Gerald F Watts

University of Pennsylvania, Philadelphia, Pennsylvania, United States

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Publications (503)1955.55 Total impact

  • Dick C Chan, Jing Pang, Gerald F Watts
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    ABSTRACT: There is growing evidence to suggest that statin therapy is associated with an increased risk of incident diabetes. The risk for statin-related diabetes depends upon many factors including age, pre-existing diabetic risk, type and potency of statin. Several mechanisms have been suggested for the diabetogenic effects of statins involving processes that alter islet ß-cell function, resulting in impaired glucose metabolism. Recent evidence suggests that the association of statin therapy with the development of diabetes may be partly mediated by a statin-induced decrease in circulating adiponectin and coenzyme Q10. The available evidence suggests the benefit of statins in reducing cardiovascular events outweigh the risk of developing diabetes. Moreover, statin therapy does not impair glycemic control in diabetic patients. Expert recommendations for the use of statins in people at risk of developing diabetes have recently been published. However, further research is required to elucidate both the association between statin use and incident diabetes as well as underlying mechanisms.
    Current Atherosclerosis Reports 01/2015; 17(1):472. · 2.92 Impact Factor
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    ABSTRACT: To analyze various business models for improving the diagnosis and treatment of familial hypercholesterolaemia. Five different strategies were analyzed and data were collected through documentary analysis and structured interviews. Interviewees included professionals from universities, Western Australia Department of Health, private medical practitioners and not-for-profit organizations. Two business models are recommended: alliance with general practitioners and primary health care organizations and a joint venture model between private cardiology clinics and lipid disorder clinics in the public sector. Primary care providers are in a good position to co-ordinate across the multi-disciplinary health services required to treat familial hypercholesterolaemia within the population. Devolution of knowledge on treatment of familial hypercholesterolaemia from centralized specialist hospital clinics to primary care services is required to improve the rate of detection of this condition in the community. An International Classification of Disease (ICD)-10 and/or a Diagnosis-Related Group (DRG) code is required to codify, catalogue and document new cases and treatment, as well as to facilitate research and re-imbursement strategies. Primary Health Care Organizations can usefully facilitate the transfer of knowledge on best standard of care to general practice, but the best model of care will require close integration of care with specialist and academic centres.
    International Journal of Evidence-Based Healthcare 12/2014; 12(4):244-254.
  • Amanda J Hooper, Gerald F Watts
    Clinical chemistry. 11/2014;
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    ABSTRACT: Introduction: In previous studies, we successfully designed complex multicompartmental microcapsules as a platform for the oral targeted delivery of lipophilic drugs in Type 2 Diabetes (T2D). Probucol (PB) is an antihyperlipidemic and antioxidant drug with the potential to show benefits in T2D. We aimed to create a novel microencapsulated formulation of PB and to examine the shape, size, and chemical, thermal, and rheological properties of these microcapsules in vitro. Method: Microencapsulation was carried out using the Büchi-based microencapsulating system developed in our laboratory. Using the polymer, sodium alginate (SA), empty (control, SA) and loaded (test, PB-SA) microcapsules were prepared at a constant ratio (1:30). Complete characterizations of microcapsules, in terms of morphology, thermal profiles, dispersity, and spectral studies, were carried out in triplicate. Results: PB-SA microcapsules displayed uniform and homogeneous characteristics with an average diameter of 1 mm. The microcapsules exhibited pseudoplastic-thixotropic characteristics and showed no chemical interactions between the ingredients. These data were further supported by differential scanning calorimetric analysis and Fourier transform infrared spectral studies, suggesting microcapsule stability.
