Articles producció científica> Medicina i Cirurgia

Real-World Outcomes with Lomitapide Use in Paediatric Patients with Homozygous Familial Hypercholesterolaemia.

  • Identification data

    Identifier: imarina:5671202
    Authors:
    Ben-Omran T, Masana L, Kolovou G, Ariceta G, Nóvoa FJ, Lund AM, Bogsrud MP, Araujo M, Hussein O, Ibarretxe D, Sanchez-Hernández RM, Santos RD
    Abstract:
    Homozygous familial hypercholesterolaemia (HoFH) is a rare, autosomal disease affecting the clearance of low-density lipoprotein cholesterol (LDL-C) from circulation, and leading to early-onset atherosclerotic cardiovascular disease (ASCVD). Treatment consists mainly of statins, lipoprotein apheresis (LA) and, more recently, the microsomal triglyceride transfer protein inhibitor lomitapide. Lomitapide is not licensed for use in children, but has been made available through an expanded access programme or on a named patient basis.This case series includes 11 HoFH patients in 10 different centres in eight countries, less than 18 years of age (mean 11.6?±?1.1 years, 64% male), with signs of ASCVD, and who have received treatment with lomitapide (mean dose 24.5?±?4.3 mg/day; mean exposure 20.0?±?2.9 months). Background lipid-lowering therapy was given according to local protocols. Lomitapide was commenced with a stepwise dose escalation from 2.5 mg or 5 mg/day; dietary advice and vitamin supplements were provided as per the product label for adults. Laboratory analysis was conducted as part of regular clinical care.In the 11 cases, mean baseline LDL-C was 419?±?74.6 mg/dL and was markedly reduced by lomitapide to a nadir of 176.7?±?46.3 mg/dL (58.4?±?6.8% decrease). Six patients achieved recommended target levels for children below 135 mg/dL, five of whom had LA frequency reduced. In one case, LDL-C levels were close to target when lomitapide was started but remained stable despite 75% reduction in LA frequency (from twice weekly to biweekly). Adverse events were mainly gastrointestinal in nature, occurred early in the treatment course and were well managed. Three patients with excursions in liver function tests were managed chiefly without intervention; two patients had de
  • Others:

    Author, as appears in the article.: Ben-Omran T, Masana L, Kolovou G, Ariceta G, Nóvoa FJ, Lund AM, Bogsrud MP, Araujo M, Hussein O, Ibarretxe D, Sanchez-Hernández RM, Santos RD
    Department: Medicina i Cirurgia
    URV's Author/s: Masana Marín, Luis
    Keywords: Transfer protein inhibitor Safety Real-world data Patient cases Paediatric Low-density lipoprotein cholesterol Lomitapide Lipidology Ldl-apheresis Insights Homozygous familial hypercholesterolaemia Guidance Experience Efficacy Density-lipoprotein apheresis Clinician Cardiology Atherosclerosis Adverse events patient cases paediatric low-density lipoprotein cholesterol lomitapide lipidology homozygous familial hypercholesterolaemia cardiology atherosclerosis adverse events
    Abstract: Homozygous familial hypercholesterolaemia (HoFH) is a rare, autosomal disease affecting the clearance of low-density lipoprotein cholesterol (LDL-C) from circulation, and leading to early-onset atherosclerotic cardiovascular disease (ASCVD). Treatment consists mainly of statins, lipoprotein apheresis (LA) and, more recently, the microsomal triglyceride transfer protein inhibitor lomitapide. Lomitapide is not licensed for use in children, but has been made available through an expanded access programme or on a named patient basis.This case series includes 11 HoFH patients in 10 different centres in eight countries, less than 18 years of age (mean 11.6?±?1.1 years, 64% male), with signs of ASCVD, and who have received treatment with lomitapide (mean dose 24.5?±?4.3 mg/day; mean exposure 20.0?±?2.9 months). Background lipid-lowering therapy was given according to local protocols. Lomitapide was commenced with a stepwise dose escalation from 2.5 mg or 5 mg/day; dietary advice and vitamin supplements were provided as per the product label for adults. Laboratory analysis was conducted as part of regular clinical care.In the 11 cases, mean baseline LDL-C was 419?±?74.6 mg/dL and was markedly reduced by lomitapide to a nadir of 176.7?±?46.3 mg/dL (58.4?±?6.8% decrease). Six patients achieved recommended target levels for children below 135 mg/dL, five of whom had LA frequency reduced. In one case, LDL-C levels were close to target when lomitapide was started but remained stable despite 75% reduction in LA frequency (from twice weekly to biweekly). Adverse events were mainly gastrointestinal in nature, occurred early in the treatment course and were well managed. Three patients with excursions in liver function tests were managed chiefly without intervention; two patients had decreases in lomitapide dose.Lomitapide demonstrated promising effectiveness in paediatric HoFH patients. Adverse events were manageable, and the clinical profile of the drug is apparently similar to that in adult patients.Amryt Pharma.
    Thematic Areas: Pharmacology (medical) Pharmacology & pharmacy Medicine, research & experimental Medicine (miscellaneous) Medicina iii Medicina ii Medicina i General medicine
    licence for use: https://creativecommons.org/licenses/by/3.0/es/
    ISSN: 0741238X
    Author's mail: luis.masana@urv.cat
    Author identifier: 0000-0002-0789-4954
    Record's date: 2023-02-18
    Papper version: info:eu-repo/semantics/publishedVersion
    Link to the original source: https://link.springer.com/article/10.1007%2Fs12325-019-00985-8
    Papper original source: Advances In Therapy. 36 (7): 1786-1811
    APA: Ben-Omran T, Masana L, Kolovou G, Ariceta G, Nóvoa FJ, Lund AM, Bogsrud MP, Araujo M, Hussein O, Ibarretxe D, Sanchez-Hernández RM, Santos RD (2019). Real-World Outcomes with Lomitapide Use in Paediatric Patients with Homozygous Familial Hypercholesterolaemia.. Advances In Therapy, 36(7), 1786-1811. DOI: 10.1007/s12325-019-00985-8
    Licence document URL: https://repositori.urv.cat/ca/proteccio-de-dades/
    Article's DOI: 10.1007/s12325-019-00985-8
    Entity: Universitat Rovira i Virgili
    Journal publication year: 2019
    Publication Type: Journal Publications
  • Keywords:

    Medicine (Miscellaneous),Medicine, Research & Experimental,Pharmacology & Pharmacy,Pharmacology (Medical)
    Transfer protein inhibitor
    Safety
    Real-world data
    Patient cases
    Paediatric
    Low-density lipoprotein cholesterol
    Lomitapide
    Lipidology
    Ldl-apheresis
    Insights
    Homozygous familial hypercholesterolaemia
    Guidance
    Experience
    Efficacy
    Density-lipoprotein apheresis
    Clinician
    Cardiology
    Atherosclerosis
    Adverse events
    patient cases
    paediatric
    low-density lipoprotein cholesterol
    lomitapide
    lipidology
    homozygous familial hypercholesterolaemia
    cardiology
    atherosclerosis
    adverse events
    Pharmacology (medical)
    Pharmacology & pharmacy
    Medicine, research & experimental
    Medicine (miscellaneous)
    Medicina iii
    Medicina ii
    Medicina i
    General medicine
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