SAWP BMWP GTWP. Other WPs SWP QWP BWP CHMP BPWP. PhVWP VWP CTWP EWP
|
|
- Aubrey Houston
- 5 years ago
- Views:
Transcription
1 SAWP GTWP BMWP Other WPs SWP BWP CHMP QWP BPWP PhVWP VWP EWP CTWP 1
2 Objetivos de las guías Armonización Orientación Transparencia Biomarker A characteristic that is objectively measured and evaluated as an indicator of normal biologic processes, pathogenic processes, or pharmacologic responses to a therapeutic intervention. Biomarkers for: Drug development: Drug activity in non-clinical and early clinical studies Proof of concept Dose-response relationship Efficacy Toxicity Identification of target populations 2
3 VECTIVIX Efficacy- PFS Effect Influenced by Unscheduled Assessments PFS Primary Analysis PFS Sensitivity Analysis HR=0.54 (95%CI: ) p< HR=0.60 (95%CI: ) p< Inability to Identify Patients Most Likely to Benefit From Panitumumab Ligand Ligand EGFR dimer Shc Grb-2 SOS Signal Adapters and Enzymes STAT Grb-2 P13K SOS Ras PTEN Akt Raf mtor FKHR GSK-3 BAD MEK 1/2 Signal Cascade Transcription Factors p27 Jun FOS Myc Cyclin D-1 MAPK Effect size depending on the K-ras stratum 100% Mutant Events / N (%) Median in Weeks 100% Wild-type Events / N (%) Median in Weeks Proportion Event-Free 90% 80% 70% 60% 50% 40% 30% 20% Panit.+BSC 76 / 90 ) 7.4 BSC Alone 95 / 100 ( 95 ) 7.3 Proportion Event-Free 90% 80% 70% 60% 50% 40% 30% 20% Panit.+BSC 115 / 124 ) 12.3 BSC Alone 114 / 119 ( 96 ) % 10% 0% Weeks 0% Weeks HR=1.00 (95%CI: ) HR=0.45 (95%CI: ) Stratified Log Rank Test p <
4 Developing reliable biomarkers Optimising drug-development Decrease late attrition rate Save costs SURROGATE A biomarker that is intended to be substitute for a clinically meaningful endpoint Attractiveness of surrogate endpoints Intellectually attractive (Pathophysiologically aimed) Shorter drug development Minimise unnecessary drug exposure Cost saving 4
5 SURROGATES ICH E9 Statistical Principles for Clinical Trials Biological plausibility Epidemiological data Quali-quantitative relationship How much of the treatment effect on the outcome could be considered as explained by the intended surrogate variable? Let discuss an example: Biomarkers in CV disease Many drugs for the treatment and/or prevention of CV diseases are currently approved based on their effect on biomarkers and/or symptoms HARD OUTCOMES IN CASE OF: No suitable biomarker available Entirely new target Specific regulatory claims for the labeling Problems with surrogates in CV disease Multifactorial disease Can the treatment effect be explained by one single parameter? How much of the expected treatment effect could be considered as accounted for by the intended surrogate variable? 5
6 Problems with surrogates in CV disease Heterogeneous population To what extent the surrogate value of a particular variable is applicable to populations with different risk profile/level Problems with surrogates in CV disease Polytherapy To what extent the observed effect is explained by the background therapy and what is the interaction with the new treatment? Problems with surrogates in CV disease Extrapolability to other drugs To what extent the surrogate allows to make reliable comparative benefit/risk assessments with other drugs: With the same mechanism of action With a different mechanism of action 6
7 Problems with surrogates in CV disease Historical failures Should they play a role?! Phase 3 Torcetrapib/atorvastatin Imaging Program Carotid IMT Subject Populations: Heterozygous FH Mixed dyslipidemia, TG > 150 Eligible for statin treatment Coronary IVUS Coronary IVUS Subject Population: Angio. proven CAD (> 20% stenosis) Eligible for statin treatment B-mode US Coronary IVUS B-mode US / 6 months S C R E E N I N G atorvastatin dose titration 10, 20, 40, or 80 mg/d Target: LDL-C to CV risk goal Run-in period of variable duration Target population Mechnology Number of subjects torcetrapib 60 mg-atorvastatin (T/A)* Randomization atorvastatin alone* 24 months D-B/ randomized Tx Same as atorvastatin dose at the end of the titration period. Endpoint Atorvastatin dose Heterozygous FH Carotid ultrasound 904 Δ IMT (mm)/year 56 mg Mixed dyslipidemia Carotid ultrasound 752 Δ IMT (mm)/year 13 mg CHD IVUS 1188 Nominal Δ PAV 23 mg 7
8 8
