Advances in cardiovascular medicines to shape new guidelines

Pharma News: Healthcare professionals, especially in primary care, are seeking updated guidance on new therapies, recent evidence on treatment thresholds and targets, and new diagnostic technologies.

In response, the Heart Foundation and the Stroke Foundation have joined forces to develop two bespoke sets of guidelines for managing hypertension and cholesterol.

Approximately 4.5 million Australian adults have high blood pressure, and 8.5 million have abnormal blood lipid levels, both of which are major risk factors for cardiovascular disease and stroke.

“There have been significant advances in medications and treatments for these conditions in recent years. These advancements make the current guidelines outdated,” said Heart Foundation CEO, David Lloyd.

“The Heart and Stroke Foundations are very much looking forward to working with key stakeholders from the clinical and disease prevention communities to design new guidelines that ensure patients receive the most up-to-date and evidence-backed advice for their health care.”

Statins have long been the primary treatment for dyslipidaemia, but achieving treatment goals has been challenging. New treatments such as PCSK9 inhibitors including Amgen’s Repatha (evolocumab) and Sanofi’s Praluent (alirocumab), and siRNA directed against PCSK9 including Novartis’ Leqvio (inclisiran), offer alternative mechanisms of action to reach target ow-density lipoprotein-cholesterol (LDL-C) levels.

A meta-analysis of 54 trials with 97,910 patients showed that PCSK9 inhibitors significantly reduced the risk of major adverse cardiac events by 16%, non-fatal myocardial infarction by 17%, and stroke by 25%.

Additionally, the ORION-9, ORION-10, and ORION-11 clinical trials demonstrated that Novartis’ Leqvio reduce LDL-C by 48–52%, with an absolute reduction of 1.3–1.8 mmol/L at 510 days compared to patients on the maximum tolerated dose of statins.

“New guidelines for clinicians that address the most up-to-date treatment modalities would represent a significant step forward in the quest to reduce the chronic disease burden in the Australian population,” said Professor Judy de Haan, President of the Australian Atherosclerosis Society.

Stroke Foundation CEO, Lisa Murphy, added, “The Australian clinical and disease prevention sectors have an exciting opportunity to help us progress the review and redesign of a global gold standard in clinical guidelines for helping people improve the management of their cholesterol and blood pressure.”

The development of these guidelines will involve collaboration with Hypertension Australia, clinical and disease prevention communities, and primary healthcare professionals. A systematic review of existing literature will be conducted later this year, with key stakeholders invited to participate. This work will support the Roadmap of the Hypertension Taskforce.

The Heart and Stroke Foundations anticipate that the new guidelines will be ready for implementation early next year, in 2025.

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