid-lowering therapy in patients
hospitalized with acute coronary syndrome:
An analysis of 65396 hospitalizations
from 344 hospitals participating in Get With
The Guidelines (GWTG). Am Heart J 2011;
161: 418–424. e1–3.
9. Nissen SE, Stroes E, Dent-Acosta RE, et al.:
Efficacy and tolerability of evolocumab vs
ezetimibe in patients with muscle-related
statin intolerance: The GAUSS-3 Randomized
Clinical Trial. JAMA 2016; 315: 1580–
1590.
10. Hirota T, Ieiri I: Drug-drug interactions that
interfere with statin metabolism. Expert
Opin Drug Metab Toxicol 2015; 11: 1435–
1447.
11. Farnier M, Jones P, Severance R, et al.: Efficacy
and safety of adding alirocumab to
rosuvastatin versus adding ezetimibe or
doubling the rosuvastatin dose in high cardiovascular-risk
patients: The ODYSSEY
OPTIONS II randomized trial. Atherosclerosis
2016; 244: 138–146.
12. Naci H, Brugts J, Ades T: Comparative tolerability
and harms of individual statins: a
study-level network meta-analysis of 246 955
participants from 135 randomized, controlled
trials. Circ Cardiovasc Qual Outcomes
2013; 6: 390–399.
13. Taylor BA, Lorson L, White CM, Thompson
PD: A randomized trial of coenzyme Q10 in
patients with confirmed statin myopathy.
Atherosclerosis 2015; 238: 329–335.
14. Kang JH, Nguyen QN, Mutka J, Le QA: Rechallenging
statin therapy in veterans with
statin-induced myopathy post vitamin D
replenishment. J Pharm Pract 2016; pii:
0897190016674407. [Epub ahead of print].
15. Toth PP, Davidson MH: Cholesterol absorption
blockade with ezetimibe. Curr Drug
Targets Cardiovasc Haematol Disord 2005;
5: 455–462.
16. Phan BA, Dayspring TD, Toth PP: Ezetimibe
therapy: mechanism of action and clinical
update. Vasc Health Risk Manag 2012; 8:
415–427.
17. Cannon CP, Blazing MA, Giugliano RP, et al.:
Ezetimibe added to statin therapy after acute
coronary syndromes. N Engl J Med 2015;
372: 2387–2397.
18. Giugliano RP, Wiviott SD, Blazing MA, et al.:
Long-term safety and efficacy of achieving
very low levels of low-density lipoprotein cholesterol
: A prespecified analysis of the IMPRO-
VE-IT trial. JAMA Cardiol 2017; 2: 547–555.
19. Jakob T, Nordmann AJ, Schandelmaier S,
Ferreira-Gonzalez I, Briel M: Fibrates for
primary prevention of cardiovascular disease
events. Cochrane Database Syst Rev
2016; 11: CD009753.
20. Wang D, Liu B, Tao W, Hao Z, Liu M: Fibrates
for secondary prevention of cardiovascular
disease and stroke. Cochrane Database Syst
Rev 2015; 10: CD009580.
21. Black DM: Gut-acting drugs for lowering
cholesterol. Curr Atheroscler Rep 2002; 4:
71–75.
22. Drexel H: Statins, fibrates, nicotinic acid,
cholesterol absorption inhibitors, anionexchange
resins, omega-3 fatty acids: which
drugs for which patients? Fundam Clin
Pharmacol 2009; 23: 687–692.
23. Abifadel M, Elbitar S, El Khoury P, et al.:
Living the PCSK9 adventure: from the identification
of a new gene in familial hypercholesterolemia
towards a potential new
class of anticholesterol drugs. Curr Atheroscler
Rep 2014; 16: 439.
24. Raal FJ, Stein EA, Dufour R, et al.: PCSK9
inhibition with evolocumab (AMG 145) in
heterozygous familial hypercholesterolaemia
(RUTHERFORD-2): a randomised,
double-blind, placebo-controlled trial. Lancet
2015; 385: 331–340.
25. Raal FJ, Honarpour N, Blom DJ, et al.: Inhibition
of PCSK9 with evolocumab in homozygous
familial hypercholesterolaemia
(TESLA Part B): a randomised, double-blind,
placebo-controlled trial. Lancet 2015; 385:
341–350.
26. Cho L, Rocco M, Colquhoun D, et al.: Clinical
profile of statin intolerance in the phase 3
GAUSS-2 study. Cardiovasc Drugs Ther 2016;
30: 297–304.
27. Moriarty PM, Thompson PD, Cannon CP, et
al.: Efficacy and safety of alirocumab vs
ezetimibe in statin-intolerant patients, with
a statin rechallenge arm: The ODYSSEY AL-
TERNATIVE randomized trial. J Clin Lipidol
2015; 9: 758–769.
28. Nissen SE, Stroes E, Dent-Acosta RE, et al.:
Efficacy and tolerability of evolocumab vs
ezetimibe in patients with muscle-related
statin intolerance: The GAUSS-3 randomized
clinical trial. JAMA 2016; 315: 1580–1590.
29. Robinson JG, Nedergaard BS, Rogers WJ, et
al.: Effect of evolocumab or ezetimibe added
to moderate- or high-intensity statin therapy
on LDL-C lowering in patients with hypercholesterolemia:
the LAPLACE-2 randomized
clinical trial. JAMA 2014; 311: 1870–
1882.
30. Koren MJ, Sabatine MS, Giugliano RP, et al.:
Long-term low-density lipoprotein cholesterol-lowering
efficacy, persistence, and safety
of evolocumab in treatment of hypercholesterolemia:
Results up to 4 years from the
open-label OSLER-1 extension study. JAMA
Cardiol 2017; 2: 598–607.
31. Bays H, Gaudet D, Weiss R, et al.: Alirocumab
as add-on to atorvastatin versus other lipid
treatment strategies: ODYSSEY OPTIONS I
randomized trial. J Clin Endocrinol Metab
2015; 100: 3140–3148.
48 VSAO JOURNAL ASMAC N° 5 Octobre 2018