9 T/A Imaging Trials: Deaths and CV Safety T/A Subjects Deaths 2 (0.4%) 2 (0.4%) Subjects with CV SAEs* A 24 (5.0%) 11 (2.4%) T/A Subjects Deaths 1 (0.3%) 1 (0.3%) Subjects with CV SAEs* A 17 (4.5%) 13 (3.5%) T/A Subjects Deaths 8 (1.4%) 6 (1.0%) Subjects with Adj. CV Events 62 (10.5%) 57 (9.6%) *investigator reported SAEs- not adjudicated as per protocol CHD death, non-fatal MI, stroke (fatal or non-fatal), hospitalization for unstable angina. A Carotid U/S HeFH Carotid U/S Type IIb IVUS CHD Atorvastatin titrated to reach a target of LDL < 100 mg/dl 9
10 10
11 Torcetrapib Large differences in HDL and LDL Small increase in SBP No effect on progression of AT INCREASED MORTALITY Approving drugs based on surrogates is approving them based on logic rather than on proof Thank goodness! Now I understand everything! 11
12 Control Group Allows differentiating between real treatment effects and other changes attributable to a number of factors: 1. Natural course of the disease 2. Patient's and observer's expectations 3. Other treatments. TYPES of CONTROLS Placebo Active control Dose-response control The control group influences the inferences that can be drawn from the CT Type of enroled population. Type of endpoint. Credibility of the study results. Regulatory acceptance. 12
13 TYPES of CONTROLS ADVANTAGES Credibility of the observed efect Allows the estimation of the net treatment effect Efficient studies Minimisation of both patients' and observers' expectations COMPONETS OF TREATMENT EFFECT PD effect Unspecific drug effect Unspecific physician effect Absolute placebo effect Global placebo effect Overall treatment effec Regression to the mean Notreatment effect A B 13
14 A B TYPES of CONTROLS DISADVANTAGES Ethical problems Practical problems Extrapolability Absence of comparative information TYPES of CONTROLS ACTIVE CONTROL ADVANTAGES No ethical nor practical concerns Provides information on: Comparative efficacy Superiority over available treatments? Comparative safety 14
15 TYPES of CONTROLS ACTIVE CONTROL DISADVANTAGES Non-Inferiority studies (almost always!) Higher sample size A P A B? RE GU LA TO RY AP PR OV AL TYPES of CONTROL NON-INFERIORITY TRIALS The control arm has an effect Sensitivity to the treatment effects Differences between both treatments are inferior to a prespecified limit Non-inferiority margin If the difference was higher than the pre-specified margin it would be detected Assay sensitivity 15
16 TYPES of CONTROL POSITIONING OF DIFFERENT REGULATORY BODIES USA Placebo-controlled trials EU Relative benefit/risk evaluation in front of avalable alternatives. Clinically relevant effect. Japan Active-comparator trials. EJEMPLO A Resultados de estudios fase III en DM. Fase aguda Estudio Tratamientos N Hamilton basal Cambio Media DE LS media EC 1 A - Dosis 1 A. Dosis EC 2 EC 3 EC 4 A - Dosis 1 A - Dosis 2 A - Dosis 2 A - Dosis 3 A - Dosis 2 A - Dosis EJEMPLO A Resultados de estudios fase III en DM. Fase aguda Estudio Tratamientos N Hamilton basal Cambio Media DE LS media EC 1 A - Dosis 1 A. Dosis EC 2 EC 3 EC 4 A - Dosis 1 A - Dosis 2 A - Dosis 2 A - Dosis 3 A Dosis
17 EJEMPLO A Estudio EC 1 Resultados de estudios fase III en DM. Fase aguda Tratamientos N Hamilton basal Cambio IC 95% Valor de p. Comparación con Media DE LS media Placebo A Dosis (-3.05, 0.71) (-3.38, 0.47) (-3.72, 0.06).058 EC 2 EC 3 EC 4 A Dosis 1 A Dosis 3 A Dosis (-4.47, -0.35) (-5.15, -1.06) (-3.56, 0.55) (-3.73, -0.58) (-4.56, -1.41) (-4.37, -1.15) (-2.53, 0.67) (-3.06, 0.02) (-2.07, 1.11) EJEMPLO A Estudio EC 1 Resultados de estudios fase III en DM. Fase aguda Tratamientos N Hamilton basal Cambio IC 95% Valor de p. Comparación con Media DE LS media Placebo A Dosis (-3.05, 0.71) (-3.38, 0.47) (-3.72, 0.06).058 EC 2 A Dosis (-4.47, -0.35) (-5.15, -1.06) (-3.56, 0.55) EC 3 A Dosis (-3.73, -0.58) (-4.56, -1.41) (-4.37, -1.15).007 < EC 4 A Dosis (-2.53, 0.67) (-3.06, 0.02) (-2.07, 1.11) EJEMPLO A Estudio EC 1 Resultados de estudios fase III en DM. Fase aguda Tratamientos N Hamilton basal Cambio IC 95% Valor de p. Comparación con Media DE LS media Placebo A Dosis (-3.05, 0.71) (-3.38, 0.47) (-3.72, 0.06).058 EC 2 A Dosis (-4.47, -0.35) (-5.15, -1.06) (-3.56, 0.55) EC 3 A Dosis (-3.73, -0.58) (-4.56, -1.41) (-4.37, -1.15).007 < EC 4 A Dosis (-2.53, 0.67) (-3.06, 0.02) (-2.07, 1.11) EC 5 A Dosis (-5.55, -2.05) <.001 EC 6 A Dosis (-3.45, -0.02)
