PCSK9 inhibitors: ¿Quo Vadis? – The FOURIER Trial: an editorial comment

PCSK9 inhibitors: ¿Quo Vadis? – The FOURIER Trial: an editorial comment

FOURIER is a mega-trial of clinical efficacy and safety of evolocumab added to treatment with moderate / high intensity statins in patients with clinically evident atherosclerotic cardiovascular disease (ASCVD).   Our destiny will be the one we have deserved. Albert Einstein (1879-1955)    The therapeutic capacity of PCSK9 inhibition added to statins with the object of

FOURIER is a mega-trial of clinical efficacy and safety of evolocumab added to treatment with moderate / high intensity statins in patients with clinically evident atherosclerotic cardiovascular disease (ASCVD).  

Our destiny will be the one we have deserved.

Albert Einstein (1879-1955) 

 

The therapeutic capacity of PCSK9 inhibition added to statins with the object of obtaining greater reductions in the levels of LDL-cholesterol (LDL-C) has already been established.  Only two years back in this same portal (1) we commented the results of the ODYSSEY LONG TERM Trial (2) and OSLER-1 / OSLER-2 Trials (3) which affirmed these effects.   In spite of the fact that these trials were not designed to asses clinical outcomes, in OSLER-2 an exploratory analysis pre-specified to examine clinical events  showed that  0,95% of the patients that received evolocumab versus 2,18% of those that received standard treatment presented a clinical event;  a fact that in some way could be considered a premonition of the results of the FOURIER Trial (Further Cardiovascular Outcomes Research with PCSK9 Inhibition in Subjects with Elevated Risk)(4) that has just been presented. FOURIER is a mega-trial of clinical efficacy and safety of evolocumab added to treatment with moderate / high intensity statins in patients with clinically evident atherosclerotic cardiovascular disease (ASCVD).  The trial design was a randomized, double blind, placebo controlled study which included an international sample of 27.564 patients with clinical ASCVD and LDL-C levels ≥70 mg/dL that were already treated with a moderate to high intensity statin regimen.  The patients were assigned to receive evolocumab (either 140 mg every 2 weeks, or 420 mg monthly) or placebo administered by subcutaneous injection. The addition of the PCSK9 inhibitory antibody evolocumab compared to placebo reduced the baseline levels of LDL-C by 59% and this reduction remained stable during the remainder of the trial, without any evidence of attenuation through the duration of the study.  The primary end point was a composite of cardiovascular death, myocardial infarction, stroke, hospitalization for unstable angina or coronary revascularization; and a key secondary efficacy end point was the composite of cardiovascular death, myocardial infarction, or stroke. After a median duration follow-up of 2.2 years, 1344 patients (9.8%) in the evolocumab treated group and 1563 patients (11.3%) of the placebo group attained the primary end point (HR: 0.85, 95% confidence limits=0.79 to 0.92; P<0.001).  For the key secondary efficacy end point there were 816 patients (5,9%) in the evolocumab treated group versus 1013 patients (7.4%) in the placebo group (HR: 0.80, 95% confidence limits=0.73 to 0.88; P<0.001).

With regards to adverse events, especially new-onset diabetes mellitus and neurocognitive events, no significant differences were found between both groups.  The only exception was a greater incidence of local reactions at the injection-site (2.1% vs. 1.6%).  New binding antibodies were detected in rare occasions (0.3%), neutralizing antibodies did not occur in any patient and above all no attenuation of the LDL-C reducing effect was observed during the 2.2 years follow-up.  This contrasts with the findings with bococizumab (a humanized, but not completely human monoclonal antibody against PCSK9) which in the recent SPIRE- 1 and 2 Trials showed an unexpected attenuation of the LDL-C lowering effect over time, the appearance of a greater degree of immunogenicity and a greater incidence of injection-site local reactions.  This led the sponsor to suspend the trial and to discontinue the global development of the drug. (5)

The authors come to the conclusion that inhibition of PCSK9 with evolocumab added to therapy with statins reduces the levels LDL-C to a median of 30 mg/dL and reduces the risk of cardiovascular events.  On the strength of these findings they have estimated that it would be necessary to treat 74 patients for a period of two years to prevent an event of cardiovascular death, myocardial infarction or stroke.

