AB0875-HPR NON-PHARMACOLOGICAL AND PHARMACOLOGICAL APPROACHES TO THE MANAGEMENT OF PATIENTS WITH OSTEOARTHRITIS AND LIPID METABOLISM DISORDERS

Background:Attention is drawn to the frequent combination of osteoarthritis (OA) with cardiovascular disease. Non-specific inflammation plays a significant role in the pathogenesis of OA and atherosclerosis. Limiting the physical activity of patients with OA is an additional important factor aggravating the course of cardiovascular disease (CVD). Chronic pain syndrome, causing a neuroendocrine response, is often the cause of the development of complications of atherosclerotic disease. Dyslipidemia is the main cause of atherosclerosis and vascular thrombosis.Objectives:To study variants of lipid metabolism disorders in female and male patients of different age groups with osteoarthritis.Methods:Case histories of 90 patients with OA were analyzed. The average age of patients was 63.27 ± 11.31 years. The average body mass index (BMI) is 39.8 ± 3.2. All patients underwent questionnaires, general clinical and biochemical blood tests with lipid profile determination, anthropometry, bioimpedansometry, and the main metabolic rate assessment using indirect calorimetry in dynamics (at the beginning of the study and after 3 months).Results:Burdened heredity for obesity, arterial hypertension (AH), diabetes mellitus (DM) was revealed. AH was diagnosed in 76 patients (84.4%), type II diabetes in 17 (18.9%), dyslipidemia and hypercholesterolemia in 56 (62.2%). Statins were taken by 43 patients (47.8%) - group I patients, which is associated with low adherence to therapy, group II included patients who did not initially take statins or stopped taking them at least 6 months before inclusion in the study.Against the background of diet therapy and physiotherapy exercises, BMI (R0.99; p <0.05), fat mass (R0.95; p <0.05) significantly decreased, lipid profile normalization was noted: total cholesterol (R0.66; p <0 .05), LDL (R0.69; p <0.05), HDL (R0.95; p <0.05), TG (R0.57; p <0.05), AST decreased (R0.64; p <0.05) and ALT (R0.76; p <0.05) in both groups of patients, regardless of lipid-lowering therapy. A decrease in fat mass correlated with TG levels (R0.51; p <0.05), an increase in skeletal muscle mass (R0.60; p <0.05), lean mass (R0.72; p <0.05), and active cell mass (R0.59; p <0.05). The lipid profile in the I group of patients was significantly better before and at the end of the study. Long-term effects have not been investigated due to the short duration of the study.Conclusion:In patients with OA, a high frequency of concomitant diseases of the cardiovascular system, lipid metabolism disorders was found. Non-drug therapy has a positive effect on the lipid profile and the level of transaminases. The decrease in body weight due to loss of fat mass reliably correlates with the level of TG. Timely use of statins contributes to the normalization of the lipid profile, reduces the risk of cardiovascular disease in patients with OA. It is necessary to study lipid profile disorders in patients with OA with recommendations for lifestyle modification (diet, physical activity), and if necessary, prescribe lipid-correcting therapy.References:[1]E. Simakova, B. Zavodovsky, L. Sivordova [et al]. Prognostic significance of lipid disorders markers determination in pathogenesis of osteoarthritis. Vestnik Rossijskoj voenno-medicinskoj akademii. 2013. No. 2 (42). P.29-32.[2]Zavodovsky B.V., Sivordova L.E. Prognostic significance value of definition of leptin level determination in osteoarthritis. Siberian Medical Journal (Irkutsk). 2012; 115(8):069-072.Disclosure of Interests:None declared

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Intensification of lipid-lowering therapy in patients with severe lipid metabolism disorders in specialized lipid control centers. Possibilities of using evolocumab

Russian Medical Inquiry ◽

10.32364/2587-6821-2020-4-7-437-444 ◽

2020 ◽

Vol 4 (7) ◽

pp. 437-444

Author(s):

O.L. Barbarash ◽

◽

V.V. Kashtalap ◽

N.V. Fedorova ◽

D.Yu. Sedykh ◽

...

Keyword(s):