18 Moltes mercès Gonzalo Calvo 18
Imaging Biomarkers: utilisation for the purposes of registration. EMEA-EFPIA Workshop on Biomarkers 15 December 2006
Imaging Biomarkers: utilisation for the purposes of registration EMEA-EFPIA Workshop on Biomarkers 15 December 2006 Vascular Imaging Technologies Carotid Ultrasound-IMT IVUS-PAV QCA-% stenosis 2 ICH E
More informationHow would you manage Ms. Gold
How would you manage Ms. Gold 32 yo Asian woman with dyslipidemia Current medications: Simvastatin 20mg QD Most recent lipid profile: TC = 246, TG = 100, LDL = 176, HDL = 50 What about Mr. Williams? 56
More informationContemporary management of Dyslipidemia
Contemporary management of Dyslipidemia Todd Anderson Feb 2018 Disclosure Statement Within the past two years: I have not had an affiliation (financial or otherwise) with a commercial organization that
More informationReview of the ESMO consensus conference on metastatic CRC Basis strategies ad groups (RAS, BRAF, etc) Michel Ducreux
Review of the ESMO consensus conference on metastatic CRC Basis strategies ad groups (RAS, BRAF, etc) Michel Ducreux 2 ESMO consensus on mcrc 2016 Chairs: Co-Chairs of working groups E Van Cutsem A Sobrero
More informationEffect of the PCSK9 Inhibitor Evolocumab on Cardiovascular Outcomes
Effect of the PCSK9 Inhibitor Evolocumab on Cardiovascular Outcomes MS Sabatine, RP Giugliano, SD Wiviott, FJ Raal, CM Ballantyne, R Somaratne, J Legg, SM Wasserman, R Scott, MJ Koren, and EA Stein for
More informationPanitumumab: The KRAS Story. Chrissie Fletcher, MSc. BSc. CStat. CSci. Director Biostatistics, Amgen Ltd
Panitumumab: The KRAS Story Chrissie Fletcher, MSc. BSc. CStat. CSci. Director Biostatistics, Amgen Ltd Clinical Background: panitumumab in mcrc Panitumumab is a fully human IgG2 monoclonal antibody directed
More informationAtherosclerosis Regression An Overview of Recent Findings & Issues
Atherosclerosis Regression An Overview of Recent Findings & Issues 13th Angioplasty Summit 2008 Cheol Whan Lee, MD University of Ulsan, Asan Medical Center, Seoul, Korea CardioVascular Research Foundation
More informationCanakinumab Anti-Inflammatory Thrombosis Outcomes Study (CANTOS)
Canakinumab Anti-Inflammatory Thrombosis Outcomes Study (CANTOS) Stable CAD (post MI) On Statin, ACE/ARB, BB, ASA Persistent Elevation of hscrp (> 2 mg/l) N = 10,061 39 Countries April 2011 - June 2017
More informationCVD risk assessment using risk scores in primary and secondary prevention
CVD risk assessment using risk scores in primary and secondary prevention Raul D. Santos MD, PhD Heart Institute-InCor University of Sao Paulo Brazil Disclosure Honoraria for consulting and speaker activities
More informationClinical Efficacy and Safety of Achieving Very Low LDL-C Levels With the PCSK9 Inhibitor Evolocumab in the FOURIER Outcomes Trial
Clinical Efficacy and Safety of Achieving Very Low LDL-C Levels With the PCSK9 Inhibitor Evolocumab in the FOURIER Outcomes Trial RP Giugliano, TR Pedersen, AC Keech, PS Sever, JG Park, and MS Sabatine,
More informationDoes High-Intensity Pitavastatin Therapy Further Improve Clinical Outcomes?
Late Breaking Clinical Trial Session at AHA 2017 Does High-Intensity Pitavastatin Therapy Further Improve Clinical Outcomes? The REAL-CAD Study in 13,054 Patients With Stable Coronary Artery Disease Takeshi
More informationCETP inhibition: pros and cons. Philip Barter The Heart Research Institute Sydney, Australia
CETP inhibition: pros and cons Philip Barter The Heart Research Institute Sydney, Australia Philip Barter Disclosures Received honorariums for lectures, consultancies or membership of advisory boards from:
More informationJUPITER NEJM Poll. Panel Discussion: Literature that Should Have an Impact on our Practice: The JUPITER Study
Panel Discussion: Literature that Should Have an Impact on our Practice: The Study Kaiser COAST 11 th Annual Conference Maui, August 2009 Robert Blumberg, MD, FACC Ralph Brindis, MD, MPH, FACC Primary
More informationARBITER 6-HALTS HDL And LDL Treatment Strategies
ARBITER 6-HALTS HDL And LDL Treatment Strategies Extended-Release Niacin or Ezetimibe and Carotid Intima Media Thickness Allen J. Taylor, M.D. Todd C. Villines, M.D. Eric J. Stanek, Pharm.D. Patrick J.