On first analysis the greatest strengths of FOURIER are the demonstration that the addition of evolocumab to therapy with statins produces a significant reduction in the level of LDL-C to levels that never before have been achieved clinically and that this is accompanied by a reduction in the rate of morbid clinical events.  It has been noted that after achieving levels of LDL-C below 30 mg/dL for 2.2 years of follow up, few adverse events have been reported, most of them mild.  No mayor unfavorable neurocognitive events or new-onset diabetes were found, questions which had remained after the ODISSEY LONG TERM trial (2) y OSLER-2 trial (3).  This opens great therapeutic expectations for numerous patients.   But along with the strengths, we always run into the weakness: the relatively short duration of follow-up and the absence of a reduction in mortality.  The mean duration of follow-up of 2.2 years is a short period, especially when compared with the great majority of the of the mayor LDL-C lowering trials that have had follow-up periods in the order of 5 years. (6)  To be honest, when FOURIER initially was designed the estimate was that it would take approximately 4 years to achieve the pre specified number of events; but the real rate of events in this population ended up being approximately 50% greater than had been expected, so that the required number of events was attained in a much shorter period of time.  The fact that the FOURlER cohort has this greater than expected morbidity, should make us open our eyes regarding possible confounders.  Another, not less important matter, is the absence of a reduction in cardiovascular mortality [251 patients (1.8%) in the evolocumab group vs. 240 patients (1.7%) in the placebo group (HR: 1.05 IC95%=0.88–1.25) P= 0.62)], and the same for all cause mortality [444 patients (3.2%) in the treatment group vs. 426 patients (3.1%)in the not treated group [(HR: 1.04 (IC95%=0.91–1.19) P= 0.54)].  The analysis of all the events (as shown in Table 2 of the original paper) proves that the benefits of the treatment with evolocumab were due to significant reductions in non-fatal myocardial infarction, revascularizations and stroke.  It is very striking to find that such significant reductions in LDL-C did not produce even a tendency to decrease mortality   In the statin mega -trial HPS (Heart Protection Study) (7) cardiovascular mortality presented an absolute risk reduction of 1.5% (P<0.0001), non-vascular mortality showed no significant differences and all cause mortality had an absolute risk reduction of 1.8% (P<0.0003). In this trial the follow-up period was five years and average LDL-C reduction was 39 mg/dL, starting with overall more elevated baseline levels of LDL-C in the great majority. This lack of impact of FOURIER on mortality requires further analysis: the possibility that there is a threshold of LDL-C lowering after which there is no mortality benefit, in spite of persistence of benefit in non fatal events: should be considered.    For the moment these facts become a limitation when we attempt to extend these findings to clinical practice and eventually to Treatment Guidelines.  We must also be prudent in the evaluation of results that report a relative risk reduction of 15% for a composite combined primary end point and a 20% relative risk reduction for key combined secondary efficacy end point.  At the end of the day this translates into about 1.5% absolute risk reduction of presenting a non fatal cardiovascular event.  As the follow-up period has been relatively short, if the observation period is prolonged an absolute risk reduction in mortality might appear in the longer term.   For the time being, due to the findings mentioned and the high cost of each treatment, my opinion is that PCSK9 inhibitors have the potential of being an option for those patients who are intolerant or non responders to statins  and for those who have familial hypercholesterolemia’s who cannot achieve adequate control with statins.  Last, but not least, PCSK9 inhibitors have finally found a place in the cholesterol lowering band-wagon for prevention of ASCVD, but we still do not know what their destiny will be.

(I wish to thank Dr. Carlos Cuneo for his critical comments)

– Clic for more information HERE

REFERENCIAS

  1. Humphreys JD. Reducir el colesterol LDL: la saga continua. Comentario Editorial de los Estudios ODISSEY LONG TERM y OSLER-1 y 2. 8/04/2015 http://www.siacardio.com/editoriales/reducir-el-colesterol-ldl-la-saga-continua/ (Last access 22/03/2017)
  2. Robinson JG, Farnier M, Krempf M, et al. Efficacy and safety of alirocumab in reducing lipids and cardiovascular events. N Engl J Med 2015;372:1489–1499.
  3. Sabatine MS, Giugliano RP, Wiviott SD, et al. Efficacy and safety of evolocumab in reducing lipids and cardiovascular events.  N Engl J Med 2015; 372:1500-1509.
  4. Sabatine MS, Giugliano RP, Keech AC, et al. Evolocumab and clinical outcomes in patients with cardiovascular disease. N Engl J Med. DOI: 10.1056/NEJMoa1615664.
  5. Pfizer discontinues global development of bococizumab, its investigational PCSK9 inhibitor. Press release from Pfizer, New York, November 1, 2016. http://www.pfizer.com/news/press-release/press-release-detail/pfizer_discontinues_global_development_of_bococizumab_its_investigational_pcsk9_inhibitor (Last access 22/03/2017)
  6. The Cholesterol Treatment Trialists’ Collaboration. Efficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170,000 participants in 26 randomised trials. Lancet 2010; 376: 1670-81.
  7. Heart Protection Study Collaborative Group. MRC/BHF Heart Protection Study of cholesterol lowering with simvastatin in 20 536 high-risk individuals: a randomised placebo controlled trial. Lancet 2002; 360: 7–22.