Lipid Metabolism ◽

Current Data ◽

Lipid Lowering ◽

Lipid Lowering Therapy ◽

Pcsk9 Inhibitors ◽

Control Center ◽

Lowering Therapy ◽

Lipid Metabolism Disorders ◽

Target Values ◽

Lipid Control

The article presents current data on the prevalence of dyslipidemia worldwide and in the Russian Federation as the main cardiovascular risk factor of developing diseases associated with atherosclerosis. The article identifies the problems of low-level detection of dyslipidemia in the population and insufficient efficacy of lipid-lowering therapy to achieve the lipid profile target values depending on the established risk. It also presents the possibilities of modern lipid-lowering therapy with the use of innovative drugs — PCSK9 inhibitors and the use of evolocumab in accordance with evidence-based medicine. Adding that, the article shows the experience of two lipid control centers (in Kemerovo and Surgut) with the postulation of the need to expand the lipid control center chain to improve methods for providing medical care to patients with severe forms of dyslipidemia. The possibilities of intensifying lipid-lowering therapy in real clinical practice are outlined on the example of patients undergoing treatment in the lipid control center of Kemerovo. Evolocumab has been shown to be highly effective: reduction of atherogenic cholesterol fractions by 67% from the baseline and high safety of such therapy.KEYWORDS: lipid metabolism disorders, statins, lipid-lowering therapy, familial hypercholesterolemia, PCSK9 inhibitors, evolocumab.FOR CITATION: Barbarash O.L., Kashtalap V.V., Fedorova N.V. et al. Intensification of lipid-lowering therapy in patients with severe lipid metabolism disorders in specialized lipid control centers. Possibilities of using evolocumab. Russian Medical Inquiry. 2020;4(7):437–444. DOI: 10.32364/2587-6821-2020-4-7-437-444.

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Unsolved Issues of Atherosclerosis Prevention and of Adequate Lipid-lowering Therapy in Patients with Acute Ischemic Cerebrovascular Accident

Rational Pharmacotherapy in Cardiology ◽

10.20996/1819-6446-2021-12-10 ◽

2022 ◽

Vol 17 (6) ◽

pp. 927-930

Author(s):

S. A. Boytsov ◽

M. A. Piradov ◽

M. M. Tanashyan ◽

I. A. Voznjouk ◽

M. V. Ezhov ◽

...

Keyword(s):

Lipid Metabolism ◽

Cerebrovascular Accident ◽

Evidence Base ◽

Lipid Lowering ◽

Lipid Lowering Therapy ◽

Acute Cerebrovascular Accident ◽

Lowering Therapy ◽

Lipid Metabolism Disorders ◽

Interdisciplinary Interaction ◽

Atherosclerosis Prevention

The existing system of medical care for patients with acute cerebrovascular accident of atherothrombotic genesis, namely lipid metabolism disorders, the modern evidence base for lipid-lowering therapy in this category of patients and the feasibility of interdisciplinary interaction of cardiologists and neurologists were discussed at a meeting of the expert council of cardiologists and neurologists in Moscow on 2021 July 7.

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Prescription patterns of lipid-lowering therapy in patients with cardiovascular disease and hypertriglyceridemia in real clinical practice in Russia

Atherosclerosis ◽

10.1016/j.atherosclerosis.2017.06.771 ◽

2017 ◽

Vol 263 ◽

pp. e237

Author(s):

Natalia Gurina ◽

Mikhail Loukianov ◽

Sergey Martsevich ◽

Alexander Zagrebelny ◽

Egor Kudryashov ◽

...

Keyword(s):

Cardiovascular Disease ◽

Clinical Practice ◽

Lipid Lowering ◽

Lipid Lowering Therapy ◽

Prescription Patterns ◽

Lowering Therapy ◽

Real Clinical Practice

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Absolute cardiovascular disease risk and lipid‐lowering therapy among Aboriginal and Torres Strait Islander Australians

The Medical Journal of Australia ◽

10.5694/mja18.00711 ◽

2018 ◽

Vol 209 (8) ◽

pp. 369

Author(s):

Rosalie Schultz

Keyword(s):

Cardiovascular Disease ◽

Torres Strait Islander ◽

Disease Risk ◽

Cardiovascular Disease Risk ◽

Lipid Lowering ◽

Lipid Lowering Therapy ◽

Lowering Therapy ◽

Torres Strait

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The impact of atherosclerotic cardiovascular disease, dyslipidaemia and lipid lowering therapy on Coronavirus disease 2019 outcomes

Current Opinion in Lipidology ◽

10.1097/mol.0000000000000763 ◽

2021 ◽

Vol Publish Ahead of Print ◽

Author(s):

Safwaan Adam ◽

Jan Hoong Ho ◽

Bilal Bashir ◽

Zohaib Iqbal ◽

Maryam Ferdousi ◽

...

