How should public health recommendations address Lp(a) measurement, a causative risk factor for cardiovascular disease (CVD)?
Publikation: Bidrag til tidsskrift › Kommentar/debat › Forskning › fagfællebedømt
Background and aims: Elevated concentrations of Lipoprotein (a) [Lp(a)] is an inherited, causal risk factor for atherosclerotic cardiovascular disease (ASCVD). This study aims to investigate the clinical utility for patients, and the economic benefit to healthcare systems and society of measuring Lp(a) concentrations more widely today. Methods: We conducted a structured literature review to identify the economic and health benefits and costs of measuring the Lp(a) concentration, potential barriers hindering the uptake of the measure, and potential solutions to address them. These findings were then discussed in an advisory board attended by experts and patient organisations. Results: It was found that if Lp(a) concentration is measured more widely today, patients, healthcare system and society would experience clinical and economic benefits even before specific Lp(a) lowering pharmacological treatments become available. Furthermore, a wider uptake of the Lp(a) measurement would support the development of epidemiological data. Conclusions: For Lp(a) measurement to be more widely used, key barriers which are hindering its uptake need to be addressed. These include i) the perception that the measure may have limited clinical value, ii) lack of awareness on Lp(a), iii) lack of data on the CV benefit of reducing Lp(a), iv) technical and clinical guidelines barriers, and v) healthcare system barriers. Scientific communities and industry should collaborate to address technical challenges and deficiencies in clinical guidelines. However, policy intervention will be crucial for national ASCVD plans to acknowledge the importance of Lp(a).
| Originalsprog | Engelsk |
|---|---|
| Tidsskrift | Atherosclerosis |
| Vol/bind | 349 |
| Sider (fra-til) | 136-143 |
| Antal sider | 8 |
| ISSN | 0021-9150 |
| DOI |
|
| Status | Udgivet - 2022 |
Bibliografisk note
Funding Information:
ALC has received honoraria, lecture fees, or research grants from: Aegerion, Amgen, Amryt, Astrazeneca, Bayer, Daiichi-Sankyo, Eli Lilly, Genzyme, Kowa, Mediolanum, Menarini, Merck, Mylan, Novartis, Pfizer, Recordati, Regeneron, Sanofi, Sigma-Tau. ED and MP were commissioned to support this analysis and they assume editorial responsibility as contributors to the study. Charles River Associates is an economic consultancy company. SEH would like to acknowledge grants RG3008 and PG008/08 from the British Heart Foundation , and the support of the UCLH NIHR BRC . SEH directs the UK Children's Familial Hypercholesterolaemia H Register which has been supported by a grant from Pfizer (24052829) given by the International Atherosclerosis Society . SEH reports receiving fees for Advisory Boards of Novartis and Amryt, and is the Medical Director of a UCL spin-out company StoreGene that offers to clinicians genetic testing for patients with FH. RDGN has received consultancy fees and/or lecture honoraria from Amgen, Akcea, Novartis, Pfizer and Sanofi. BGN reports consultancies or talks sponsored by AstraZeneca, Sanofi, Regeneron, Akcea, Amgen, Kowa, Novartis, Novo Nordisk, Esperion, and Silence Therapeutics. In the last three years ES-T has got honoraria for lectures and been a member of advisory boards from: Fresenius Medical Care, Daiichi-Sankyo, Novartis, Sanofi and Amgen.
Funding Information:
It was found that if Lp(a) concentration is measured more widely today, patients, healthcare system and society would experience clinical and economic benefits even before specific Lp(a) lowering pharmacological treatments become available. Furthermore, a wider uptake of the Lp(a) measurement would support the development of epidemiological data.ALC has received honoraria, lecture fees, or research grants from: Aegerion, Amgen, Amryt, Astrazeneca, Bayer, Daiichi-Sankyo, Eli Lilly, Genzyme, Kowa, Mediolanum, Menarini, Merck, Mylan, Novartis, Pfizer, Recordati, Regeneron, Sanofi, Sigma-Tau. ED and MP were commissioned to support this analysis and they assume editorial responsibility as contributors to the study. Charles River Associates is an economic consultancy company. SEH would like to acknowledge grants RG3008 and PG008/08 from the British Heart Foundation, and the support of the UCLH NIHR BRC. SEH directs the UK Children's Familial Hypercholesterolaemia H Register which has been supported by a grant from Pfizer (24052829) given by the International Atherosclerosis Society. SEH reports receiving fees for Advisory Boards of Novartis and Amryt, and is the Medical Director of a UCL spin-out company StoreGene that offers to clinicians genetic testing for patients with FH. RDGN has received consultancy fees and/or lecture honoraria from Amgen, Akcea, Novartis, Pfizer and Sanofi. BGN reports consultancies or talks sponsored by AstraZeneca, Sanofi, Regeneron, Akcea, Amgen, Kowa, Novartis, Novo Nordisk, Esperion, and Silence Therapeutics. In the last three years ES-T has got honoraria for lectures and been a member of advisory boards from: Fresenius Medical Care, Daiichi-Sankyo, Novartis, Sanofi and Amgen.
Publisher Copyright:
© 2022 Elsevier B.V.
ID: 318032091