 

 

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  • ANNA
    agosto 3, 2021, 10:52 am

    Thanks to God and also to Dr. OBINA, the great herbal man that cured me from HERPES. I contacted the virus from my partner three years ago, i almost spent all i had because i was restless and i need to get rid of the virus and i did not rest until i saw people testimony about Dr. OBINA recommendation online for how he has being curing HERPES with his herbs and i emailed him and tell him my problem and he prepare my cure and send it to me and gave me instructions on how to use the herbs and behold after i finish drinking it i went to the hospital for checkup and the result was negative and the virus was completely gone from my body. You can contact Dr. OBINA to get your herbs too and cure yourself from these virus. His Email: obinnaspelltemple@yahoo.com or add him on WhatsApp +19492293867 Dr. OBINA has cure so many different type of diseases with his herbs such as HERPES, HIV/AIDS. CANCER of all kinds, HSV 1&2, DIABETES and so many more. I want to thank God for using Dr. OBINA to cure me from herpes. Dr. OBINA is truly gifted by God. add him on WhatsApp +19492293867

    REPLY
    • Patterson@ANNA
      marzo 28, 2022, 4:02 pm

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      REPLY
      • Alexandra Valasquez@Patterson
        abril 28, 2022, 9:59 am

        Alexandra Valasquez
        This is an advise to those who are searching for a cure to Herpes. I got genital herpes from my ex boyfriend who was sleeping around with different girls, such a shameless pig. I can’t believe this. A great testimony that i must share to all herpes patients in the world. I never believed that their could be any complete cure for herpes or any cure for herpes outbreaks, but the good news is that there is and it is very effective. Herpes is a serious and recurring disease which can’t be cured through drugs or injections by the medical doctors. The best way to deal with herpes is by using natural herbal medicines and specifically, natural herbal medicine produced by reliable and qualified herbal doctors like DR.WATER. Some medical doctors even know about these herbal medicines from DR.WATER, and they get it at a cheaper price from DR.WATER and sell it more expensive to their patients. I have read about DR.WATER, the great herbalist doctor from African, who can cure disease with his powerful herbal medicines. For those people suffering from the following diseases, Herpes, HIV, Cancer, Hepatitis, Diabetes, Hpv genital warts, different Infections and many more, you should please contact him for his herbal medicine because i am a living testimony and i was cured of herpes after using his herbal medicine. I contacted him directly with the whatsapp number that i will be leaving below, he sent me his medicine which i took for 2 weeks and since then, i have gone for a check up 3 times, and all i was tested herpes negative. you can reach him through his email: Drwaterhivcurecentre@gmail.com or Whatsapp: +2349050205019

        REPLY
        • Diego Trigueros@Alexandra Valasquez
          abril 28, 2022, 10:00 am

          So many technological advances, and they still cannot discover the effective vaccine against HIV, Cancer, Diabetes, Herpes simplex ? And the Covid19 vaccines, is that even effective? … They spend all resources researching and producing weapons to kill more people. More medical science advancements, and less weapon production is the way to go, and this will make human being a truly intelligent being. I advise people to start looking to alternative cure to their illness like natural roots and herbs, rather than putting all their hopes on these scientist who seems to prioritize weapons of mass destruction over vital medicines to save lives. Natural herbal medicine might just be all you need to get rid of those your reoccurring health issues or Shingles (Herpes Zoster) outbreakes and other illnesses that these scientist refused to provide solutions to. I have used natural herbal medicines from Dr.Water to cure several people with Herpes Zoster. Where those pharmaceutical drugs have failed, Dr.Water herbal medicine has done the job effortlessly. We can not continue to live with Herpes, HIV, Diabetes, genital warts, cancer, hepatitis B , until they eventually take our lives because our scientist have failed to find the right solution, when there are very effective herbal cures to all these illnesses and you don’t even need to spend much money to get these remedies. For now i am recommending only Dr.Water herbal medicine for whoever is interested, this is his WHATS-APP : +2349050205019. there are still other nice herbal remedies out there, yes i tired few also, but that of Dr.Water is the one i have confirmed to be the most effective of them all.

          REPLY
          • HENRIETTE AMUNAZO@Diego Trigueros
            abril 28, 2022, 10:01 am

            I WAS CURED OF HERPES SIMPLEX VIRUS BY DR WATER, THE GREAT HERBALIST.
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            i am so happy to share this testimony with the world because generally there are so many doubts about the cure of HERPES simplex virus. This is real take it serious, my name is HENRIETTE AMUNAZO and i am so happy that today i can give this testimony to the world and also help people who has been condemned just as i was. Who will believe that a herb can cure HERPES completely from the body?, i never believed that this will work, i have spend a lot of money getting drugs from the hospital to supress outbreaks, it got to a time that all i was wanted was death to come because i was broke and i already have strong outbreaks from the herpes virus. One day i was going through the internet asking questions online just to know more about the latest development in the medical sector to see if there is still hope then i stumbled on a post about this great man called DR WATER through an online friend who publicly made a testimony on how she was also cured of herpes simplex virus 2 by this herbal doctor who is well known for his strong ancient herbal practice for HERPES, HIV, WARTS and CANCER cure. At first i doubted both the woman and the doctor just as so many that see’s this post would doubt because medically it has been proven impossible but later i decided to give him a try so i emailed him. I did not believe him that much, I just wanted to give him a try. He replied my mail and needed some Information about me, then I sent them to him, he prepared a herbal medicine (CURE) and sent it through Online Courier Service for delivery. He gave my details to the Courier Office. They told me that 3-5 days I will receive the package and after receiving it, i took the medicine as prescribed by him at the end of 13days that the medcine lasted, he told me to go to the hospital for a test, and i went, surprisingly after the test the doctor confirm me Herpes simplex virus free, i thought it was a joke, i went to other hospitals and was also confirmed herpes free, i will say it was like a miracle. I waited to see if i will get any outbreaks again and its been 2 months now, i have not experienced any outbreak. Thank you sir for saving my life even if you cannot see this post, i shall never stop testifying the impact you made in my life by restoring back my life when i was being stigmatized and even avoided by family and friends. I promise I will always testify of your good works. if you have herpes simplex virus, HIV patient, Diabetes, human papilloma virus or genital warts, contact him and I am sure you will get cured, contact him via:
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            . FIBRIOD, CYST
            . INFERTILITY [HUSBAND OR WIFE ]

