Interv Akut Kardiol. 2016;15(1):54-57

PCSK9 inhibitors in light of recent data

Michal Vrablík
Centrum preventivní kardiologie, 3. interní klinika 1. LF UK a VFN, Praha

Twelve years ago, a discovery was made of a new protein termed as proprotein convertase subtilisin/kexin type 9 (PCSK9), which significantly

affects the levels of serum LDL-cholesterol. In a very short period of time, research led to preparing several options how to

therapeutically affect PCSK9. Among the most advanced is the development of specific monoclonal antibodies blocking this protein.

As a result, the number of recirculating LDL-receptors on the hepatocyte surface is increased, leading to a reduction in serum LDL-cholesterol

(and other atherogenic lipids) by 50–70 % beyond the level achievable with other available therapies. The safety and efficacy

of PCSK9 inhibitors is being tested in an extensive research programme involving several manufacturers. This novel therapeutic option

represents hope for difficult-to-treat patients with familial hypercholesterolaemia or statin intolerance and, in the future, even for those

with very high and high cardiovascular risk failing to reach target LDL-cholesterol levels with currently available therapies.

Keywords: cardiovascular risk, LDL-cholesterol, lipid-lowering drugs, PCSK9, monoclonal antibodies

Published: February 1, 2016  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
Vrablík M. PCSK9 inhibitors in light of recent data. Interv Akut Kardiol. 2016;15(1):54-57.
Download citation

References

  1. Vrablík M, Freiberger T, Lánská V, et al. Projekt Atractiv: zlepšení kardiovaskulární prevence v podmínkách primární péče v České republice. VnitrLek 2008; 54(12): 1131-1139.
  2. Češka R, Štulc T. Implementation of cardiovascular disease prevention guidelines in to clinical practice: an unmet challenge? CurrPharm Des. 2015; 21(9): 1180-1184. Go to original source... Go to PubMed...
  3. Nordestgaard B, Chapman J, Humphries SE, et al. Familial hypercholesterolemia is under diagnosed and under treated in the general population. Guidance for clinicians to prevent coronary heart disease. Eur Heart J 2013.
  4. Seidah NG. PCSK9 as a therapeutic target of dyslipidemia. Expert Opin Ther Targets 2009; 13: 19e28. Go to original source... Go to PubMed...
  5. Ference BA, Yoo W, Alesh I, et al. Effectof long-term exposure to lowerlow-density lipoprotein cholesterol beginning early in life on the risk of coronary heart disease: a Mendelian randomization analysis. J Am Coll Cardiol 2012; 60(25): 2631-2639. Go to original source... Go to PubMed...
  6. Catapano AL, Papadopoulos N. The safety of therapeutic monoclonal antibodies: Implications for cardiovascular disease and targeting the PCSK9 pathway. Atherosclerosis 2013; 228: 18-28. Go to original source... Go to PubMed...
  7. Dadu RT, Ballantyne CM. Lipid lowering with PCSK9 inhibitors. Nat Rev Cardiol. 2014; 11(10): 563-575. Go to original source... Go to PubMed...
  8. Bloom D, Hala T, Bolognese M, et al. A 52-week placebo-controlled trial of evolocumab in the treatment of hypercholesterolemia. N Engl J Med 2014; 370(19): 1809-1819. Go to original source... Go to PubMed...
  9. Robinson JG, Farnier M, Krempf M, et al. Long-term safety, tolerability and efficacy of alirocumab versus placebo in high cardiovascular risk patients: first results from the ODYSSEY LONG TERM study in 2,341 patients. Kongres AHA, Chicago, USA, 15-19. 11. 2014.
  10. Raal F, Scott R, Somaratne R, et al. Low-density lipoprotein cholesterol-lowering effects of AMG 145, a monoclonal antibody to proproteinconvertasesubtilisin/kexin type 9 serine protease in patients with heterozygous familial hypercholesterolemia: the Reduction of LDL-C with PCSK9 Inhibition in Heterozygous Familial Hypercholesterolemia Disorder (RUTHERFORD) randomized trial. Circulation. 2012 Nov 13; 126(20): 2408-2417. Go to original source... Go to PubMed...
  11. Kraml P. Evolokumab a projekt PROFICIO: první výsledky. Vnitřní lékařství 2015; 61: 953-957. Go to PubMed...
  12. Češka R. Inhibice PCKS9 jako nová naděje pro nemocné s familiární hypercholesterolemií, statinovou intolerancí a posléze pro všechny pacienty v nejvyšším kardiovaskulárním riziku? Zaměřeno na alirokumab - Praluent. Vnitřní lékařství 2015; 61: 946-951. Go to PubMed...
  13. Navarese EP, Kolodziejczak M, Schulze V, et al. Effect of pro protein convertasesubstilisin/kexin type 9 antibodies in adults with hypercholesterolemia. Ann Intern Med 2015; 163: 40-51. Go to original source... Go to PubMed...
  14. Lipinski MJ, Escarcega RO, Lhermusier T, et al. The impact of PCSK9 Inhibitors on lipid levels and outcomes in patients with primary hypercholesterolemia: a network meta-analysis. Abstract 19342, AHA Scientific Sessions, Orlando, USA.




Interventional Cardiology

Madam, Sir,
please be aware that the website on which you intend to enter, not the general public because it contains technical information about medicines, including advertisements relating to medicinal products. This information and communication professionals are solely under §2 of the Act n.40/1995 Coll. Is active persons authorized to prescribe or supply (hereinafter expert).
Take note that if you are not an expert, you run the risk of danger to their health or the health of other persons, if you the obtained information improperly understood or interpreted, and especially advertising which may be part of this site, or whether you used it for self-diagnosis or medical treatment, whether in relation to each other in person or in relation to others.

I declare:

  1. that I have met the above instruction
  2. I'm an expert within the meaning of the Act n.40/1995 Coll. the regulation of advertising, as amended, and I am aware of the risks that would be a person other than the expert input to these sites exhibited


No

Yes

If your statement is not true, please be aware
that brings the risk of danger to their health or the health of others.