Araya VJ, Bolaños AM

Idioma: Español
Referencias bibliográficas: 19
Paginas: 11-16
Archivo PDF: 449.60 Kb.

RESUMEN

La disminución en los niveles de LDL sérico con estatinas ha demostrado reducir las complicaciones y mortalidad por enfermedad cardiovascular. Sin embargo, 10-20% de los pacientes muestran intolerancia a éstas o resistencia para lograr la meta de LDL como en pacientes con hipercolesterolemia familiar. Actualmente se han desarrollado estudios en búsqueda de medicamentos alternativos para pacientes con hipercolesterolemia severa, como es el caso del Evolocumab. Éste es un anticuerpo monoclonal dirigido contra PCSK9, que permite la reducción en la concentración sérica de LDL. Los estudios demostraron una disminución estadísticamente significativa de hasta un 66% en los grupos tratados con Evolocumab, asociado o no a estatinas, en comparación con placebo y/o ezetimibe. Mostrando ser efectiva en un lapso de 12 semanas. Aunque fue bien tolerado se relacionó con efectos adversos, sin embargo su incidencia fue similar es comparación al grupo control. El problema de estos estudios se debe a inconsistencias en el diseño de éstos, así como conflicto de interés por parte sus autores. Aunque se ha demostrado la efectividad del Evolocumab en la disminución del LDL, es necesario realizar una mayor investigación que permita comprender su eficacia y seguridad a largo plazo, así como demostrar una posible reducción en la mortalidad. Hasta el momento, el Evolocumab es una alternativa terapéutica en aquellas poblaciones con hipercoleterolemia familiar que no logran alcanzar niveles óptimos de LDL.

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