    Mark Liveris Health Sciences Research Students Seminar, Curtin University; 11/2014
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    ABSTRACT: Microencapsulation as a novel delivery method for the potential antidiabetic drug, Probucol Presented by: Armin Mooranian, Biotechnology and Drug Development Research Laboratory, School of Pharmacy, Curtin Health Innovation Research Institute, Biosciences Research Precinct Course: Doctor of Philosophy Primary Supervisor: Hani Al-Salami, Biotechnology and Drug Development Research Laboratory, School of Pharmacy, Curtin Health Innovation Research Institute, Biosciences Research Precinct Co-Supervisors: Zhongxiang Fang, School of Public Health and Hesham Al-Sallami, School of Pharmacy (Otago University, New Zealand) Introduction: In previous studies, we successfully designed complex multicompartmental microcapsules as a platform for the oral targeted delivery of lipophilic drugs in Type 2 Diabetes (T2D). Probucol (PB) is an antihyperlipidemic and antioxidant drug with the potential to show benefits in T2D. We aimed to create a novel microencapsulated formulation of PB and to examine the shape, size, and chemical, thermal, and rheological properties of these microcapsules in vitro. Method: Microencapsulation was carried out using the Büchi-based microencapsulating system developed in our laboratory. Using the polymer, sodium alginate (SA), empty (control, SA) and loaded (test, PB-SA) microcapsules were prepared at a constant ratio (1:30). Complete characterizations of microcapsules, in terms of morphology, thermal profiles, dispersity, and spectral studies, were carried out in triplicate. Results: PB-SA microcapsules displayed uniform and homogeneous characteristics with an average diameter of 1 mm. The microcapsules exhibited pseudoplastic-thixotropic characteristics and showed no chemical interactions between the ingredients. These data were further supported by differential scanning calorimetric analysis and Fourier transform infrared spectral studies, suggesting microcapsule stability. Conclusion: The new PB-SA microcapsules have good structural properties and may be suitable for the oral delivery of PB in T2D. Further studies are required to examine the clinical efficacy and safety of PB in T2D. Presentation Details: Oral Presentation for the 2014 Mark Liveris Health Sciences Research Students Seminar at Curtin University.
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    ABSTRACT: •We address clinical challenges in the diagnosis and management of Familial Hypercholesterolemia patients•We address the controversies in diagnosing Homozygous FH•We offer a clinical care pathway to identify and manage patients with varying phenotypic severity of FH•We address the under-diagnosis and under-treatment of all FH patients•We address genotyping and cascade screening in FH patients
    Journal of Clinical Lipidology 11/2014; · 3.59 Impact Factor
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    ABSTRACT: The objective of this study was to identify factors associated with poor dietary intake (less than four servings of fruit and vegetables daily) in a large nationally representative sample of adults with psychotic disorders.
    Australian and New Zealand Journal of Psychiatry 10/2014; · 3.77 Impact Factor
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    ABSTRACT: Postprandial lipaemia, due to elevated plasma apolipoprotein (apo) B-48 concentrations, contributes to increased cardiovascular risk in obesity. Proprotein convertase subtilisin/kexin type 9 (PCSK9) and apoC-III may play a role in regulating apoB-48 metabolism. We investigated the associations between plasma PCSK9 and apoC-III concentrations and the kinetics of apoB-48 in obese subjects.Seventeen obese subjects were given an oral fat load. ApoB-48 tracer/tracee ratios were measured after intravenous d3-leucine administration using gas chromatography-mass spectrometry. Kinetic parameters, including secretion and fractional catabolic rates (FCR), were derived using a multi-compartmental model. Plasma PCSK9 and apoC-III concentrations were significantly and positively (P<0.05 in all) associated with the total area-under-curve (AUC) and incremental AUC for apoB-48, and inversely with apoB-48 FCR. Plasma PCSK9 and apoC-III concentrations were not correlated (P>0.05 in all) with basal secretion or number of apoB-48 secreted over the postprandial period. In stepwise regression analysis, plasma PCSK9 was the best predictor of the total and incremental AUCs for plasma apoB-48, and the FCR of apoB-48. The association between plasma PCSK9 and apoC-III and apoB-48 FCR remained significant (P<0.05 in all) after adjusting for age, homeostasis model assessment score (HOMA), hepatic lipase or lipoprotein lipase. In a multiple regression model, 31% of variance in apoB-48 FCR was accounted for by plasma PCSK9 and apoC-III concentrations (adjusted R2 =0.306, P<0.05). However, their associations with TRL-apoB-48 FCR were not independent of each other. Our results suggest that the catabolism of TRL-apoB-48 in the postprandial state may be co-ordinated by PCSK9 and apoC-III in obese individuals.