More informationJohn J.P. Kastelein MD PhD Professor of Medicine Dept. of Vascular Medicine Academic Medial Center / University of Amsterdam
Latest Insights from the JUPITER Study John J.P. Kastelein MD PhD Professor of Medicine Dept. of Vascular Medicine Academic Medial Center / University of Amsterdam Inflammation, hscrp, and Vascular Prevention
More informationUpdate on Dyslipidemia and Recent Data on Treating the Statin Intolerant Patient
Update on Dyslipidemia and Recent Data on Treating the Statin Intolerant Patient Steven E. Nissen MD Chairman, Department of Cardiovascular Medicine Cleveland Clinic Disclosure Consulting: Many pharmaceutical
More informationEffective Treatment Options With Add-on or Combination Therapy. Christie Ballantyne (USA)
Effective Treatment Options With Add-on or Combination Therapy Christie Ballantyne (USA) Effective treatment options with add-on or combination therapy Christie M. Ballantyne, MD Center for Cardiovascular
More informationCOMMITTEE FOR MEDICINAL PRODUCTS FOR HUMAN USE (CHMP)
European Medicines Agency Evaluation of Medicines for Human Use London, 29 July 2004 CPMP/EWP/3020/03 COMMITTEE FOR MEDICINAL PRODUCTS FOR HUMAN USE (CHMP) NOTE FOR GUIDANCE ON CLINICAL INVESTIGATION OF
More informationLessons from Recent Atherosclerosis Trials
Lessons from Recent Atherosclerosis Trials Han, Ki Hoon MD PhD Asan Medical Center Seoul, Korea Change of concept Primary vs. secondary prevention Low risk vs. High risk High Risk CHD and equivalents CHD
More informationStudy 2 ( ) Pivotal Phase 3 Study Top-Line Results. October 29, 2018
Study 2 (1002-047) Pivotal Phase 3 Study Top-Line Results October 29, 2018 Safe Harbor Forward-Looking Statements These slides and the accompanying oral presentation contain forward-looking statements
More informationESC Geoffrey Rose Lecture on Population Sciences Cholesterol and risk: past, present and future
ESC Geoffrey Rose Lecture on Population Sciences Cholesterol and risk: past, present and future Rory Collins BHF Professor of Medicine & Epidemiology Clinical Trial Service Unit & Epidemiological Studies
More informationClinical Trials and Clinical Practice: Surrogates at the Clinician/Patient Interface
Clinical Trials and Clinical Practice: Surrogates at the Clinician/Patient Interface Linda Lévesque, BScPhm, MSc, PhD Associate Professor, Department of Community Health and Epidemiology Queen s University
More informationRegulatory Experience in Reviewing CV Safety for Diabetes
Regulatory Experience in Reviewing CV Safety for Diabetes Drugs Kristina Dunder MD, PhD, Alternate CHMP member MPA, Sweden Disclaimer The views and opinions expressed in the following PowerPoint slides
More informationLipid Management 2013 Statin Benefit Groups
Clinical Integration Steering Committee Clinical Integration Chronic Disease Management Work Group Lipid Management 2013 Statin Benefit Groups Approved by Board Chair Signature Name (Please Print) Date
More informationThe JUPITER trial: What does it tell us? Alice Y.Y. Cheng, MD, FRCPC January 24, 2009
The JUPITER trial: What does it tell us? Alice Y.Y. Cheng, MD, FRCPC January 24, 2009 Learning Objectives 1. Understand the role of statin therapy in the primary and secondary prevention of stroke 2. Explain
More informationDyslipidemia in the light of Current Guidelines - Do we change our Practice?
Dyslipidemia in the light of Current Guidelines - Do we change our Practice? Dato Dr. David Chew Soon Ping Senior Consultant Cardiologist Institut Jantung Negara Atherosclerotic Cardiovascular Disease
More informationCost-effectiveness of evolocumab (Repatha ) for hypercholesterolemia
Cost-effectiveness of evolocumab (Repatha ) for hypercholesterolemia The NCPE has issued a recommendation regarding the cost-effectiveness of evolocumab (Repatha ). Following NCPE assessment of the applicant
More informationCHOLESTEROL-LOWERING THERAPHY
CHOLESTEROL-LOWERING THERAPHY TRIALS NUMBER OF PARTICIPANTS NUMBER OF WOMEN PERCENTAGE OF WOMEN MEAN AGE MEAN - (YEARS) TRIALS WITH ANALYSIS BY GENDER N, (%) 50,194 15,036 30.0% 60.8 3.2 1/ 6 (16.7%) HR
More informationInvasive Evaluation of High Risk or Vulnerable Plaque A Powerful Tool to Address Potential Pharmacological Agents? Jagat Narula, MD PhD MACC
Invasive Evaluation of High Risk or Vulnerable Plaque A Powerful Tool to Address Potential Pharmacological Agents? Jagat Narula, MD PhD MACC No Conflicts of Interest to Declare Histological Signatures
More informationManaging Dyslipidemia in Disclosures. Learning Objectives 03/05/2018. Speaker Disclosures
Managing Dyslipidemia in 2018 Glen J. Pearson, BSc, BScPhm, PharmD, FCSHP, FCCS Professor of Medicine (Cardiology) Co-Director, Cardiac Transplant Clinic; Associate Chair, Health Research Ethics Boards;
More informationDisclosures No relationships (not even to an employer) No off-label uses. Cholesterol Lowering Guidelines: What now?
Disclosures No relationships (not even to an employer) No off-label uses Cholesterol Lowering Guidelines: What now?, FACP 1 2 65-year-old white woman Total cholesterol 175mg/dL HDL 54 mg/dl LDL 96 mg/dl
More informationPIK3CA Mutations in HER2-Positive Breast Cancer
2016.4.29. GBCC PIK3CA Mutations in HER2-Positive Breast Cancer Seock-Ah Im, MD, PhD. Department of Internal Medicine Seoul National University Hospital Contents Introduction TCGA data HER2 signaling pathway
More informationReview of guidelines for management of dyslipidemia in diabetic patients
2012 international Conference on Diabetes and metabolism (ICDM) Review of guidelines for management of dyslipidemia in diabetic patients Nan Hee Kim, MD, PhD Department of Internal Medicine, Korea University
More informationPCSK9 Agents Drug Class Prior Authorization Protocol
PCSK9 Agents Drug Class Prior Authorization Protocol Line of Business: Medicaid P & T Approval Date: February 21, 2018 Effective Date: April 1, 2018 This policy has been developed through review of medical
More informationSubclinical atherosclerosis in CVD: Risk stratification & management Raul Santos, MD
Subclinical atherosclerosis in CVD: Risk stratification & management Raul Santos, MD Sao Paulo Medical School Sao Paolo, Brazil Subclinical atherosclerosis in CVD risk: Stratification & management Prof.
