Hypercholesterolemia. New therapeutic options to combat it

(Adnkronos) - The resources are available, but it is difficult to manage these patients and get them to the destination. One of the answers is the Territorial Specialist Care Department, which brings together cardiologists, diabetologists, nephrologists, and pulmonologists.

Triveneto, January 23, 2023 - Cholesterol is one of the major risk factors for cardiovascular disease and has a significant clinical, administrative, and financial impact on the National Health Service. It is sufficient to note that over 224,000 people pass away from cardiovascular diseases each year in Italy, and that approximately 47,000 of these deaths can be attributed to poor cholesterol management.

Approximately 16 billion euros are spent on healthcare costs directly and indirectly each year, according to quantifiable costs. Despite this scenario, the majority (80%) of the more than 1 million patients who are at the greatest risk fail to meet the benchmark set by the most recent international guidelines.

Thankfully, the treatments that are available in this field, which are all highly effective, have produced solid scientific evidence that has been accumulated over the years on their preventive and curative value both in primary and secondary prevention, but today it is necessary to intervene further because there are unmet needs. During the conference "PNRR, HYPERCHOLESTEROLEMIA, CARDIOVASCULAR RISK AMONG UNRESOLVED NEEDS, INNOVATION AND NEW ORGANIZATIONAL NEEDS - TRIVENETO," experts discussed this issue as well as the potential for enhancing and improving the path of prevention, diagnosis, and treatment of cardiovascular diseases.

facilitated by Motore Sanità with the unrestricted assistance of Daiichi-Sankyo. According to Claudio Bilato, President of ANMCO Veneto and SIPREC Delegate - Italian Society for Cardiovascular Prevention Triveneto, "I have a very serious problem as a cardiologist: that of guaranteeing the lipid target in patients who have had an acute coronary syndrome.".

This is most likely caused by the fact that, despite using the best medical treatments possible, we are unable to completely control what is known as residual risk. This residual risk is the result of a number of factors, including diabetes, thrombotic risk, persistent chronic inflammation risk, and, most importantly, the fact that LDL cholesterol levels are frequently not adequately controlled (under the new recommendations from the European Society of Cardiology and the European Society of Atherosclerosis, LDL cholesterol levels in patients at cardiovascular risk should be brought down to less than 55 percent).

The issue is how to achieve the organizational goal, which is to guarantee that patients who require appropriate treatment can receive it. In other words, the tools are there; the challenge is figuring out how to use them. Nadia Citroni, Head of the Dyslipidemia and Atherosclerosis Center at Trento Hospital, also discussed the tools in these words: "We have always dealt with patients with dyslipidemia and for us this is a good historical moment: we are enthusiastic about having new pharmacological options available that, theoretically, allow us to bring patients to target.

However, there are limitations to the therapeutic options available, such as statin intolerance, which affects 9% of the patients receiving treatment. Targeting patients who are at extremely high or even extreme risk for vascular disease is a problem as well.

There is a problem with not reaching the targets in patients who have secondary events because we also see patients with familial hypercholesterolemia, in whom even the available therapeutic options associated with the condition frequently do not bring us patients to the target. The managerial and organizational criticalities that have also prompted the development of these new organizational therapies are a crucial chapter as well.

In order to try to create monitoring criteria, we need to find connected paths in different contexts. And then there is the issue of low therapeutic adherence, which is highlighted by Giorgio Colombo, Scientific Director of the CEFAT Center for Economics and Evaluation of Drugs and Health Technology University of Pavia: "According to data from the italian medicines agency (AIFA), people over 65 take more than 10 substances a year.

I'm more concerned with who is in charge of making these therapies as effective as possible than with the quantity of drugs. This is a crucial question that needs to be addressed in the realm of health policy, whether it is done by the pharmacist or the family doctor.

Keep in mind that adherence is influenced by the cost of the medication (the subject's share of the cost), as well as other factors like the complexity of the treatment. The level of patient adherence decreases with increasing cost.

The National Health Service's costs go up and adherence goes up when sharing increases, which is the final factor to take into account. Thus, the primary methods for boosting adherence are: self-monitoring and self-management programs for medications, better communication of the benefits of medications and the harms associated with their improper use, direct pharmacist involvement in medication management, and adoption of as few complicated therapeutic plans as possible.

In response to the question of how to manage patients, Andrea Di Lenarda, Director of the SC Cardiovascular Pathologies ASUGI, stated: "As long as we specialists are also dispersed throughout the area, it is obvious that managing these patients to get them to their destination is not simple. Establishing a new territorial specialist care department that brings together cardiologists, diabetologists, nephrologists, and pulmonologists is one of the solutions we have suggested and that has been accepted to make it easier to take control of the chronic patient and to increase the likelihood of getting him to the target.

Laura Avalle's cell phone number is at Motor Health Press Office: communication@motoresanita . it. Liliana Carbone's cell phone number is 320 0981950.

www.motoresanita.it, phone number 347-2642114.

Establishing a new territorial specialist care department that brings together cardiologists, diabetologists, nephrologists, and pulmonologists is one of the solutions we have suggested and that has been accepted to make it easier to take control of the chronic patient and to increase the likelihood of getting him to the target.