    Clinical science (London, England : 1979). 10/2014;
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    Raul D Santos, Gerald F Watts
    Lancet. 10/2014;
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    ABSTRACT: Background Familial hypercholesterolaemia (FH), a co-dominantly inherited disease of cholesterol that markedly increases risk of premature coronary artery disease (CAD), is significantly under-diagnosed. Primary health care is increasingly seen as a setting in which to increase the detection rate of index cases. We report a prospective study of three methods of case detection using pre-existing primary health care services in one community. Methods Three methods of case detection were tested: pathology laboratory database search, workplace health checks and general practice database search. People identified at risk by each of the three screening methods were offered detailed assessment for FH using the Dutch Lipid Clinic Network Criteria score (DLCNCS). Results 1316 participants underwent detailed assessment for FH. The proportion of at risk people identified for further assessment was in decreasing order: GP (659 of 2494, 26.4%), workplace assessment (60 of 268, 22.4%) and pathology database (597 of 4517, 13.2%) p < 0.001. Eight-six (6.5%) were identified as clinical FH (DLCNCS > 5) of which 59 had genetic testing and 11 of 59, 18.6%, were confirmed to have a mutation causing FH. Pathology database detected the greatest number of clinical FH (51 of 86, 59.3%) and mutation positive participants (8 of 11, 72.7%). Conclusion Screening within primary health care was successful in detecting participants with FH. An integrated case detection model combining screening of pathology and GP databases is proposed.
    Heart Lung &amp Circulation 09/2014; · 1.25 Impact Factor
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    ABSTRACT: In previous studies, we developed and characterised multicompartmental microcapsules as a platform for the targeted oral delivery of lipophilic drugs in type 2 diabetes (T2D). We also designed a new microencapsulated formulation of probucol-sodium alginate (PB-SA), with good structural properties and excipient compatibility. The aim of this study was to examine the stability and pH-dependent targeted release of the microcapsules at various pH values and different temperatures. Microencapsulation was carried out using a Büchi-based microencapsulating system developed in our laboratory. Using SA polymer, two formulations were prepared: empty SA microcapsules (SA, control) and loaded SA microcapsules (PB-SA, test), at a constant ratio (1:30), respectively. Microcapsules were examined for drug content, zeta potential, size, morphology and swelling characteristics and PB release characteristics at pH 1.5, 3, 6 and 7.8. The production yield and microencapsulation efficiency were also determined. PB-SA microcapsules had 2.6 ± 0.25% PB content, and zeta potential of -66 ± 1.6%, suggesting good stability. They showed spherical and uniform morphology and significantly higher swelling at pH 7.8 at both 25 and 37°C (p < 0.05). The microcapsules showed multiphasic release properties at pH 7.8. The production yield and microencapsulation efficiency were high (85 ± 5 and 92 ± 2%, respectively). The PB-SA microcapsules exhibited distal gastrointestinal tract targeted delivery with a multiphasic release pattern and with good stability and uniformity. However, the release of PB from the microcapsules was not controlled, suggesting uneven distribution of the drug within the microcapsules.
    AAPS PharmSciTech 08/2014; · 1.58 Impact Factor
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    ABSTRACT: Context: Statins are effective cholesterol-lowering agents that reduce cardiovascular disease risk but also have pleiotropic effects that may extend to other lipid classes. Objective: To investigate, in a post-hoc analysis, the dose-dependent effects of rosuvastatin on plasma sphingolipids and phospholipids in men with the metabolic syndrome. Methods: Subjects (N=12) were studied in a randomized, double-blind, triple-crossover trial of 5-wk treatment period with placebo or rosuvastatin (10 or 40mg/day) with 2-wk wash-outs between treatments. Plasma sphingolipid profiling was determined by liquid chromatography electrospray ionization tandem mass spectrometry. Results: Rosuvastatin at 10mg/day (R10) and 40mg/day (R40) significantly (all P<0.001 unless stated otherwise) lowered plasma cholesterol (% change with R10; % change with R40) (-34%; -42%) and LDL-cholesterol (-49%; -57%) and triglyceride (-24%, P=0.03; -42%) concentrations. Compared with placebo, R10 and R40 significantly decreased plasma levels of total sphingolipids including ceramide (-33%; -37%), sphingomyelin (-27%; -31%), monohexosylceramide (-40%; -47%), dihexosylceramide (-31%; -34%), trihexosylceramide (-29%; -31%), and GM3 gangliosides (-29%; -26%), lysophosphatidylcholine (-32%; -37%), alkylphosphatidylcholine (-19%; -19%), phosphatidylcholine (-17%; -19%), alkenylphosphatidylcholine (plasmalogen) (-20%; -22%), alkylphosphatidylethanolamine (-20% P=0.008; -24% P=0.02), alkenylphosphatidylethanolamine (plasmalogen) (-24% P=0.003; -23% P=0.007), phosphatidylglycerol (-24% P=0.07, -31% P=0.046), phosphatidylinositol (-34%; -40%). No significant changes were found with phosphatidylethanolamine and phosphatidylserine. Significant dose-effects were found with the majority of the plasma sphingolipids whereas only phosphatidylcholine, lysophosphatidylcholine, alkylphosphatidylcholine, alkenylphosphatidylcholine (plasmalogen), and phosphatidylinositol had significant dose-effects. Similar changes were found with plasma sphingolipids when normalised to total phosphatidylcholine concentration. Conclusions: Rosuvastatin dose-dependently lowers plasma sphingolipids and phospholipids, independent of LDL lowering, in men with the metabolic syndrome.
