REPATHA TO REDUCE BAD CHOLESTEROL |
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In Malaysia, non-communicable diseases (NCDs) are the main cause of death, contributing to an estimated 73% of total deaths. The biggest contributor to this are cardiovascular diseases inclusive of heart attacks and strokes. According to the 2015 National Health and Morbidity Survey, an estimated 47.7 per cent of Malaysians aged 18 and above have high blood cholesterol (hypercholesterolaemia). The accumulation of cholesterol within the arteries results in atherosclerosis which could possibly lead to myocardial infarction (heart attack) or stroke.
Cholesterol exists in two forms; low density lipoprotein (LDL or “bad” cholesterol) and high-density lipoprotein (HDL or “good” cholesterol). LDL carries cholesterol to tissues which may result in obstruction of blood vessels. Therefore, high levels of LDL cholesterol is recognised as a major risk factor for cardiovascular diseases. Amgen recently announced the availability of Repatha, a PCSK9 inhibitor for lowering high cholesterol. Cardiac Vascular Sentral Kuala Lumpur (CVSKL) Consultant Cardiologist Dr. Choo Gim Hooi pointed out that Repatha contains an active substance called evolocumab. "Evolocumab is designed to attach to a substance called PCSK9 that affects the liver’s ability to take in cholesterol. By attaching to, and mopping up PCSK9, the medicine increases the amount of cholesterol entering the liver and consequently, lowers the level of cholesterol in the blood. With Repatha inhibiting the protein, in combination with statin, the liver is able to reduce LDL (bad cholesterol) in the blood by up to 70 percent." Statins are commonly prescribed to lower high LDL. However, for some patients it may not be sufficient. The PCSK9 inhibitors such as evolocumab (Repatha) can assist further by considerably reducing LDL cholesterol in patients who cannot reach optimum results using standard therapy with statins. Repatha can be used in combination with a statin for patients who are unable to achieve adequate reduction in LDL cholesterol at the maximum tolerated dose of statin. Data from clinical trials demonstrated that Repatha resulted in up to 77 per cent additional LDL-C reduction in patients already receiving statin therapy. In Malaysia, Repatha is indicated as an adjunct to diet and maximally tolerated statin therapy for the treatment of adults with heterozygous familial hypercholesterolemia or clinical atherosclerotic cardiovascular disease, who require additional lowering of LDL-C; and also as an adjunct to diet and other LDL-lowering therapies for the treatment of patients with homozygous familial hypercholesterolemia, who require additional lowering of LDL-C. |