In a nutshell
This paper reviewed the role of proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors in the treatment of heart disease.
Some background
PCSK9 is a protein that is involved in the breakdown of fat. A mutation of PCSK9 can increase the risk of the disorder familial hypercholesterolemia. Patients with this disorder have very high levels of low-density lipoprotein (LDL) cholesterol. This is a bad type of cholesterol that increases the risk of heart disease.
It is suggested that drugs that inhibit (block) PCSK9 could reduce levels of cholesterol. This would help in treatment of heart disease. Drugs like alirocumab (Praluent), evolucumab, ezetimibe (Zetia) and bococizumab are drugs that inhibit PCSK9. They can be used together with statins, a group of drugs that lower cholesterol levels.
Methods & findings
This review examined research being done on the safety and effectiveness of PCSK9 inhibitors.
Treatment with bococizumab has led to a 53% decrease in LDL cholesterol levels. Additionally, short-term studies of about 12 weeks showed that this drug was relatively safe.
In another study, evolocumab reduced LDL cholesterol levels at 12 weeks by 55-57%. Ezetimibe reduced LDL cholesterol levels by 18-19%.
In patients who also received an intense statin treatment, evolocumab reduced LDL cholesterol levels by 66-75% compared with placebo (drug that has no real effect). In patients with familial hypercholesterolemia, a treatment of statin plus evolocumab reduced LDL cholesterol by about 60% compared with placebo.
A long-term study examined the effectiveness of alirocumab in patients with uncontrolled high cholesterol who received the maximum allowed of statins. At 24 weeks, levels of LDL cholesterol were reduced by 62% in patients who received alirocumab compared to placebo. 79% of patients receiving alirocumab achieved an LDL cholesterol level of less than 70 mg/dL compared to 8% of patients receiving placebo.
The bottom line
The authors concluded that PCSK9 inhibitors show promising results. They significantly lower levels of low-density lipoprotein cholesterol.
The fine print
What’s next?
Talk to your doctor about PCSK9 inhibitors available to treat high cholesterol levels.
Published By :
Journal of the American College of Cardiology
Date :
Jun 23, 2015