    The Journal of Clinical Endocrinology and Metabolism 08/2014; · 6.31 Impact Factor
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    ABSTRACT: Familial hypercholesterolaemia (FH) is the most common monogenic lipid disorder associated with premature coronary heart disease (CHD). However, the majority of people with FH are undiagnosed or undertreated. Early cholesterol lowering therapy reduces cardiovascular disease mortality in FH. Low awareness and knowledge of FH in specialty and general practice highlights the need for strategies to improve the detection and management of FH. We present an algorithm describing a multidisciplinary approach to FH detection and management. We highlight the role of primary care, and where GPs can work with preventive cardiologists to improve care of FH. Novel strategies to detect index cases with FH are presented including the community laboratory, highlighting patients at high risk of FH, and targeted FH detection through searching the general practice database. General practitioners request over 90% of LDL cholesterol measurements in the community. Once an individual with FH is detected only a small proportion of patients require specialty management with the majority of patients suitably managed in primary care. However, it is crucial to screen family members, as 50% of first-degree family members are expected to have FH due to the autosomal dominant inheritance.
    Heart Lung &amp Circulation 08/2014; · 1.25 Impact Factor
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    ABSTRACT: Context: Low plasma HDL cholesterol is a major abnormality in abdominal obesity. This relates due to accelerated HDL catabolism but the underlying mechanism requires further elucidation. The relationships between HDL catabolism and other variables that may be modified in abdominal obesity, such as VLDL subspecies (VLDL1, VLDL2) kinetics, liver fat or visceral adiposity, remain to be investigated. Objectives: Our aim was to study the associations between HDL apoA-I fractional catabolic rate (FCR) and the kinetics of VLDL subspecies and estimates of liver, visceral and subcutaneous fat. Design: We carried out a multicentre in vivo kinetic study using stable isotopes (deuterated leucine and glycerol) in 62 individuals with abdominal obesity. Results: In multivariate analysis, among the morphological and biological parameters that may predict ApoA-I FCR, liver fat (β=0.400, p=0.003) and VLDL1-apoB (β=0.307, p=0.020) were independently associated with apoA-I FCR. In multivariate analysis, among the kinetic parameters, VLDL1-TG indirect FCR (β=-0.357, p=0.001), VLDL1-TG PR (β= 0.213p=0.048) and apoA-II FCR (β=0.667, p<0.0001) were independently associated with apoA-I FCR. After adjustment for VLDL1-TG PR, liver fat was no more correlated with apoA-I FCR. No association between apoA-I FCR and visceral fat was observed. Conclusions: We show that VLDL1 is an important independent determinant of apoA-I FCR and more precisely that apoA-I FCR is independently associated with both catabolism and production of VLDL1-TG. In addition, we show an association between liver fat and apoA-I FCR that is mostly mediated by VLDL1-TG production. These data indicate that, in abdominal obesity, dysfunctional VLDL1 metabolism is an important modulator of HDL apoA-I catabolism.
