According to the data reported in the "Chinese Guidelines for the Management of Blood Lipids (2023)", the total prevalence of hyperlipidemia in the adult population in mainland China has reached an astonishing 35.6%, which means that there is an average of 1 patient with hyperlipidemia in every 3 Chinese people.
Under such astonishing data, people can't help but focus on the relevant indicators that reflect blood lipid levels, after all, no one wants to make their blood vessels become "oil pipes", and the biggest cost of chronic diseases is blood lipid-lowering drugs.
In the past, patients with hyperlipidemia mostly used imported Western drugs such as atorvastatin, bezafibrate tablets or ezetimibe tablets, not to mention the high price, and some of them had unsatisfactory effects after taking them.
Fortunately, this year, a new domestic PCSK9 inhibitor lipid-lowering drug - tolecimab injection (trade name: Symbila) was released. What are the characteristics and advantages of tolecimab compared with other similar drugs?
1. The new drug tolecimab is really so good at lowering blood lipids?
1. The new drug tolecimab, 6 advantages you don't know
First of all, from the perspective of modern medicine, LDL cholesterol level is an important risk factor for inducing atherosclerotic disease, and if it can be controlled within the ideal range, it will help delay the formation of sclerotic plaques and reduce the occurrence of serious cardiovascular events such as myocardial infarction and cerebral infarction.
To date, atorvastatin is a commonly used drug in middle-aged and elderly patients with hyperlipidemia, which lowers blood lipids by inhibiting proprotease convertase in the liver. In the past, the domestic drug Leke (Inks Lanna) referred to this pharmaceutical perspective and achieved the goal of reducing cholesterol by about 44% in 4 years by inhibiting the protease convertase in the liver.
In contrast, tolecimab belongs to the PCSK9 inhibitor class of drugs, which can specifically bind to the low-density lipoprotein receptor (LDLR) to form a complex, and then transport to the lysosome, so as to accelerate the degradation of LDLR and reduce LDL-C levels.
Secondly, from the perspective of indications, atorvastatin and Inkslana are too strong, so they are more used for the treatment of patients with primary hypercholesterolemia and less or not for the treatment of patients with mild hyperlipidemia, while tolecimab can be administered in small doses on the basis of diet control to meet the needs of mild to moderate patients for hypolipidemia.
In addition, tolecimab has the ability to improve the liver's ability to break down cholesterol, while atorvastatin and Leco can reduce cholesterol synthesis, that is, the two can be used in complementarity. In this way, tolecimab can indeed be called the strongest lipid-lowering ability among the currently marketed drugs, regardless of its combination effect with atorvastatin.
Finally, according to clinical study data published in JACC, tolecimab injections every 4 weeks showed that LDL-C levels in the drug group were 68.9% lower than baseline levels by week 12. It is worth mentioning that tolecimab can provide 2 weeks, 4 weeks and 6 weeks with 3 treatment intervals according to the needs of patients, so as to meet the needs of humanized treatment.
It can be seen that tolecimab has at least 6 advantages:
First, the effect of 68.9% lipid reduction in 12 weeks can inhibit the degree of arteriosclerosis in a more timely manner;
Second, compared with drugs such as atorvastatin, its unique lipid-lowering mechanism has less damage to the patient's liver and a higher safety factor;
Third, tolecimab can be used in combination with other drugs to increase the lipid-lowering effect:
Fourth, compared with other drugs, tolecimab can better meet the lipid-lowering needs of patients with mild to moderate hyperlipidemia:
Point 5, the three drug regimens with long treatment intervals have achieved the purpose of humanized treatment;
The sixth point is that the tolecimab developed by mainland scholars is more inclined to the Chinese physique, and if it can be included in medical insurance in the future, the cost performance will only be higher.
Of course, no matter how good the medicine is, it only solves the condition that has already occurred.
If you can intervene in time by adjusting your diet and exercise before hyperlipidemia is onset, you may not be able to rely on medication. Therefore, it is recommended that middle-aged and elderly people over 50 years old must be vigilant if they have the following 3 typical symptoms!
2. The 3 major abnormal symptoms of hyperlipidemia cannot afford to delay treatment
If you have yellow bumps the size of a grain of rice around your eyes, it means that there is a disorder in the body's internal lipid metabolism;
If you wake up in the morning and feel dizzy, or because of the increased viscosity of your blood;
If you have blurred vision and a grayish-white ring about 1-2mm wide around your black eyeball, this is due to excessive deposition of lipid metabolites at the corneal edge.
The above three conditions are all external manifestations of hyperlipidemia, but if the blood lipid profile is judged only by physical symptoms, the adverse consequences may have already formed.
Based on this, according to the recommendations of the "Guidelines for the Management of Blood Lipids in China (2023)", adults under the age of 40 need to measure their blood lipids every 2~5 years, people over 40 years old should be tested every year, and high-risk groups such as smokers, obese people and familial hyperlipidemia should be tested every 3~6 months.
