• About
  • Masthead
  • License Content
  • Advertise
  • Submit Press Release
  • RSS/Email List
  • Write for us
  • Contact us
2 Minute Medicine
No Result
View All Result

No products in the cart.

SUBSCRIBE
  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • AccountLog-in/out
    • Subscribe
    • Sign-in
    • My account
2 Minute Medicine
  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • AccountLog-in/out
    • Subscribe
    • Sign-in
    • My account
SUBSCRIBE
2 Minute Medicine
Subscribe
Home All Specialties Cardiology

The ODYSSEY OUTCOMES trial: Alirocumab associated with reduced ischemic events after acute coronary syndrome

byJames RoebkerandDayton McMillan
November 30, 2018
in Cardiology, Chronic Disease, Emergency
Reading Time: 3 mins read
0
Share on FacebookShare on Twitter

1. Among patients that suffered a recent acute coronary syndrome (ACS) and had elevated levels of atherogenic lipoproteins despite intensive or maximum-intensive statin therapy, alirocumab reduced the number of recurrent cardiovascular ischemic events. This response was more robust with higher levels of low-density lipoprotein (LDL) cholesterol.

2. The safety profile of alirocumab was similar to placebo, with the exception of an increased number of local injection-site reactions that were mostly mild and self-limited.

Evidence Rating Level: 1 (Excellent)      

Study Rundown: Patients who have suffered a recent acute coronary syndrome are at high risk for recurrent ischemic cardiovascular events. This risk is in part due to elevated levels of LDL-C and other atherogenic lipoproteins, and persists despite high intensity statin therapy. While previous randomized trials have established the ability of proprotein convertase subtilisin–kexin type 9 (PCSK-9) inhibitors to substantially reduce LDL cholesterol, it is uncertain if this treatment can reduce cardiovascular risk post-ACS. This study aimed to compare the safety and efficacy of alirocumab, a monoclonal antibody to PCSK-9, with placebo among patients with recent ACS already on intensive or maximum-tolerated statin therapy. The primary outcome – a composite of death from coronary heart disease (CHD), nonfatal myocardial infarction (MI), ischemic stroke, and unstable angina – was significantly reduced in the alirocumab group compared to placebo and the response was more robust with higher levels of LDL cholesterol. Among key secondary outcomes, alirocumab also reduced any CHD event, major CHD events, any cardiovascular event, and a composite of death from any cause, nonfatal MI, or nonfatal stroke. The incidence of adverse events was similar between alirocumab and placebo, with the exception that local injection-site reactions were more common with alirocumab. Though the high cost of PCSK-9 inhibitors should be considered, the results of this trial suggest their use be justified in certain post-ACS patients.

This was a randomized, double-blinded trial that featured a large sample size and was of longer duration than previous trials of PCSK-9 inhibitors; however, additional trials are still needed to confirm long-term safety. The trial was also the first to titrate drug levels to a target LDL cholesterol. Similar to previous trials, the study was limited by the infrequent use of ezetimibe and did not take into account the high cost of PCSK-9 inhibitors, a critical factor in determining whether these drugs will gain widespread use.

Click to read the study in NEJM

Relevant Reading: Evolocumab and clinical outcomes in patients with cardiovascular disease

RELATED REPORTS

The timing of administering aspirin and nitroglycerin in patients with STEMI ECG changes alter patient outcome

Clopidogrel monotherapy is superior to aspirin monotherapy for chronic maintenance after percutaneous coronary intervention

A prospective evaluation of clinical HEART score agreement, accuracy, and adherence in emergency department chest pain patients