    The Journal of clinical endocrinology and metabolism. 07/2014;
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    ABSTRACT: Elevated plasma triglyceride (TG) concentrations are associated with an increased risk of atherosclerotic cardiovascular disease (CVD), hepatic steatosis and pancreatitis. Existing pharmacotherapies, such as fibrates, n-3 polyunsaturated fatty acids (PUFAs) and niacin, are partially efficacious in correcting elevated plasma TG. However, several new TG-lowering agents are in development that can regulate the transport of triglyceride-rich lipoproteins (TRLs) by modulating key enzymes, receptors or ligands involved in their metabolism. Balanced dual peroxisome proliferator-activated receptor (PPAR) α/γ agonists, inhibitors of microsomal triglyceride transfer protein (MTTP) and acyl-CoA:diacylglycerol acyltransferase-1 (DGAT-1), incretin mimetics, and apolipoprotein (apo) B-targeted antisense oligonucleotides (ASOs) can all decrease the production and secretion of TRLs; inhibitors of cholesteryl ester transfer protein (CETP) and angiopoietin-like proteins (ANGPTLs) 3 and 4, monoclonal antibodies (Mabs) against proprotein convertase subtilisin/kexin type 9 (PCSK9), apoC-III-targeted ASOs, selective peroxisome proliferator-activated receptor modulators (SPPARMs), and lipoprotein lipase (LPL) gene replacement therapy (alipogene tiparvovec) enhance the catabolism and clearance of TRLs; dual PPAR-α/δ agonists and n-3 polyunsaturated fatty acids can lower plasma TG by regulating both TRL secretion and catabolism. Varying degrees of TG reduction have been reported with the use of these therapies, and for some agents such as CETP inhibitors and PCSK9 Mabs findings have not been consistent. Whether they reduce CVD events has not been established. Trials investigating the effect of CETP inhibitors (anacetrapib and evacetrapib) and PCSK9 Mabs (AMG-145 and REGN727/SAR236553) on CVD outcomes are currently in progress, although these agents also regulate LDL metabolism and, in the case of CETP inhibitors, HDL metabolism. Further to CVD risk reduction, these new treatments might also have a potential role in the management of diabetes and non-alcoholic fatty liver disease owing to their insulin-sensitizing action (PPAR-α/γ agonists) and potential capacity to decrease hepatic TG accumulation (PPAR-α/δ agonists and DGAT-1 inhibitors), but this needs to be tested in future trials. We summarize the clinical trial findings regarding the efficacy and safety of these novel therapies for hypertriglyceridemia.
    Progress in Lipid Research 07/2014; · 10.25 Impact Factor
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    ABSTRACT: Homozygous familial hypercholesterolaemia (HoFH) is a rare life-threatening condition characterized by markedly elevated circulating levels of low-density lipoprotein cholesterol (LDL-C) and accelerated, premature atherosclerotic cardiovascular disease (ACVD). Given recent insights into the heterogeneity of genetic defects and clinical phenotype of HoFH, and the availability of new therapeutic options, this Consensus Panel on Familial Hypercholesterolaemia of the European Atherosclerosis Society (EAS) critically reviewed available data with the aim of providing clinical guidance for the recognition and management of HoFH.
    European heart journal. 07/2014;
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    ABSTRACT: Introduction: Cardiovascular disease (CVD) remains the leading cause of death in industrialized nations. Despite clear evidence of CVD risk reduction with HMG-CoA reductase inhibitors (statins), the side effects of these medications, particularly myopathy, limit their effectiveness. Studies into the mechanisms, aetiology and management of statin myopathy are limited by lack of an internationally agreed clinical definition and tools for assessing outcomes. Currently there is a paucity of evidence to guide the management of patients affected by statin myopathy; with the exception of dose reduction, there is little evidence that other strategies can improve statin tolerance, and even less evidence to suggest these alternate dosing strategies reduce cardiovascular risk.Areas covered: This review will cover current definitions, clinical presentations, risk factors, pathogenesis and management. PubMed was searched (English language, to 2014) for key articles pertaining to statin myopathy. This review then briefly describes our experience of managing this condition in a tertiary lipid disorders clinic, in the setting of limited guiding evidence.Expert opinion: Knowledge gaps in the field of statin myopathy are identified and future research directions are suggested. We urge the need for international attention to address this important, but largely neglected clinical problem, that if unresolved will remain an impediment to the effective prevention and treatment of CVD.
    Expert Opinion on Drug Safety 07/2014; · 2.74 Impact Factor
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    ABSTRACT: Antipsychotic drugs such as clozapine and olanzapine are associated with an increased risk for type 2 diabetes, but relatively little is known about the relationship between risk factors for type 2 diabetes established in the general population and type 2 diabetes in people with psychosis. We estimated the prevalence of established risk factors and their association with type 2 diabetes in a nationally representative sample of people with an ICD-10 psychosis (N=1642) who gave a fasting blood sample (N=1155). Logistic regression was used to summarize associations adjusted for age and sex. In this sample, whose mean duration of psychosis was 14.7 years, 12.1% (13.1% of women and 11.5% of men) had type 2 diabetes at age 18-64 years based on current fasting blood glucose levels or treatment with a hypoglycaemic drug. Risk was greatly increased in young adults compared with the general population and peaked in middle age. Risk factors in the general population were common in people with psychosis and strongly associated with type 2 diabetes in those people. Treatment with clozapine was associated with an increased risk and treatment with olanzapine with a decreased risk for type 2 diabetes. The development of diabetes or pre-diabetes may therefore influence the likelihood of treatment with olanzapine over time. The strongest predictors of type 2 diabetes in a multivariate model were a body mass index of at least 40 and treated hypercholesterolemia, followed by a body mass index between 35 and 39.9, a family history of diabetes and treated hypertension. There was minimal to no confounding of the association between type 2 diabetes and current clozapine or olanzapine treatment, but neither association remained significant after adjustment for other predictors. Longitudinal relationships among predictors are likely to be complex, and previous antipsychotic drug treatment may at least partly explain risks associated with severe obesity, dyslipidemia and hypertension. A focus on weight loss is warranted in people with psychosis, but prevention strategies for type 2 diabetes should be broadened to include those with emerging dyslipidemia, hypertension and a family history of diabetes.