More informationSTABILITY Stabilization of Atherosclerotic plaque By Initiation of darapladib TherapY. Harvey D White on behalf of The STABILITY Investigators
STABILITY Stabilization of Atherosclerotic plaque By Initiation of darapladib TherapY Harvey D White on behalf of The STABILITY Investigators Lipoprotein- associated Phospholipase A 2 (Lp-PLA 2 ) activity:
More informationClinical Trial Synopsis TL-OPI-516, NCT#
Clinical Trial Synopsis, NCT#00225277 Title of Study: A Double-Blind, Randomized, Comparator-Controlled Study in Subjects With Type 2 Diabetes Mellitus Comparing the Effects of Pioglitazone HCl Versus
More informationSafeguarding public health Subgroup Analyses: Important, Infuriating and Intractable
Safeguarding public health Subgroup Analyses: Important, Infuriating and Intractable The views expressed herein are not necessarily those of MHRA, EMA, EMA committees or their working parties. Rob Hemmings
More informationWhen Statins Aren t Enough: Appropriate Therapies for High-Risk Patients with Diabetes
When Statins Aren t Enough: Appropriate Therapies for High-Risk Patients with Diabetes Kim K. Birtcher, MS, PharmD, AACC, FNLA, CLS, BCPS (AQ-Cardiology), CDE Clinical Professor University of Houston College
More informationEzetimibe and SimvastatiN in Hypercholesterolemia EnhANces AtherosClerosis REgression (ENHANCE)
Ezetimibe and SimvastatiN in Hypercholesterolemia EnhANces AtherosClerosis REgression (ENHANCE) Thomas Dayspring, MD, FACP Clinical Assistant Professor of Medicine University of Medicine and Dentistry
More informationMethods. Background and Objectives STRADIVARIUS
STRADIVARIUS Effect of on Progression of Atherosclerosis in Patients with Abdominal Obesity and Coronary Artery Disease Steven E. Nissen MD Stephen J. Nicholls MBBS PhD, Kathy Wolski MPH, Josep Rodés-Cabau
More informationShould we prescribe aspirin and statins to all subjects over 65? (Or even all over 55?) Terje R.Pedersen Oslo University Hospital Oslo, Norway
Should we prescribe aspirin and statins to all subjects over 65? (Or even all over 55?) Terje R.Pedersen Oslo University Hospital Oslo, Norway The Polypill A strategy to reduce cardiovascular disease by
More informationESC GUIDELINES ON DIABETES AND CARDIOVASCULAR DISEASES
ESC GUIDELINES ON DIABETES AND CARDIOVASCULAR DISEASES Pr. Michel KOMAJDA Institute of Cardiology - IHU ICAN Pitie Salpetriere Hospital - University Pierre and Marie Curie, Paris (France) DEFINITION A
More informationPCSK9 Inhibitors and Modulators
PCSK9 Inhibitors and Modulators Pam R. Taub MD, FACC Director of Step Family Cardiac Rehabilitation and Wellness Center Associate Professor of Medicine UC San Diego Health System Disclosures Speaker s
More informationSafety of Anacetrapib in Patients with or
Safety of Anacetrapib in Patients with or at Risk for Coronary Heart Disease Christopher P. Cannon, MD, Sukrut Shah, PhD, RPh, Hayes M. Dansky, MD, Michael Davidson, MD, Eliot A. Brinton, MD, Antonio M.
More information4 th and Goal To Go How Low Should We Go? :
4 th and Goal To Go How Low Should We Go? : Evaluating New Lipid Lowering Therapies Catherine Bourg Rebitch, PharmD, BCACP Clinical Associate Professor Disclosure The presenter has nothing to disclose
More informationPlacebo-Controlled Statin Trials EXPLAINING THE DECREASE IN DEATHS FROM CHD! PREVENTION OF CARDIOVASCULAR DISEASE IN WOMEN EXPLAINING THE DECREASE IN
PREVENTION OF CARDIOVASCULAR DISEASE IN WOMEN Robert B. Baron MD MS Professor and Associate Dean UCSF School of Medicine Declaration of full disclosure: No conflict of interest EXPLAINING THE DECREASE
More informationPCSK9 antibodies: A new therapeutic option for the treatment of hypercholesterolemia
: 262-267, 2017 Περίληψη Διάλεξης PCSK9 antibodies: A new therapeutic option for the treatment of hypercholesterolemia I. Gouni-Bethold Polyclinic for Endocrinology, Diabetes, and Preventive Medicine University
More informationDyslipidemia: Lots of Good Evidence, Less Good Interpretation.