            REPLY
          • Diallo Antoine@HENRIETTE AMUNAZO
            abril 28, 2022, 10:02 am

            What else can I say about him, today am equally very grateful to Dr.Water as I am finally cured of HIV disease that have been eating me up for over a year and 6 months. After searching for different means to get my self cure but nothing seems to work out, behold today i can boldly stand and testify to the world at large that with the help of herbal medicine, I have found myself back to my feet and healthy again in just after few weeks after i got in contact with a great herbalist, through help on a blog which talk about HIV cure. Few weeks ago, i saw an of a lady eplainning how she was cured through the herbal medicine too which was sent to her by Dr.Water. So i decided to give this great man a try by contacting him via his email and mobile number, i explained to him what my problems his and he promised that me all would be fine and well by the time he his done with is own work. I just had to believe in him, which i did ,low and behold, today i am very happy as it was just all like a magic that is why i have come here to testify to the world at large and also to share my experience because I know there are many people out there who are also in searching for a cure to one disease or the other. You can as well get in contact with DR.WATER now for herbal medicine help through his WhatsApp +2349050205019 as i fully believe he is able and capable to cure HIV/AIDS and can also cure all of these diseases: HEPATITIS B, HPV WARTS, CANCER, hERPES SIMPLEX VIRUS, ALS, DIABETES TYPE1&2, INFERTILITY IN BOTH MALE AND FEMALE

            REPLY
          • Daouda Millogo BARRO@Diallo Antoine
            abril 28, 2022, 10:04 am

            I was diagnosed as HEPATITIS B carrier after tests were done to investigate my frequent fatigue. I had chronic hepatitis b with fibrosis of the liver already present (liver cirrhosis). My doctors said Hepatitis B virus does not have any medical cure because the virus is capable of hiding within the human cells, and it remains protected from your immune system. I started Lamivudine [Epivir-HBV] treatment which reduced the viral load initially. After a couple of years the virus became resistant and i decided to try a more natural approach to treat the virus, so i ordered a HEPATITIS B Herbal formula treatment from Dr.Water after reading much about his products online. This natural HBV treatment totally reversed my condition. I did another blood test after 1 month of the treatment and i tested negative to the virus. Go to Dr.Water to help you cure your Hepatitis B today. You can also contact this great natural healer Dr.Water, on WhatApp +2349050205019 and on email: Drwaterhivcurecentre@gmail.com This treatment is a breakthrough for all HBV carriers. If you have this hepatitis B virus, I don’t think there is any need wasting your money and time on medical treatment, simply quickly contact this herbal doctor now.

            REPLY
          • Rosella Santos Jr@Daouda Millogo BARRO
            abril 28, 2022, 10:05 am

            I still don’t know the right words to express my gratitude to this great man Dr.Water. After been diagnosed of HERPES SIMPLEX VIRUS 2 years ago, i was given so many health prescription and advice with no improvement, so I totally lost hope, until i found testimonies of the great Dr.Water, from my online researches on google. Like anybody would be, I was very skeptical about contacting him, but i later did and he opened up to me and told me what was involved to get the remedies for my herpes. I had to try it out too, and in just few days i started using it all my pains and itching stopped completely. I still had to complete the treatment which was 2 weeks, and after i did, the herpes was all gone. Right now i can tell you that few months now, i have not had any kind of outbreak, no itching, no irritation and no bumps. I never thought that herpes can be cured. From the bottom of my heart I’m truly grateful, i pray you have live long so you can help many more people on earth with your herbal medical support. You can write him via email DRWATERHIVCURECENTRE@GMAIL.COM or for easy and fast communication you can also call or add him on whatsapp with this mobile number +2349050205019. One thing i love most about Dr.Water is his honesty and sincerity. And also,he is very polite with his patients, everything he told me was what he did, and his herbal medicines are very affordable.

            REPLY
          • Mariano Suarez@Rosella Santos Jr
            abril 28, 2022, 10:06 am

            I was diagnosed of HSV (Herpes) few years ago and my doctor told me there was no permanent cure for the disease. I was given medication to slow down the progress of the virus. At the initial stage it was not so bad till it progressed to a stage were i had difficulties going about my daily activities because i constantly felt pains in my penis, and around my genital were i had these blisters. I was totally devastated and i was even ashamed to complain to anyone. I saw a publication about a doctor called Dr.Water, and from what i read, he was using herbal medicines to cure illnesses like HERPES, Human papillomavirus, ALS, Diabetes, HIV, and so on. I opted to contacted him via email, after a few dicussion, i ordered for his medicine. He prepared the medicine and shipped it to me. When i received the herbal medicine, I took it according to his instructions. After using it as instructed, few weeks later i went to the hospital to have a blood test and the test came out negetive. To my greatest surprise, i was cured of this stubborn virus just by using a simple herbal product.
            That is why i am here sharing my testimony as much as i can to create as much awareness as possible so that people can also benefit and be cured too. contact him for help, via his email: {DRWATERHIVCURECENTRE@GMAIL.COM} or WhatsApp (+2349050205019). this is my persona email: marianosuarezsm@gmail.com, you add me on hangout