Keyword(s):

Cardiovascular Disease ◽

Lipid Lowering ◽

Atherosclerotic Cardiovascular Disease ◽

Lipid Lowering Therapy ◽

Lowering Therapy ◽

The Impact

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The Effect of Micronized Fenofibrate on Lipid Profiles of Patients Converted from Gemfibrozil

Hospital Pharmacy ◽

10.1177/001857870203700915 ◽

2002 ◽

Vol 37 (9) ◽

pp. 953-956 ◽

Cited By ~ 1

Author(s):

Jim M. Backes ◽

Patrick M. Moriarty ◽

Cheryl A. Gibson

Keyword(s):

Randomized Trial ◽

Lipid Profile ◽

Lipid Profiles ◽

Comparative Data ◽

Lipid Lowering ◽

Lipid Lowering Therapy ◽

Two Agents ◽

Lowering Therapy ◽

Micronized Fenofibrate ◽

The Mean

Although numerous studies have established the efficacy of micronized fenofibrate (MF) and gemfibrozil in improving lipid profiles, there are limited comparative data on the lipid-lowering effects of these two agents. The objective of this study was to evaluate the mean changes in lipid values of hypertriglyceridemic patients crossed over from gemfibrozil to MF. The Medical charts of 21 patients were analyzed retrospectively. Patients were maintained on gemfibrozil 600 mg twice daily for a minimum of 3 months. The patient's last fasting lipid profile on gemfibrozil was compared to the first lipid profile after crossover to MF 200 to 201 mg/day. Patients were excluded if there were alterations in other lipid-lowering therapy during the cross-over or documented non-adherence. The lipid profiles after the crossover showed a significant reduction in triglycerides (56%; P < 0.05) and TC/HDL ratio (38%; P < 0.05) and a significant increase in HDL (22%; P < 0.05). There were nonsignificant changes in other lipid values: TC (-22%; P = 0.058), LDL (+5%; P = 0.866) and LDL/HDL ratio (+6; P = 1.0). The results show that MF had additional favorable effects on triglycerides, HDL, and TC/HDL ratio compared with gemfibrozil. A larger, randomized trial to confirm these effects is warranted.

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P938Extensive formation of atherosclerotic cardiovascular disease in subjects with severe familial hypercholesterolemia defined by the international atherosclerosis society criteria

European Heart Journal ◽

10.1093/eurheartj/ehz747.0532 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

S Funabashi ◽

Y Kataoka ◽

M Harada-Shiba ◽

M Hori ◽

T Doi ◽

...

Keyword(s):

Cardiovascular Disease ◽

High Risk ◽

Familial Hypercholesterolemia ◽

Peripheral Artery Disease ◽

Cardiac Death ◽

Lipid Lowering ◽

Lipid Lowering Therapy ◽

Peripheral Artery ◽

Lowering Therapy ◽

Artery Disease

Abstract Introduction The International Atherosclerosis Society (IAS) has proposed “severe familial hypercholesterolemia (FH)” as a FH phenotype with the highest cardiovascular risk. Coronary artery disease (CAD) represents a major atherosclerotic change in FH patients. Given their higher LDL-C level and atherogenic clinical features, more extensive formation of atherosclerosis cardiovascular disease including not only CAD but stroke/peripheral artery disease (PAD) may more frequently occur in severe FH. Methods 481 clinically-diagnosed heterozygous FH subjects were analyzed. Severe FH was defined as untreated LDL-C>10.3 mmol/l, LDL-C>8.0 mmol/l+ 1 high-risk feature, LDL-C>4.9 mmol/l + 2 high-risk features or presence of clinical ASCVD according to IAS proposed statement. Cardiac (cardiac death and ACS) and non-cardiac (stroke and peripheral artery disease) events were compared in severe and non-severe FH subjects. Results Severe FH was identified in 50.1% of study subjects. They exhibit increased levels of LDL-C and Lipoprotein (a) with a higher frequency of LDLR mutation. Furthermore, a proportion of %LDL-C reduction>50% was greater in severe FH under more lipid-lowering therapy (Table). However, during the observational period (median=6.3 years), severe FH was associated with a 5.9-fold (95% CI, 2.05–25.2; p=0.004) and 5.8-fold (95% CI, 2.02–24.7; p=0.004) greater likelihood of experiencing cardiac-death/ACS and stroke/PAD, respectively (picture). Multivariate analysis demonstrated severe FH as an independent predictor of both cardiac-death/ACS (hazard ratio=3.39, 95% CI=1.12–14.7, p=0.02) and stroke/PAD (hazard ratio=3.38, 95% CI=1.16–14.3, p=0.02) events. Clinical characteristics of severe FH Non-severe FH Severe FH P-value Baseline LDL-C (mmol/l) 5.3±1.5 6.6±2.0 <0.0001 Lp(a) (mg/dl) 15 [8–28] 21 [10–49] <0.0001 LDLR mutation (%) 49.6% 58.9% 0.00398 On-treatment LDL-C (mmol) 133 [106–165] 135 [103–169] 0.9856 %LDL-C reduction>50% 21.3% 49.8% <0.0001 High-intensity statin (%) 13.3% 42.3% <0.0001 PCSK9 inhibitor (%) 6.3% 21.2% <0.0001 Clinical outcome Conclusions Severe FH subjects exhibit substantial atherosclerotic risks for coronary, carotid and peripheral arteries despite lipid lowering therapy. Our finding underscore the screening of systemic arteries and the adoption of further stringent lipid management in severe FH patients.

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