Farmakoterapi Pasien Hiperkolesterolemia Familial: Suatu Tinjauan Narasi
Abstract
Hiperkolesterolemia familial (FH) merupakan kelainan autosomal dominan yang ditandai dengan kadar low-density lipoprotein kolesterol (LDL-C) yang tinggi pada plasma. Bahaya risiko kejadian kardiovaskular dan tingginya angka prevalensi menjadikan hiperkolesterolemia familial beban penyakit yang harus segera ditangani. Tujuan penulisan artikel ini adalah membahas manajemen terapi farmakologis untuk menurunkan kadar LDL-C dalam plasma. Metode artikel ini merupakan tinjauan pustaka dengan penelusuran elektronik komprehensif dilakukan menggunakan PubMed dan Google Scholar. Pencarian terbatas pada bahasa Inggris dan bahasa Indonesia. Didapatkan 51 literatur yang sesuai dengan topik dan dianalisa. Terdapat banyak terapi dislipidemia yang tersedia dengan berbagai target terapi. Statin tetap menjadi yang paling popular dan pilihan utama pada rekomendasi-rekomendasi yang ada. Meskipun begitu, pada pasien intoleransi statin, terdapat banyak pula pilihan pengobatan yang dinilai cukup efektif untuk menurunkan kadar LDL-C, meskipun banyak juga diantaranya masih membutuhkan penelitian lebih lanjut dalam hal keamanan jangka panjang. Kesimpulannya statin tetap menjadi lini pertama dalam pengobatan hiperkolesterolemia familial, jika target tidak tercapai dapat dikombinasikan dengan obat penurun kolesterol lainnya.
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References
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Akoumianakis, I., Zvintzou, E., Kypreos, K., & Filippatos, T. D. (2021). ANGPTL3 and Apolipoprotein C-III as Novel Lipid-Lowering Targets. Current Atherosclerosis Reports, 23(5). https://doi.org/10.1007/s11883-021-00914-7
Avis, H. J., Hutten, B. A., Gagné, C., Langslet, G., McCrindle, B. W., Wiegman, A., … Stein, E. A. (2010). Efficacy and Safety of Rosuvastatin Therapy for Children With Familial Hypercholesterolemia. Journal of the American College of Cardiology, 55(11), 1121–1126. https://doi.org/10.1016/j.jacc.2009.10.042
Ballantyne, C. M., Banach, M., Mancini, G. B. J., Lepor, N. E., Hanselman, J. C., Zhao, X., & Leiter, L. A. (2018). Efficacy and safety of bempedoic acid added to ezetimibe in statin-intolerant patients with hypercholesterolemia: A randomized, plasebo-controlled study. Atherosclerosis, 277, 195–203. https://doi.org/10.1016/j.atherosclerosis.2018.06.002
Ballantyne, C. M., Bays, H., Catapano, A. L., Goldberg, A., Ray, K. K., & Saseen, J. J. (2021). Role of Bempedoic Acid in Clinical Practice. Cardiovascular Drugs and Therapy, 35(4), 853–864. https://doi.org/10.1007/s10557-021-07147-5
Bateman, B. T., Hernandez-Diaz, S., Fischer, M. A., Seely, E. W., Ecker, J. L., Franklin, J. M., … Huybrechts, K. F. (2015). Statins and congenital malformations: cohort study. BMJ (Clinical Research Ed.), 350, h1035. https://doi.org/10.1136/bmj.h1035
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Bile Acid Resins or Sequestrants. (2012). LiverTox: Clinical and Research Information on Drug-Induced Liver Injury, (Md), 2–5. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/31643664
Blom, D. J., Harada-Shiba, M., Rubba, P., Gaudet, D., Kastelein, J. J. P., Charng, M. J., … Rosenson, R. S. (2020). Efficacy and Safety of Alirocumab in Adults With Homozygous Familial Hypercholesterolemia: The ODYSSEY HoFH Trial. Journal of the American College of Cardiology, 76(2), 131–142. https://doi.org/10.1016/j.jacc.2020.05.027