            REPLY
          • Luana Julian@Mariano Suarez
            abril 28, 2022, 10:07 am

            Hello hello everyone My name is Luana Salvador, I am from Braga in Portugal, I am a member of the Minho staff. I have been suffering from genital warts (HPV) for more than 5 years and suddenly I spent a lot of money to make sure I was healthy, but luckily 2 months ago on February 3, 2017 to be precise, I came into contact with a herbal healer online who has helped many people around the world and cures seemingly incurable diseases, his name is Dr_water. First of all I thought it was a joke until I contacted Dr_water through this email DRWATERHIVCURECENTRE@GMAIL.COM and he told me that he is curing me. He asked me for my data and the money for the treatment. After a week he sent me medicine to Portugal and gave me prescriptions to use the medicine. And really, I started to get my health back as soon as I started using the medicine, I noticed that the warts start to dry up and gradually disappear. I finished the treatment last month and then I went to my hospital and my doctor confirmed that I was cured of HPV, all the medical tests I did were negative, I was completely cured. I am very happy to share this experience because I still cannot contain my enthusiasm.
            This is his Whatsapp number +2349050205019, and this is his email: DRWATERHIVCURECENTRE@GMAIL.COM. It also has medicines to cure HIV, Herpes, Diabetes, Hepatitis B and C, Cancer, Asthma and many more. I think it can cure almost a kind of disease. You can follow me on twitter @ luanajulian1981

            REPLY
          • Miranda Filipe@Luana Julian
            abril 28, 2022, 10:08 am

            Dr WAter is the only one who could ever get my HERPES and Shingles cured with his herbal products. I have tried almost everything but i couldn’t find any solution to my painful rashes and stripe of blisters. Despite all these happening to me, i always spend a lot on buying HERPES drugs from hospitals and taking some several medications but no relief, until one day i was just browsing on the internet when i came across a great post of Henriette, who truly said that she was been diagnose with HERPES and was healed through the help of these great powerful herbal doctor. Sometime i really wonder why people called him Dr. WAter, i never knew it was all because of the great and perfect work that he has been doing that made him so popular. So, I quickly contacted him, and he ask me some few questions and then he said something i will never forget. He said that anyone who has used his herbal medicine always get healed after 2 weeks. I was amazed, because i could sense that he was being very honest, so i did all that he requested to buy this medicine. When i started using this medicine, after a few days the blisters were all gone, no rashes on my body anymore. I patiently waited to finish the dosage, before i went to a nearby hospital to see a gynacologist for check up. And i was told that i was negative of the herpes and shingle. I was very amazed and happy about the healing, and i can’t hold my joy, so i am here to tell anyone going through similar health issues to stop wasting your money on hospital medicine, get Dr. WAter herbal products now and be healed. Contact him on whatsapp: +2349050205019 or DRWATERHIVCURECENTRE@GMAIL.COM.
            i am leaving my facebook name here : Miranda Filipe (the profile with a white car in the background) and my email mirandafilipe01@gmail.com for those who would want to speak to me.

            REPLY
    • noble lacey@ANNA
      abril 27, 2022, 9:47 pm

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    • emily joss@ANNA
      junio 12, 2022, 8:57 am

      I am here again to say a big thanks to dr aba for making me a complete woman again, i was infected with Herpes for 2 years. I have been seriously praying to God and searching for a cure. I came here last month to search for solution to my problem and i saw comment of people talking about different doctors and God directed me to choose dr aba and i contacted Him, he sent me a medicine and directed me on how i will take the medicine for 14 days, i did so and went for a test and my result came out as Negative. i am so happy, i shared tears of happiness and i have taken it upon myself to always testify about how God used dr aba to solve my problem. I am a clean woman now, without any virus, if you are infected with any disease like HIV, AIDS,CANCER, HERPES or any other disease you can also be happy like me by contacting dr aba through his Email: dr.abaherbalhome@gmail.com or whatsapp him +2348107155060

      REPLY
    • mary vernon@ANNA
      julio 6, 2022, 5:08 am

      I am from California and a few months ago I was confirmed herpes 1 virus positive and ever since then I have been doing research on how I can get rid of the virus, I was lucky to come across aba herbs. I inbox Dr Aba after scrolling through his page, the doctor. responded nicely and told me that he is going to ship the cure medications to me via a shipping company, he also said I am going to get cured within two to three weeks! I never doubted him because many have said so much good news about his herbal medicine on every site and everything really went as planned.. His herbal treatments are completely legit and I recommend you contact him on dr.abaherbalhome@gmail.com or WhatsApp his number on +2348107155060.