    World psychiatry: official journal of the World Psychiatric Association (WPA) 06/2014; 13(2):176-83. · 8.97 Impact Factor
  • Heart Lung &amp Circulation 05/2014; · 1.25 Impact Factor
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    ABSTRACT: Background: Familial hypercholesterolaemia (FH) imposes significant burden of premature coronary heart disease (CHD). Objective: This study aimed to determine the cost-effectiveness of FH based on genetic testing, supplemented with the measurement of plasma low-density-lipoprotein (LDL) cholesterol concentration and treatment with statins. Methods: A Markov model with a 10-year time horizon was constructed to simulate the onset of first-ever CHD and death in close relatives of probands with genetically confirmed FH. The model comprised three health states: ‘Alive without CHD; ‘Alive with CHD’; and ‘Dead’. Decision-analysis compared the clinical consequences and costs of cascade-screening versus no-screening from an Australian healthcare perspective. The annual risk of CHD and benefits of treatment was estimated from cohort study. The underlying prevalence of FH, sensitivity, specificity, cost of screening, treatment and clinic follow-up visits were derived from a cascade-screening for FH in Western Australia. An annual discount rate of 5% was applied to costs and benefits. Results: The model estimated that screening for FH would reduce the 10-year incidence of CHD from 50.0% to 25.0% among people with FH. Of every 100 people screened, there was an overall gain of 24.95 life-years and 29.07 quality adjusted life years (QALYs) (discounted). The incremental cost-effectiveness ratio (ICER) was AUD $4,155 per years of life saved (YoLS) and AUD $3,565 per QALY gained. Conclusion: This analysis within an Australian context, demonstrates that cascade-screening for FH, using genetic testing supplemented with the measurement of plasma LDL cholesterol concentrations and treatment with statins, is cost-effective means of preventing CHD in families at-risk of FH.
    Journal of Clinical Lipidology 05/2014; · 3.59 Impact Factor

Publication Stats

9k Citations
1,955.55 Total Impact Points

Institutions

  • 2014
    • University of Pennsylvania
      • Institute for Translational Medicine and Therapeutics
      Philadelphia, Pennsylvania, United States
  • 1995–2014
    • Royal Perth Hospital
      Perth City, Western Australia, Australia
    • University of Western Australia
      • • School of Medicine and Pharmacology
      • • Western Australian Institute for Medical Research (WAIMR)
      Perth City, Western Australia, Australia
  • 2013
    • Gold Coast University Hospital
      Southport, Queensland, Australia
    • Mashhad University of Medical Sciences
      • Biotechnology Research Center
      Mashhad, Razavi Khorasan, Iran
  • 1994–2013
    • University of London
      Londinium, England, United Kingdom
  • 2012
    • Monash University (Australia)
      • Department of Epidemiology and Preventive Medicine
      Melbourne, Victoria, Australia
    • Royal Prince Alfred Hospital
      Camperdown, New South Wales, Australia
  • 2007–2012
    • University of Sydney
      Sydney, New South Wales, Australia
    • Baker College, Australia
      Hornsby, New South Wales, Australia
  • 2011
    • Università Politecnica delle Marche
      • Department of Biochemistry, Biology and Genetics
      Ancona, The Marches, Italy
    • Pierre and Marie Curie University - Paris 6
      Lutetia Parisorum, Île-de-France, France
  • 2006–2010
    • Sir Charles Gairdner Hospital
      Perth City, Western Australia, Australia
  • 2000–2009
    • The Keogh Institute For Medical Research
      Perth City, Western Australia, Australia
  • 2005–2006
    • Curtin University Australia
      • • Discipline of Health Sciences
      • • School of Public Health
      Bentley, Western Australia, Australia
    • Tehran University of Medical Sciences
      • School of Public Health (SPH)
      Tehrān, Ostan-e Tehran, Iran
  • 1988
    • St. Mary Medical Center
      Long Beach, California, United States