Dyslipidemia: Lots of Good Evidence, Less Good Interpretation. G Michael Allan Evidence & CPD Program, ACFP Associate Professor, Dept of Family, U of A. CFPC CoI Templates: Slide 1 Faculty/Presenter Disclosure
More informationThe Latest Generation of Clinical
The Latest Generation of Clinical Guidelines: HTN and HLD Dave Brackett Clinical Guideline Purpose Uniform approach Awareness of key details Diagnosis Treatment Monitoring Evidence based approach Inform
More informationIRESSA (Gefitinib) The Journey. Anne De Bock Portfolio Leader, Oncology/Infection European Regulatory Affairs AstraZeneca
IRESSA (Gefitinib) The Journey Anne De Bock Portfolio Leader, Oncology/Infection European Regulatory Affairs AstraZeneca Overview The Drug The Biomarker and Clinical Trials Sampling Lessons Learned The
More information(Regulatory) views on Biomarker defined Subgroups
(Regulatory) views on Biomarker defined Subgroups Norbert Benda Disclaimer: Views expressed in this presentation are the author's personal views and not necessarily the views of BfArM Biomarker defined
More informationThe Clinical Unmet need in the patient with Diabetes and ACS
The Clinical Unmet need in the patient with Diabetes and ACS Professor Kausik Ray (UK) BSc(hons), MBChB, MD, MPhil, FRCP (lon), FRCP (ed), FACC, FESC, FAHA Diabetes is a global public health challenge
More informationThe inhibition of CETP: From simply raising HDL-c to promoting cholesterol efflux and lowering of atherogenic lipoproteins Prof Dr J Wouter Jukema
The inhibition of CETP: From simply raising HDL-c to promoting cholesterol efflux and lowering of atherogenic lipoproteins Prof Dr J Wouter Jukema Dept Cardiology, Leiden University Medical Center, Leiden,
More informationANCHOR Study Results Overview
TM ANCHOR Study Results Overview April 18, 2010 Nasdaq: AMRN www.amarincorp.com 1 Forward Looking Statement This presentation contains forward looking statements, including those relating to the Company
More informationHow to Handle Statin Intolerance in the High Risk Patient
How to Handle Statin Intolerance in the High Risk Patient Thomas D. Conley, MD FACC FSCAI Disclosures: None 1 Definition of High Risk Primary Prevention ASCVD Risk Calculator Adults >21 yrs, LDL 190 mg/dl
More informationMacrovascular Residual Risk. What risk remains after LDL-C management and intensive therapy?
Macrovascular Residual Risk What risk remains after LDL-C management and intensive therapy? Defining Residual Vascular Risk The risk of macrovascular events and microvascular complications which persists
More informationThe Indian Polycap Study 1 & 2 (TIPS 1 & 2) and The International Polycap Study 3 & 4 (TIPS 3 & 4)
The Indian Polycap Study 1 & 2 (TIPS 1 & 2) and The International Polycap Study 3 & 4 (TIPS 3 & 4) Denis Xavier MD, MSc Professor and Head, Pharmacology, St. John's Medical College Coordinator, Division
More informationFelix Vallotton Ball (1899) LDL-C management in Asian diabetes: moderate vs. high intensity statin --- a lesson from EMPATHY study
Felix Vallotton Ball (1899) LDL-C management in Asian diabetes: moderate vs. high intensity statin --- a lesson from EMPATHY study Conflict of interest disclosure None Committee of Scientific Affairs Committee
More informationCLINICAL OUTCOME Vs SURROGATE MARKER
CLINICAL OUTCOME Vs SURROGATE MARKER Statin Real Experience Dr. Mostafa Sherif Senior Medical Manager Pfizer Egypt & Sudan Objective Difference between Clinical outcome and surrogate marker Proper Clinical
More informationNew evidences in heart failure: the GISSI-HF trial. Aldo P Maggioni, MD ANMCO Research Center Firenze, Italy
New evidences in heart failure: the GISSI-HF trial Aldo P Maggioni, MD ANMCO Research Center Firenze, Italy % Improving survival in chronic HF and LV systolic dysfunction: 1 year all-cause mortality 20
More informationInflammation and and Heart Heart Disease in Women Inflammation and Heart Disease
Inflammation and Heart Disease in Women Inflammation and Heart Disease What is the link between een inflammation and atherosclerotic disease? What is the role of biomarkers in predicting cardiovascular
More informationJanet B. Long, MSN, ACNP, CLS, FAHA, FNLA Rhode Island Cardiology Center
Primary and Secondary Prevention of Coronary Artery Disease: What is the role of non statin drugs (fenofibrates, fish oil, niacin, folate and vitamins)? Janet B. Long, MSN, ACNP, CLS, FAHA, FNLA Rhode
More informationAdvanced HER2+ Breast Cancer: New Options and How to Deploy Them. José Baselga MD, PhD
Advanced HER2 Breast Cancer: New Options and How to Deploy Them José Baselga MD, PhD HER2 signaling results in a multitude of cellular effects, including increased cellular proliferation HER2 HER3 RAS
More informationPreventing Cardiovascular Disease With Lipid Management: Matching Therapy to Risk
PREVENTING CARDIOVASCULAR DISEASE WITH LIPID MANAGEMENT : MATCHING TREATMENT TO RISK Robert B. Baron MD MS Professor and Associate Dean UCSF School of Medicine Declaration of full disclosure: No conflict
More informationDo Women Benefit From Statins for Primary Prevention?: Controversy, Challenges and Consensus
Do Women Benefit From Statins for Primary Prevention?: Controversy, Challenges and Consensus C. Noel Bairey Merz MD, FACC, FAHA Professor and Women s Guild Endowed Chair Director, Barbra Streisand Women
More informationCase Presentation. Rafael Bitzur The Bert W Strassburger Lipid Center Sheba Medical Center Tel Hashomer
Case Presentation Rafael Bitzur The Bert W Strassburger Lipid Center Sheba Medical Center Tel Hashomer Case Presentation 50 YO man NSTEMI treated with PCI 1 month ago Medical History: Obesity: BMI 32,
More informationDisclosures (2013 to the present)
What level and types of CV safety data acquisition should be considered to sufficiently characterize a drug s benefit/risk assessment by the end of Phase 3 development? Cardiac Safety Research Consortium
More informationLDL cholesterol and cardiovascular outcomes?