      REPLY
    • mary vernon@ANNA
      julio 12, 2022, 5:35 am

      I’m here to testify about the great work Dr Aba did for me. I have been suffering from (HERPES) disease for the past 5 years and had constant pain, especially in my knees. During the first year, I had faith in God that i would be healed someday.This disease .started circulating all over my body and i have been taking treatment from my doctor, few weeks ago i came across a testimony of one lady on the internet testifying about a Man called Dr Aba on how he cured her from Herpes Simplex Virus. And she also gave the email address of this man and advised anybody to contact him for help for any kind of sickness that he would be of help, so I emailed him telling him about my (HERPES Virus) he told me not to worry that i was going to be cured!! Well i never believed it,, well after all the procedures and remedy given to me by this man few weeks later i started experiencing changes all over me as Dr Aba assured me that i will be cured,after some time i went to my doctor to confirmed if i have be finally healed behold it was TRUE, So friends my advice is if you have such sickness or any other at all you can contact Dr Aba via email dr.abaherbalhome@gmail.com You can also call or whatsApp his telephone number on +2348107155060. Thanks once again Dr Aba.

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    • reyes sandra@ANNA
      julio 13, 2022, 1:34 pm

      I am so happy, i never believe i will be this happy again in life, I was working as an air-hoster ( cabby crew ) for 3years but early this year, i loose my job because of this deadly disease called Herpes virus (HSV), I never felt sick or have any symptom, till all workers were ask to bring their doctor report, that was how i got tested and i found out that am HSV positive. that make me loose my job, because it was consider as an STD and is incurable disease, i was so depress was thinking of committing suicide, till i explain to a friend of mine, who always said to me a problem share is a problem solved, that was how she directed me to Dr Aba, that was how i contacted him and get the medication from this doctor and i got cured for real, I just went back to my work and they also carry out the test to be real sure and i was negative. Please contact this doctor if you are herpes positive or any STD diseases his email is: dr.abaherbalhome@gmail.com or you can call or whatsApp his mobile number on +2348107155060

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    • anne davis@ANNA
      julio 14, 2022, 4:28 pm

      I have been suffering from Herpes for the past 3 years and 8 months, and ever since then i have been taking series of treatment but there was no improvement until i came across testimonies of Dr.Aba on how he has been curing different people from different diseases all over the world, then i contacted him as well. After our conversation he sent me the medicine which I took according, to his instructions. When i was done taking the herbal medicine i went for a medical checkup and to my greatest surprise i was cured from Herpes. My heart is so filled with joy. If you are suffering from Herpes or any other disease you can contact Dr.Aba today on this Email address: dr.abaherbalhome@gmail.com or WhatsApp him on this Tell.Number +2348107155060

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    • emily jade@ANNA
      julio 15, 2022, 4:29 am

      I am from California and a few months ago I was confirmed herpes 1 virus positive and ever since then I have been doing research on how I can get rid of the virus, I was lucky to come across aba herbs. I inbox Dr Aba after scrolling through his page, the doctor responded nicely and told me that he is going to ship the cure medications to me via a shipping company, he also said. I am going to get cured within two to three weeks! I never doubted him because many have said so much good news about his herbal medicine on every site and everything really went as planned.. His herbal treatments are completely legit and I recommend you contact him on dr.abaherbalhome@gmail.com or WhatsApp his number on +2348107155060.

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    • emily davis@ANNA
      julio 27, 2022, 6:14 am

      God bless Dr. Aba for his marvelous work in my life, I was diagnosed of HERPES since 2016 and I was taking my medications, I wasn’t satisfied i needed to get the HERPES out of my system, I searched about some possible cure for HERPES i saw a comment. about Dr. Aba, how he cured HERPES with his herbal medicine, I contacted him and he guided me. I asked for solutions, he started the remedy for my health, he sent me the medicine. I took the medicine as prescribed by him and 14 days later I was cured from HERPES you can reach him through his email at dr.abaherbalhome@gmail.com or WhatsApp him on +2348107155060

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  • KATHRINE MELNICK
    agosto 8, 2021, 4:10 pm

    BEST URGENT EFFECTIVE LOVE SPELL TO GET YOUR EX/HUSBAND/WIFE BACK FAST AND TO SAVE YOUR MARRIAGE NOW CONTACT LORD ZULU ON WHATSAPP DIRECTLY +1 (424) 361‑7554. Hi everyone I’m here to testify of a great and powerful spell caster called Lord Zulu. I was so confused and devastated when my husband left me without a word, I needed him back desperately because I loved him so much. So a friend of mine introduced me to this powerful spell caster who had helped her in getting her lover back, so I contacted him and he promised that in less than 72 hours he will come back to me. After I did all he asked, to my greatest surprise my husband who had refused to speak with me came to my house and asked for forgiveness for all he had made me go through and now we are living happily together, if you have any relationship problem I will advise you contact him for your testimonies . Below are his contact details. Contact him on WhatsApp @ +1(424)361‑7554. BLOGSPOT: allsupremepowersolutionhome.blogspot.com EMAIL: Allsupremepowersolutionhome@gmail.com

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  • KATHRINE MELNICK
    agosto 8, 2021, 4:10 pm