In-Depth [randomized controlled trial]: Patients (n=18,924) who suffered from an ACS in the prior 1-12 months, were on high-intensity statin therapy (or documented intolerance), and had inadequate lipid control (LDL ³ 70 mg/dl, non-high density lipoprotein ³ 100 mg/dl, or apolipoprotein B ³ 80 mg/dl) were randomized to subcutaneous alirocumab every two weeks (n=9,462) or placebo (n=9,462). Alirocumab was titrated between 75 and 150 mg for a goal LDL cholesterol between 25 and 50 mg/dl. Median follow-up time was 2.8 years. The primary outcome was a composite of: death from CHD, nonfatal MI, fatal or nonfatal ischemic stroke, and unstable angina requiring hospitalization. Baseline LDL cholesterol level was 92±31 mg for all enrolled patients. In the alirocumab group at 4 months, 12 months, and 48 months, the mean LDL cholesterol level was 40 mg/dl, 48 mg/dl, and 66 mg/dl, respectively; in the placebo group, mean LDL levels were 93 mg/dl, 96 mg/dl, and 103 mg/dl, respectively. The composite primary outcome occurred in 903 patients (9.5%) in the alirocumab group compared to 1052 patients (11.1%) in the placebo group (hazard ratio [HR], 0.85; 95% confidence interval [CI], 0.78 to 0.93; P<0.001). Patients with LDL cholesterol levels ³ 100 mg/dl demonstrated the greatest reduction in risk of the primary outcome. Among key secondary outcomes, patients in the alirocumab group had a significantly lower risk of: any CHD event, major CHD event, any cardiovascular event, and a composite of death from any cause, nonfatal MI, or nonfatal ischemic stroke. The incidence of adverse events was similar in both groups, with the exception of local injection-site reactions (3.8 with alirocumab vs. 2.1% with placebo), which were mostly mild and self-limited.

Image: PD

©2018 2 Minute Medicine, Inc. All rights reserved. No works may be reproduced without expressed written consent from 2 Minute Medicine, Inc. Inquire about licensing here. No article should be construed as medical advice and is not intended as such by the authors or by 2 Minute Medicine, Inc

Tags: ACSheart attack
Previous Post

Atezolizumab and nab-paclitaxel prolong progression-free survival for patients with metastatic triple-negative breast cancer: the IMpassion130 trial

Next Post

Quick Take: Effect of Pregabalin on Radiotherapy-Related Neuropathic Pain in Patients With Head and Neck Cancer: A Randomized Controlled Trial

RelatedReports

Using HEART score to risk stratify patients with chest pain is safe but underutilized in the ED
Cardiology

The timing of administering aspirin and nitroglycerin in patients with STEMI ECG changes alter patient outcome

November 24, 2021
Rilonacept may lower pericarditis recurrence in patients with relapsing pericarditis
Cardiology

Clopidogrel monotherapy is superior to aspirin monotherapy for chronic maintenance after percutaneous coronary intervention

July 7, 2021
Cardiology

A prospective evaluation of clinical HEART score agreement, accuracy, and adherence in emergency department chest pain patients

June 24, 2021
#VisualAbstract: Polypill plus aspirin treatment decreases cardiovascular event incidence
Chronic Disease

#VisualAbstract: Polypill plus aspirin treatment decreases cardiovascular event incidence

April 21, 2021
Next Post
Quick Take: Effect of Pregabalin on Radiotherapy-Related Neuropathic Pain in Patients With Head and Neck Cancer: A Randomized Controlled Trial

Quick Take: Effect of Pregabalin on Radiotherapy-Related Neuropathic Pain in Patients With Head and Neck Cancer: A Randomized Controlled Trial

Quick Take: Deep learning for chest radiograph diagnosis: A retrospective comparison of the CheXNeXt algorithm to practicing radiologists

Quick Take: Deep learning for chest radiograph diagnosis: A retrospective comparison of the CheXNeXt algorithm to practicing radiologists

Quick Take: Association of Prenatal Exposure to Air Pollution with Autism Spectrum Disorder

Quick Take: Association of Prenatal Exposure to Air Pollution with Autism Spectrum Disorder

License Our Award-Winning Physician-Written Medical News and Visual Abstracts

2 Minute Medicine is the leading authoritative medical news licensing service, and the only with reports written by practicing doctors.

LICENSE CONTENT

Get 2MM+ Premium Access

No ads & unlimited access to all current reports, over 9000 searchable archived reports, visual abstracts, Weekly Rewinds, and the online edition of The Classics Series™ textbook.

Subscription Options
2 Minute Medicine

2 Minute Medicine® is an award winning, physician-run, expert medical media company. Our content is curated, written and edited by practicing health professionals who have clinical and scientific expertise in their field of reporting. Our editorial management team is comprised of highly-trained MD physicians. Join numerous brands, companies, and hospitals who trust our licensed content.

Recent Reports

  • Wellness Check: Mental Health
  • #VisualAbstract: Addition of elotuzumab to lenalidomide and dexamethasone did not significantly improve survival outcomes in newly diagnosed, transplant-ineligible multiple myeloma
  • #VisualAbstract: Pretreatment with radiotherapy and two cycles of concurrent cisplatin may reduce toxicity in locally advanced nasopharyngeal carcinoma
License Content
Terms of Use | Disclaimer
Cookie Policy
Privacy Statement (EU)
Disclaimer

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.

  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.