Brown, M. S., & Goldstein, J. L. (1986). A receptor-mediated pathway for cholesterol homeostasis. Science, 232(4746), 34–47. https://doi.org/10.1126/science.3513311
Constatine, M. M., & Cleary, K. (2013). Pravastatin for the Prevention of Preeclampsia in High-Risk Pregnant Women. Obstet Gynecol, 23(1), 1–7. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3624763/pdf/nihms412728.pdf
Costantine, M. M., Cleary, K., Hebert, M. F., Ahmed, M. S., Brown, L. M., Ren, Z., … Hankins, G. (2016). Safety and Pharmacokinetics of Pravastatin Used for the Prevention of Preeclampsia in High-Risk Pregnant Women: A Pilot Randomized Controlled Trial. Physiology & Behavior, 176(3), 139–148. https://doi.org/10.1016/j.ajog.2015.12.038.Safety
Fiorentino, R., & Chiarelli, F. (2021). Treatment of dyslipidaemia in children. Biomedicines, 9(9). https://doi.org/10.3390/biomedicines9091078
Fogacci, F., Ferri, N., Toth, P. P., Ruscica, M., Corsini, A., & Cicero, A. F. G. (2019). Efficacy and Safety of Mipomersen: A Systematic Review and Meta-Analysis of Randomized Clinical Trials. Drugs, 79(7), 751–766. https://doi.org/10.1007/s40265-019-01114-z
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Giugliano, R. P., Cannon, C. P., Blazing, M. A., Nicolau, J. C., Corbalán, R., Špinar, J., … Braunwald, E. (2018). Benefit of Adding Ezetimibe to Statin Therapy on Cardiovascular Outcomes and Safety in Patients With Versus Without Diabetes Mellitus: Results From IMPROVE-IT (Improved Reduction of Outcomes: Vytorin Efficacy International Trial). Circulation, 137(15), 1571–1582. https://doi.org/10.1161/CIRCULATIONAHA.117.030950
Graham, M. J., Lee, R. G., Brandt, T. A., Tai, L.-J., Fu, W., Peralta, R., … Tsimikas, S. (2017). Cardiovascular and Metabolic Effects of ANGPTL3 Antisense Oligonucleotides . New England Journal of Medicine, 377(3), 222–232. https://doi.org/10.1056/nejmoa1701329
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Harada-Shiba, M., Arai, H., Ishigaki, Y., Ishibashi, S., Okamura, T., Ogura, M., … Yokote, K. (2018). Guidelines for diagnosis and treatment of familial hypercholesterolemia 2017. Journal of Atherosclerosis and Thrombosis, 25(8), 751–770. https://doi.org/10.5551/jat.CR003
Khoury, E., Brisson, D., Roy, N., Tremblay, G., & Gaudet, D. (2019). Review of the long-term safety of lomitapide: a microsomal triglycerides transfer protein inhibitor for treating homozygous familial hypercholesterolemia. Expert Opinion on Drug Safety, 18(5), 403–414. https://doi.org/10.1080/14740338.2019.1602606
Lamb, Y. N. (2020). Rosuvastatin/Ezetimibe: A Review in Hypercholesterolemia. American Journal of Cardiovascular Drugs, 20(4), 381–392. https://doi.org/10.1007/s40256-020-00421-1
Li, Y. H., Ueng, K. C., Jeng, J. S., Charng, M. J., Lin, T. H., Chien, K. L., … Yeh, H. I. (2017). 2017 Taiwan lipid guidelines for high risk patients. Journal of the Formosan Medical Association, 116(4), 217–248. https://doi.org/10.1016/j.jfma.2016.11.013
Ma, Y. Bin, Chan, P., Zhang, Y., Tomlinson, B., & Liu, Z. (2019). Evaluating the efficacy and safety of atorvastatin + ezetimibe in a fixed-dose combination for the treatment of hypercholesterolemia. Expert Opinion on Pharmacotherapy, 20(8), 917–928. https://doi.org/10.1080/14656566.2019.1594776
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Authors
Purwowiyoto, S. L. and Afiyani, N. . (2023) “Farmakoterapi Pasien Hiperkolesterolemia Familial: Suatu Tinjauan Narasi”, Farmasains : Jurnal Ilmiah Ilmu Kefarmasian, 10(1), pp. 9–18. doi: 10.22236/farmasains.v10i1.8743.
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