    BEST URGENT EFFECTIVE LOVE SPELL TO GET YOUR EX/HUSBAND/WIFE BACK FAST AND TO SAVE YOUR MARRIAGE NOW CONTACT LORD ZULU ON WHATSAPP DIRECTLY +1 (424) 361‑7554. Hi everyone I’m here to testify of a great and powerful spell caster called Lord Zulu. I was so confused and devastated when my husband left me without a word, I needed him back desperately because I loved him so much. So a friend of mine introduced me to this powerful spell caster who had helped her in getting her lover back, so I contacted him and he promised that in less than 72 hours he will come back to me. After I did all he asked, to my greatest surprise my husband who had refused to speak with me came to my house and asked for forgiveness for all he had made me go through and now we are living happily together, if you have any relationship problem I will advise you contact him for your testimonies . Below are his contact details. Contact him on WhatsApp @ +1(424)361‑7554. BLOGSPOT: allsupremepowersolutionhome.blogspot.com EMAIL: Allsupremepowersolutionhome@gmail.com

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  • KATHRINE MELNICK
    agosto 8, 2021, 4:10 pm

    BEST URGENT EFFECTIVE LOVE SPELL TO GET YOUR EX/HUSBAND/WIFE BACK FAST AND TO SAVE YOUR MARRIAGE NOW CONTACT LORD ZULU ON WHATSAPP DIRECTLY +1 (424) 361‑7554. Hi everyone I’m here to testify of a great and powerful spell caster called Lord Zulu. I was so confused and devastated when my husband left me without a word, I needed him back desperately because I loved him so much. So a friend of mine introduced me to this powerful spell caster who had helped her in getting her lover back, so I contacted him and he promised that in less than 72 hours he will come back to me. After I did all he asked, to my greatest surprise my husband who had refused to speak with me came to my house and asked for forgiveness for all he had made me go through and now we are living happily together, if you have any relationship problem I will advise you contact him for your testimonies . Below are his contact details. Contact him on WhatsApp @ +1(424)361‑7554. BLOGSPOT: allsupremepowersolutionhome.blogspot.com EMAIL: Allsupremepowersolutionhome@gmail.com

    REPLY
  • KATHRINE MELNICK
    agosto 8, 2021, 4:10 pm

    BEST URGENT EFFECTIVE LOVE SPELL TO GET YOUR EX/HUSBAND/WIFE BACK FAST AND TO SAVE YOUR MARRIAGE NOW CONTACT LORD ZULU ON WHATSAPP DIRECTLY +1 (424) 361‑7554. Hi everyone I’m here to testify of a great and powerful spell caster called Lord Zulu. I was so confused and devastated when my husband left me without a word, I needed him back desperately because I loved him so much. So a friend of mine introduced me to this powerful spell caster who had helped her in getting her lover back, so I contacted him and he promised that in less than 72 hours he will come back to me. After I did all he asked, to my greatest surprise my husband who had refused to speak with me came to my house and asked for forgiveness for all he had made me go through and now we are living happily together, if you have any relationship problem I will advise you contact him for your testimonies . Below are his contact details. Contact him on WhatsApp @ +1(424)361‑7554. BLOGSPOT: allsupremepowersolutionhome.blogspot.com EMAIL: Allsupremepowersolutionhome@gmail.com

    REPLY
    • MICHAEL BAY@KATHRINE MELNICK
      febrero 20, 2022, 1:21 am

      hello everyone i am MICHAEL BAY from Florida a medical doctor i never believed herbal products could solve what my science technology could not solve ,i have been having little penis size since childhood and that really Embarrass me a lot and up till now that i am 37 years old i still find it difficult to find a permanent solution until my friend from Africa at work place introduce his uncle to me Dr Harry .he told me about his wonderful works and decided to contact him through his website he gave me https://drharryherbaltempl.wixsite.com/solutiontemple and he replied me and we discussed my situation and told me what i need to do ,i did it and received his herbal medicine through UPS and i got it within 3/5 days and used his miraculous herbal mixture cream just as he told me ,its just 4 days i started measuring and got 4 inches already and after two weeks i got 11 inches size and 8.0 girth size .i was so happy because no woman will dare reject me now with my big Cock .life is really full of surprises me that was having 2 inches before now having 11 inches big cock size .so if you need any help or cure to any sickness or disease like small penis,low sperm count,premature ejaculation,HIV/AIDS ,herpes ,spells of all kinds etc you can quickly visit his website link
      https://drharryherbaltempl.wixsite.com/solutiontemple whatsapp him on +2349036417079 good luck as you reach him

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      • Woźniak Krystyna@MICHAEL BAY
        mayo 12, 2022, 5:40 am

        Hello my name is Krystyna, I want to thank Dr. Jatto for bringing back my life. I was cured from genital herpes 2 with the herbal medicine Dr. Jatto sent it to me. I got to know about Dr. Jatto through a friend that was also cured from Diabetes after taking Dr. Jatto herbal medicine. Dr. Jatto herbal medicine works very fast without any side effects. I recommend Dr. Jatto to everyone suffering from genital herpes or any type of disease, His medicine will cure you 100% completely. You can contact him through His WhatsApp Number:+2348156965480 or email address: drjattolovespelltemple01@gmail.com or his Website: https://drjattolovespellte0.wixsite.com/my-jattosite

