PCSK9 Inhibitors for LDL Cholesterol Reduction: Emerging Clinical Perspectives

摘要

Morbidity and mortality from cardiovascular disease in the United States has trended lower over the past several decades. Much of this risk reduction can be attributed to the use of statin therapies to lower low-density lipoprotein cholesterol (LDL-C). Despite this, coronary heart disease remains the leading cause of death in men and women. Residual risk may persist in patients who fail to achieve LDL-C targets or in those who are unable to tolerate moderate- or high-dose statins. Patients with familial hypercholesterolemia (FH) may be unable to achieve LDL-C targets despite high-dose statin therapy. Recently, monoclonal antibody therapy to reduce PCSK9 activity at the surface of the hepatocyte has been approved for use in those with FH or cardiovascular disease who require additional LDL-C lowering despite the use of maximally tolerated statins. PCSK9 blocking antibodies may reduce LDL-C up to 70 beyond levels achieved with statin therapies alone.