LDL cholesterol and cardiovascular outcomes? Prof Kausik Ray, BSc (hons), MBChB, FRCP, MD, MPhil (Cantab), FACC, FESC Professor of Cardiovascular Disease Prevention St Georges University of London Honorary
More informationResults of the GLAGOV Trial
Results of the GLAGOV Trial Global Assessment of Plaque Regression with a PCSK9 Antibody as Measured by Intravascular Ultrasound Steven E. Nissen MD Stephen J. Nicholls MBBS PhD Consulting: Many companies
More informationReflection paper on assessment of cardiovascular risk of medicinal products for the treatment of cardiovascular and metabolic diseases Draft
1 2 3 21 May 2015 EMA/CHMP/50549/2015 Committee for Medicinal Products for Human Use (CHMP) 4 5 6 7 Reflection paper on assessment of cardiovascular risk of medicinal products for the treatment of cardiovascular
More informationCUANDO COMENZAR, HASTA CUANTO LLEGAR Y CON QUE TRATAR AL PACIENTE HIPERTENSO CON DM2
CUANDO COMENZAR, HASTA CUANTO LLEGAR Y CON QUE TRATAR AL PACIENTE HIPERTENSO CON DM2 Patricio López-Jaramillo MD PhD FACP Director de Investigaciones y de la Clínica de Síndrome Metabólico, Prediabetes
More informationRegulatory Hurdles for Drug Approvals
Regulatory Hurdles for Drug Approvals William R. Hiatt, MD Professor of Medicine/Cardiology University of Colorado School of Medicine President, CPC Clinical Research 25 min Conflicts CPC Clinical Research
More informationModel Based Meta Analysis for comparative effectiveness and endpoint to endpoint relationships
Model Based Meta Analysis for comparative effectiveness and endpoint to endpoint relationships Jaap W Mandema www.wequantify.com PaSiPhIC San Luis Obispo CA July 15 2011 1 Model-based Meta-analyses WHAT?
More informationReflection paper on assessment of cardiovascular safety profile of medicinal products
25 February 2016 EMA/CHMP/50549/2015 Committee for Medicinal Products for Human Use (CHMP) Reflection paper on assessment of cardiovascular safety profile of medicinal products Draft agreed by Cardiovascular
More informationThe Committee for Medicinal Products for Human Use
www.eurordis.org The Committee for Medicinal Products for Human Use Patrick Salmon HPRA Barcelona, 4th June, 2015 2 CHMP 3 CHMP Move 4 The New CHMP 5 Where it all happens! 6 CHMP... What is it? CHMP What
More informationStatistical Analyses. Topics to be covered. Plenary Session 3: Correlative Studies in Phase III Trials: Biomarkers. Statisticians vs Epidemiologists
Plenary Session 3: Correlative Studies in Phase III Trials: Biomarkers Statistical Analyses Chris O Callaghan (Dongsheng Tu*) Statisticians vs Epidemiologists 5 statisticians and 5 epidemiologists are
More informationLEADER Liraglutide and cardiovascular outcomes in type 2 diabetes
LEADER Liraglutide and cardiovascular outcomes in type 2 diabetes Presented at DSBS seminar on mediation analysis August 18 th Søren Rasmussen, Novo Nordisk. LEADER CV outcome study To determine the effect
More informationCholesterol lowering intervention for cardiovascular prevention in high risk patients with or without LDL cholesterol elevation
TrialResults-center.org www.trialresultscenter.org Cholesterol lowering intervention for cardiovascular prevention in high risk patients with or without LDL cholesterol elevation A systematic review and
More informationSanjay Kaul, MD, FACC, FAHA Division of Cardiology Cedars-Sinai Medical Center Los Angeles, California
Targeting Inflammation in Atherosclerosis: Has CANTOS Nailed It? Controversies and Advances in the Treatment of Cardiovascular Disease The Seventeenth in the Series Beverly Hills, November 16, 2017 Sanjay
More informationDaniele Santini University Campus Bio-Medico Rome, Italy
Daniele Santini University Campus Bio-Medico Rome, Italy Anti EGFR therapy and colorectal cancer Cetuximab or Panitumumab Adapted from Ciardiello F. and Tortora G. NEJM 2008;358:1160-74 Who will benefit
More informationegfr > 50 (n = 13,916)
Saxagliptin and Cardiovascular Risk in Patients with Type 2 Diabetes Mellitus and Moderate or Severe Renal Impairment: Observations from the SAVOR-TIMI 53 Trial Supplementary Table 1. Characteristics according
More informationGuideline on clinical investigation of medicinal products in the treatment of lipid disorders
19 December 2013 Committee for Medicinal Products for Human Use (CHMP) Guideline on clinical investigation of medicinal products in the treatment of lipid disorders Adopted by CHMP July 2004 Date for coming
More informationBiomarkers are NOT useful Surrogates in Lipid Lowering Trials, but they are great Biomarkers!
