WASHINGTON – With the results of two blockbuster trials in lipid-lowering PCSK9 inhibitors, the long-awaited verdict on LDL cholesterol’s effect on cardiovascular outcomes is in: Lower is better.
In a video interview at the annual meeting of the American College of Cardiology, Paul M. Ridker, MD, added that “lower is better for longer.”
Dr. Ridker presented results of the SPIRE (Studies of PCSK9 Inhibition and the Reduction of Vascular Events) program in bococizumab. Bococizumab was revealed to spur antibody responses in some patients, leading Pfizer to discontinue the SPIRE program and any further development. However, the combined endpoint for all six SPIRE trials was reduced by 25%, a trend that continued with longer treatment.
The FOURIER (Further Cardiovascular Outcomes Research with PCSK9 Inhibition in Subjects with Elevated Risk) trial, presented by Marc S. Sabatine, MD, of Brigham and Women’s Hospital in Boston, showed a reduction of 15% in the cardiovascular events.
Both the SPIRE and the FOURIER program have now provided evidence saying “lower is better for longer,” Dr. Ridker said in a video interview. The challenge is, “who do we want to get these drugs into first?”
For his part, Dr. Ridker, director of the Center for Cardiovascular Disease Prevention at Brigham and Women’s Hospital and professor of medicine at Harvard Medical School, Boston, will focus on his very-high-risk patients who are receiving the most aggressive therapy possible.