New lipid therapies: PCSK9 inhibitors

• Main Authors: Farah Meah, DO, Arshi Basit, MD, Alaleh Mazhari, DO, Mary Ann Emanuele, MD, Nicholas Emanuele, MD
• Format: Article
• Language: English
• Published: Elsevier 2016-12-01
• Series: Journal of Clinical and Translational Endocrinology Case Reports
• Online Access: http://www.sciencedirect.com/science/article/pii/S2214624516300132
• ISSN: 2214-6245

Pharmacologic therapy reduces cardiovascular risk in a variety of primary and secondary prevention clinical situations in addition to lifestyle modifications. Low density lipoprotein cholesterol (LDL-C) is a key mediator of atherogenesis. Most cholesterol guidelines propose specific LDL-C while recently the ACC/AHA recommends statin therapy without a specific LDL-C target. Proprotein convertase subtilisin kexin 9 (PCSK9) is a serine protease that leads to LDL receptor degradation. The decreased availability of LDL receptors results in decreased clearance and an increase of circulating LDL-C particles. Monoclonal antibodies that inhibit PCSK9 (PCSK9 abs) reduce LDL-C levels and may be especially helpful in familial hypercholesterolemia and statin-intolerant patients. PCSK9 inhibition is an exciting and promising new therapy for protection against macrovascular events. Keywords: LDL, LDL receptor, Atherothrombosis, Familial hyperlipidemia, Alirocumab, Evolocumab