Criteri di appropriatezza nella gestione della terapia ipocolesterolemizzante con alirocumab nel paziente ad alto rischio cardiovascolare. L’opinione di un gruppo multidisciplinare di esperti italiani

Translated title of the contribution: Appropriateness criteria for the management of lipid-lowering therapy with alirocumab in high cardiovascular risk patients. The opinion of a multidisciplinary group of Italian experts

Maddalena Lettino, Alberto Zambon, Giuseppe Musumeci, Marcello Arca, Claudio Bilato, Natale Daniele Brunetti, Paolo Calabrò, Gavino Casu, Francesco Chiarella, Pompilio Faggiano, Marco Ferlini, Gabriele Guardigli, Egidio Imbalzano, Ciro Indolfi, Rossella Marcucci, Alberto Menozzi, Gian Francesco Mureddu, Pasquale Perrone Filardi, Matteo Pirro, Livia PisciottaMarino Scherillo, Patrizia Suppressa, Massimo Uguccioni, Ferdinando Varbella, Luigi Gentile, Claudio Rapezzi, Maurizio Averna

Research output: Contribution to journalArticle

Abstract

High levels of LDL cholesterol (LDL-C) represent a causal factor for cardiovascular diseases on an atherosclerotic basis, with a direct correlation between these and mortality or cardiovascular events, such that the reduction of both is associated proportionally and linearly with the reduction of LDL-C.Statins and ezetimibe are used for LDL-C lowering but may not be sufficient to achieve the targets defined by the ESC/EAS guidelines, which recommend use of PCSK9 inhibitors for further LDL-C reduction in patients not at goal.This project submitted 86 clinical scenarios to a group of experts, cardiologists, internists and lipidologists, collecting their opinion on the appropriateness of different behaviors and decisions. We used the RAND/UCLA method of assessing the appropriateness of clinical interventions, validated to combine the best scientific evidence available with expert judgment. To this end, the benefit-risk ratio was evaluated in the proposed clinical scenarios. Each indication was classified as "appropriate", "uncertain" or "inappropriate" based on the average score given by the participants.This document presents the results of a consensus process that led to the development of recommendations for the management of clinical scenarios on the treatment of patients with dyslipidemia, which cannot always be solved with scientific evidence alone.

Translated title of the contributionAppropriateness criteria for the management of lipid-lowering therapy with alirocumab in high cardiovascular risk patients. The opinion of a multidisciplinary group of Italian experts
Original languageItalian
Pages (from-to)3-21
Number of pages19
JournalGiornale italiano di cardiologia (2006)
Volume21
Issue number4
DOIs
Publication statusPublished - Apr 1 2020

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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  • Cite this

    Lettino, M., Zambon, A., Musumeci, G., Arca, M., Bilato, C., Brunetti, N. D., Calabrò, P., Casu, G., Chiarella, F., Faggiano, P., Ferlini, M., Guardigli, G., Imbalzano, E., Indolfi, C., Marcucci, R., Menozzi, A., Mureddu, G. F., Filardi, P. P., Pirro, M., ... Averna, M. (2020). Criteri di appropriatezza nella gestione della terapia ipocolesterolemizzante con alirocumab nel paziente ad alto rischio cardiovascolare. L’opinione di un gruppo multidisciplinare di esperti italiani. Giornale italiano di cardiologia (2006), 21(4), 3-21. https://doi.org/10.1714/3331.33006