If your HDL level is not too low (normal value 1.16~1.55mmol/L) and your LDL level is not too high (normal value should be less than 3.12mmol/L), we can achieve early reversal by adjusting dietary patterns and exercise intervention in the early stage of the disease.
Because there is a need to cure diseases, scientists develop various drugs to cure or control diseases. However, in real life, it is easy for us to rely on some great drugs to the point of forgetting about their side effects.
Second, excellent drugs need to be used with caution
1. Can the hypoglycemic drug semagluf really be used for weight loss?
As the saying goes, "a medicine is three parts poison", even the best drugs are no exception, yet many users deliberately ignore the side effects just to achieve a certain purpose, such as semaglutide injection.
Sugar friends should have heard of semaglutide injection, which is a long-acting insulin with a very good hypoglycemic effect. However, after a long period of clinical use, many patients have found that the weight loss effect of using it is also very good.
So, how does semaglutide achieve both blood sugar and weight loss?
According to relevant data, the hypoglycemic mechanism of semaglutide is to reduce blood sugar by selectively binding and activating GLP-1 receptors to stimulate insulin and glucagon secretion.
It is precisely because of this hypoglycemic mechanism that when the body's blood sugar rises, semaglutide will have a hypoglycemic effect, and when the body's blood sugar is normal, semaglutide will instead reduce appetite and increase satiety by acting on the hypothalamus.
This is also why people can find another layer of weight loss effect of semaglutide in addition to lowering blood sugar. It's worth pondering, is semaglutide really suitable for non-diabetic people to lose weight?
First of all, losing weight by suppressing appetite and exchanging malnutrition for a better figure is obviously not a wise choice;
Secondly, even if you can tolerate adverse reactions such as diarrhea, vomiting, and constipation, semaglutide can cause an increase in heart rate, or damage the function of heart tissue for a long time;
Finally, the mainland does not recognize the weight loss effect of the drug, and after normal people use it, once there is a problem, there is no guarantee.
2. Long-term use of 3 types of over-the-counter drugs may have a damaged immune system
In life, we often keep some over-the-counter medicines such as cough suppressants and anti-inflammatory drugs at home, and take them immediately when we get sick, and the effect is very good.
However, if the human body relies too much on good medicines, it will affect the normal functioning of the immune system, which in turn will give more bacteria and viruses a chance to multiply in the body. In this regard, I will briefly tell you about 3 common drugs.
The first is an analgesic and anti-inflammatory drug, a typical representative - ibuprofen extended-release capsules.
Although the inflammatory response is the result of the body's immune defense, excessive "redness, swelling, heat, and pain" can cause physical dysfunction, especially fever and pain, which is the most unbearable.
Based on this, ibuprofen sustained-release capsules can meet people's antipyretic needs. Its mechanism of action is to inhibit the synthesis of prostaglandins, first to prevent the continuous output of inflammatory response, and then release antipyretic signals to the thermoregulatory center, at the same time, it can also stimulate the body to produce a cooling source, two-pronged to achieve the purpose of cooling.
Therefore, ibuprofen can be used as an emergency pain reliever, but it cannot be relied on for continuous analgesia, and finding the cause of the pain is the most important thing.
What's more, it has been clinically found that those patients who have been taking over-the-counter drugs such as ibuprofen for a long time have mild liver function disorders, elevated aminotransferases during physical examination, and gastrointestinal ulcers and bleeding in severe cases.
The second is the common compound licorice preparation, which is very effective in relieving cough, but the glycyrrhizic acid in it can increase the cortisol level in the body and reduce the potassium level in the body.
If the potassium content in the body is insufficient, it means that dangerous substances such as carbon dioxide in the human body will remain in the body, and the mild ones will suffer from poor energy, fatigue, decreased immunity, and even irregular heart rate.
The third is short-acting antihypertensive drugs, such as alisartan cilexetil and benidipine.
Many patients with pre-hypertension often do not change their high-salt, high-lipidemia diet Xi, but choose to rely on these short-acting antihypertensive drugs, so that they regret it when they are finally officially diagnosed.
III. Conclusion
The advent of a new lipid-lowering drug, tolecimab injection, is believed to bring some comfort to many patients and their families, after all, no one wants to get tired easily when they get old, or fall due to blurred vision, and need to be taken care of everywhere.
However, it is worth noting that no matter how good the medicine is, it cannot match the health of the body. How to keep yourself in a good state for a long time, in addition to regular physical examination to obtain specific data, do not rely on drugs, do a good job in nutrition management and exercise is the best way to solve the problem of disease.
文献： 【1】Tafolecimab in Chinese Patients With Hypercholesterolemia (CREDIT-4): A Randomized.Double-Blind, Placebo-Controlled Phase 3 Trial.
[2] Jiang Linshuang, Chen Maowei.Clinical characteristics analysis of atorvastatin drug-induced liver injury[J/OL].Chinese General Practice,1-5[2023-12-26].
[3] Liang Jingru, Yang Xiaolei, Du Wandi, et al.Clinical research progress of the novel GLP-1 receptor agonist semaglutide[J].Chinese Journal of Clinical Pharmacy,2022,31(10):790-796.
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