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        • Maya Bouchard@Woźniak Krystyna
          junio 6, 2022, 5:31 pm

          I always thought HIV had no cure not until i saw a post of an African herbal doctor called Dr JATTO who healed a person of HIV virus, i thought it was a joke not until i contacted the great man myself after some while he sent me a herbal which i took for 2 weeks and to my greatest surprise i was healed. I don’t know how this doctor did it but he made sure i got my healing, thanks Dr JATTO God bless you. You can contact him also if you want your virus to be gone completely contact DR JATTO via email: drjattolovespelltemple@yahoo.co.uk, his website: https://drjattolovespellte0.wixsite.com/my-jattosite also sent him a Whatsapp Chat: +2348156965480.

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          • ALBERT MIKE@Maya Bouchard
            junio 10, 2022, 7:54 pm

            HELLO EVERYONE I WAS BROWSING THE INTERNET AND I SAW A LOT OF WRONG QUOTE CONCERNING THE ILLUMINATI SOCIETY, I FELT BAD ABOUT IT, I WANT TO LET YOU KNOW FEW THINGS ABOUT THE ILLUMINATI SOCIETY. FIRST, I JOIN THE ILLUMINATI SOCIETY THROUGH THE HELP OF AN AGENT SOMEONE INTRODUCED ME TO ONLINE, AFTER YEARS OF DETERMINATION TO BE A MEMBER. BEING A MEMBER OF THE ILLUMINATI YOUR WEALTH IS GUARANTEE, YOU WILL BE PROTECTED, FAME, POWER INFLUENCE E.T.C ALL THESE THEY WILL GIVE YOU. ONE THING I WANT TO CORRECT IS THAT THE ILLUMINATI DON’T PAY MEMBER ANY SALARY, IF YOU ARE NEWLY INITIATED THEY WILL GIVE YOU THE SEED OF WEALTH AND BLESS YOU WITH WISDOM, POWER, INFLUENCE E.T.C YOU NEED TO BE SUCCESSFUL THE SEED OF WEALTH IS THE ONLY MONEY THE ILLUMINATI SOCIETY GIVE TO THEIR MEMBER, WITH THIS YOU CAN START ANYTHING WITH THE MONEY AND YOU WILL BE SUCCESSFUL. ANOTHER THING IS THAT THE SOCIETY HAVE SPECIAL BLESSING FOR POLITICIANS AND SUPER STARS. BEING AN ILLUMINATI MEMBER IS A PERSONAL DECISION, THE SOCIETY DON’T FORCE OR BEG PEOPLE TO JOIN THEM. I JOINED BECAUSE I WANT TO, NO BODY FORCE ME AND AM VERY HAPPY TO BE A MEMBER TODAY BECAUSE THEY HAVE CONTRIBUTED GREATLY TO MY LIFE BY MAKING ME ONE OF THE LEADING BUSINESS MAN IN THE WORLD. IF YOU ARE INTERESTED IN JOINING THE ILLUMINATI SOCIETY CALL/WHATSAPP Mr BERRY WARD on +39 351 232 2984 email grandmasterilluminati29@gmail.com HE WAS THE ONE THAT HELP ME AND I PROMISE I WILL FOREVER BE GRATEFUL.

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          • jenny@ALBERT MIKE
            agosto 1, 2022, 2:18 am

            Dr David has really made me so much believe that natural herbs can cure Herpes. I have been a Herpes virus patient for some years now, I have been running here and there looking for help/cure but none could help. I ran into a testimony by someone who testified how she was cured of a terrible disease by Dr David, so I decided to contact the herbal doctor. I explained to him, and he said he can cure me. We started the process and he prepared herbs and sent them to me in my country and gave me directions on how I should use them. I followed his directions and now To God be the glory he could cure me with his herbal mixture. I really appreciate you for bringing back my healthy life again. Thank you so many friends have joined me to thank dr David for what he has actually done for me. I pray for long life and prosperity, his contact. Email address drudodavid@gmail.com , via whats-app +2349031202378 Thanks dr David for your help in my life and family… and most especially to you Dr. THANKS.

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          • jenny@jenny
            agosto 1, 2022, 2:19 am

            Dr David has really made me so much believe that natural herbs can cure Herpes. I have been a Herpes virus patient for some years now, I have been running here and there looking for help/cure but none could help. I ran into a testimony by someone who testified how she was cured of a terrible disease by Dr David, so I decided to contact the herbal doctor. I explained to him, and he said he can cure me. We started the process and he prepared herbs and sent them to me in my country and gave me directions on how I should use them. I followed his directions and now To God be the glory he could cure me with his herbal mixture. I really appreciate you for bringing back my healthy life again. Thank you so many friends have joined me to thank dr David for what he has actually done for me. I pray for long life and prosperity, his contact. Email address drudodavid@gmail.com , via whats-app +2349031202378 Thanks dr David for your help in my life and family… and most especially to you Dr. THANKS.

            REPLY

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