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Colesterolo LDL: L’acido bempedoico (NILEMDO®) riduce significativamente il colesterolo nei pazienti con ipercolesterolemia familiare. L’analisi presentata all’EAS2020

L’ipercolesterolemia familiare eterozigote è una condizione comune che colpisce più di 30 milioni di persone nel mondo e causa un aumentato rischio di eventi cardiovascolari come infarto o ictus. Nei pazienti affetti da questa condizione che assumevano statine alla massima dose tollerata, l’acido bempedoico ha ridotto i livelli di colesterolo LDL del 22,3% rispetto al placebo. I dati di un’analisi aggregata su 3.000 pazienti presentati da Daiichi Sankyo all’EAS 2020

Roma, 8 ottobre 2020 – L’acido bempedoico (NILEMDO®) ha dimostrato riduzioni significative del colesterolo nelle persone con la forma più comune di ipercolesterolemia familiare. [1],[2] In occasione dell’88° Congresso annuale della European Atherosclerosis Society (EAS 2020), Daiichi Sankyo ha presentato i dati di un'analisi aggregata di oltre 3.000 pazienti arruolati in due studi di fase III.

L'acido bempedoico ha ridotto i livelli di colesterolo delle lipoproteine ​​a bassa densità (C-LDL) del 22,3% rispetto al placebo, nei pazienti con ipercolesterolemia familiare eterozigote (HeFH) che assumevano statine alla massima dose tollerata con o senza ulteriori terapie ipolipemizzanti (LLT). L'acido bempedoico è stato ben tollerato e non sono stati osservati nuovi eventi avversi.3 

L’ipercolesterolemia familiare eterozigote è una condizione comune che colpisce più di 30 milioni di persone nel mondo e causa un aumentato rischio di eventi cardiovascolari come infarto o ictus. [3],[4],[5] [6]  Fino all'80% dei pazienti non raggiunge gli obiettivi di C-LDL raccomandati dalle linee guida nonostante ricevano trattamenti come statine e altre terapie ipolipemizzanti. "Nei pazienti con HeFH, se non trattati, il rischio di malattia cardiovascolare aterosclerotica aumenta fino a 10-20 volte rispetto a chi non presenta HeFH, principalmente come conseguenza di ipercolesterolemia cronica severa. Nei pazienti con HeFH, una decisa riduzione del colesterolo LDL è, dunque, un intervento fondamentale per la prevenzione anche se è un obiettivo difficile da raggiungere; per questo sono necessarie nuove opzioni di trattamento. - Ha spiegato P. Barton Duell, Professore di Medicina all’ Oregon Health & Science University di Portland, che ha presentato i dati all'EAS – Questa analisi dimostra che l'acido bempedoico porta una riduzione clinicamente significativa del colesterolo LDL con un buon profilo di sicurezza, se aggiunto ad altri farmaci ipolipemizzanti in pazienti affetti da ipercolesterolemia familiare eterozigote. Tali risultati forniscono nuove importanti informazioni per questi pazienti e i medici che ora hanno un'ulteriore opzione da considerare".

L’acido bempedoico (NILEMDO®) é un innovativo trattamento first-in-class in monosomministrazione giornaliera, che riduce i valori di C-LDL e può essere associato ad altri trattamenti orali per abbassarne ulteriormente i livelli.[7] Agisce sul ben noto processo di sintesi del colesterolo, a monte del target epatico delle statine, consentendo una ulteriore riduzione del livello di C-LDL quando aggiunto alla terapia con statine o ad altre terapie ipolipemizzanti. 1,[8] Grazie al suo innovativo meccanismo d’azione, NILEMDO® non è attivo nel muscolo scheletrico, diminuendo così le possibilità di effetti collaterali muscolo-correlati.1,2 L'acido bempedoico è approvato in Europa per la riduzione del colesterolo LDL negli adulti con ipercolesterolemia primaria o dislipidemia mista. 1                                              

“L'acido bempedoico fornisce un nuovo meccanismo d'azione per la riduzione del colesterolo LDL che è complementare alle statine e ad altre terapie ipolipemizzanti. Ciò significa che può essere utilizzato come aggiunta ai trattamenti esistenti per abbassare ulteriormente i livelli di C-LDL. - Ha dichiarato Jarkko Soronen, Direttore del Dipartimento di Medical Affairs, Antithrombotic & Cardiovascular di Daiichi Sankyo Europa. “Livelli elevati di LDL sono una causa diretta e provata di malattia cardiovascolare aterosclerotica. L'acido bempedoico e la sua associazione a dose fissa con ezetimibe potrebbero diventare nuove importanti opzioni di trattamento che hanno il potenziale per ridurre il peso delle malattie cardiovascolari in Europa, dove i costi sanitari diretti associati ammontano a 111 miliardi di euro all'anno".

Riferimenti

[1] Barton Duell P, et al. Efficacy and Safety of Bempedoic Acid in Patients with Heterozygous Familial Hypercholesterolemia: Analysis of Pooled Patient-level Data From Phase 3 Clinical Trials. Presentation at the European Atherosclerosis Society 88th Congress Virtual Meeting. October 2020.

[2] Di Taranto, MD, et al. Familial hypercholesterolemia: A complex genetic disease with variable phenotypes. European Journal of Medical Genetics. 2020. 63;4:103831.

[3] The Task Force for the management of dyslipidaemias of the European Society of Cardiology (ESC) and European Atherosclerosis Society (EAS). ESC/EAS guidelines for the management of dyslipidaemia. European Heart Journal. 2020 Jan 1;41(1):111-188. doi:10.1093/eurheartj/ehz455.

[4] Fox KM, et al. Treatment patterns and low-density lipoprotein cholesterol (LDL-C) goal attainment among patients receiving high- or moderate-intensity statins. Clinical Research in Cardiology 2018; 107: 380–388.

[5] Kotseva K, et al. Lifestyle and impact on cardiovascular risk factor control in coronary patients across 27 countries: Results from the European Society of Cardiology ESC-EORP EUROASPIRE V registry. European Journal of Preventative Cardiology. 2019;26(8):824–835.

[6] McGowan, MP, et al. Diagnosis and treatment of heterozygous familial hypercholesterolemia. Journal of the American Heart Association. 2019. 8;24:e013225.

[7] European Medicines Agency. NILEMDO® Summary of Product Characteristics. March 2020.  

[8] Pinkosky SL, et al. Liver- specific ATP-citrate lyase inhibition by bempedoic acid decreases LDL-C and attenuates atherosclerosis. Nature Communications. 2016; 7:13457. DOI:10.1038/ncomms13457.