Biomarkers are NOT useful Surrogates in Lipid Lowering Trials, but they are great Biomarkers! Robert M Califf MD Vice Chancellor for Clinical Research Duke University CHD Mortality Rate Per 1000 Total
More informationLipid Studies That Rocked My World Gabor Gyenes Medicine Grand Rounds May 27, 2011
Lipid Studies That Rocked My World Gabor Gyenes Medicine Grand Rounds May 27, 2011 Disclosure of Conflicts of Interest I have received travel grants and honoraria from sanofi-aventis, Pfizer, Servier,
More informationMaking War on Cholesterol with New Weapons: How Low Can We/Should We Go? Shaun Goodman
Making War on Cholesterol with New Weapons: How Low Can We/Should We Go? Shaun Goodman Disclosures Research grant support, speaker/consulting honoraria: Sanofi and Regeneron Including ODYSSEY Outcomes
More informationGet a Statin or Not? Learning objectives. Presentation overview 4/3/2018. Treatment Strategies in Dyslipidemia Management
Get a Statin or Not? Treatment Strategies in Dyslipidemia Management Michelle Chu, PharmD, BCACP, CDE Assistant Professor of Clinical Pharmacy, USC School of Pharmacy Sahar Dagher, PharmD Virtual Care
More informationResults of ODYSSEY OUTCOMES Trial
Results of ODYSSEY OUTCOMES Trial Evaluation of long-term cardiovascular outcomes after Acute Coronary Syndrome (ACS) during treatment with Praluent (alirocumab) Investor call at ACC, Orlando, March 10,
More informationNo relevant financial relationships
MANAGEMENT OF LIPID DISORDERS Balancing Benefits and harms Disclosure Robert B. Baron, MD MS Professor and Associate Dean UCSF School of Medicine No relevant financial relationships baron@medicine.ucsf.edu
More informationNo relevant financial relationships
MANAGEMENT OF LIPID DISORDERS: WHERE DO WE STAND WITH THE NEW PRACTICE GUIDELINES? Robert B. Baron MD MS Professor and Associate Dean UCSF School of Medicine Disclosure No relevant financial relationships
More informationEXCEL vs. NOBLE: How to Treat Left Main Disease in 2017 AATS International Cardiovascular Symposium December 8-9, 2017
EXCEL vs. NOBLE: How to Treat Left Main Disease in 2017 AATS International Cardiovascular Symposium December 8-9, 2017 Igor F. Palacios, MD Director of Interventional Cardiology Professor of Medicine Massachusetts
More informationUse of Subgroups to Rescue a Trial or Improve Benefit-Risk
1 Use of Subgroups to Rescue a Trial or Improve Benefit-Risk Martin King, Ph.D. Director, Statistics Global Pharmaceutical R&D, Abbott Abbott Park, IL USA 2 Disclaimer The opinions in this presentation
More informationAlirocumab Treatment Effect Did Not Differ Between Patients With and Without Low HDL-C or High Triglyceride Levels in Phase 3 trials
Alirocumab Treatment Effect Did Not Differ Between Patients With and Without Low HDL-C or High Triglyceride Levels in Phase 3 trials G. Kees Hovingh, 1 Richard Ceska, 2 Michael Louie, 3 Pascal Minini,
More informationHYPERCHOLESTEROLEMIA
UPDATES ON HYPERCHOLESTEROLEMIA WITH EMPHASIS ON PCSK9 INHIBITORS July, 2018 Chicago by Ernesto L. Chua, MD, FACC, FACP, FPCP Board Certified in Internal Medicine Board Certified in Cardiology COL, USAF,
More informationDECLARATION OF CONFLICT OF INTEREST. Nothing to disclose
DECLARATION OF CONFLICT OF INTEREST Nothing to disclose Four-Year Clinical Outcomes of the OLIVUS (Impact of OLmesartan on progression of coronary atherosclerosis; evaluation by IntraVascular UltraSound
More informationDisclosure. No relevant financial relationships. Placebo-Controlled Statin Trials
MANAGEMENT OF HYPERLIPIDEMIA AND CARDIOVASCULAR RISK IN WOMEN: Balancing Benefits and Harms Disclosure Robert B. Baron, MD MS Professor and Associate Dean UCSF School of Medicine No relevant financial
More informationLifetime clinical and economic benefits of statin-based LDL lowering in the 20-year Followup of the West of Scotland Coronary Prevention Study
Lifetime clinical and economic benefits of statin-based LDL lowering in the 20-year Followup of the West of Scotland Coronary Prevention Study Harvey White Green Lane Cardiovascular Service and Cardiovascular
More information5/2/2016. Outpatient Stroke Management Sheila Smith MD May 5, 2016
Outpatient Stroke Management Sheila Smith MD May 5, 2016 1 Management of Outpatient Stroke Objectives Review blood pressure management post stroke Review antithrombotic therapy Review statin therapy Discuss
More informationThis clinical study synopsis is provided in line with Boehringer Ingelheim s Policy on Transparency and Publication of Clinical Study Data.
abcd Clinical Study Synopsis for Public Disclosure This clinical study synopsis is provided in line with s Policy on Transparency and Publication of Clinical Study Data. The synopsis which is part of the
More informationImplications of Drug-related Increases in Blood Pressure
Implications of Drug-related Increases in Blood Pressure Preston M. Dunnmon, MD, FACP, FACC Division of Cardiovascular and Renal Products US Food and Drug Administration July 18, 2012 Disclaimer The findings
More information