PCSK9 inhibitors lower LDL-C levels by 55% to 72% and reduce atherosclerotic cardiovascular disease events in high-risk patients, demonstrating a favorable safety profile.
Do PCSK9 inhibitors reduce LDL-C and atherosclerotic cardiovascular disease events in high-risk patients?
PCSK9 inhibitors are recommended for high-risk patients with LDL-C ≥70 mg/dl on maximally tolerated oral therapies to safely and effectively lower LDL-C and reduce ASCVD events.
Variants in proprotein convertase subtilisin/kexin type 9 (PCSK9) provide insights into mechanisms regulating low-density lipoprotein (LDL) levels. Human monoclonal antibodies that target PCSK9 lower LDL cholesterol (LDL-C) levels by 55% to 72% in different high-risk patient groups. Clinical trials with PCSK9 inhibitors have demonstrated reductions in atherosclerotic cardiovascular disease events, particularly in patients with recent acute coronary syndrome, multivessel coronary artery disease, or peripheral arterial disease. Commonly observed profound reductions in LDL-C to levels <25 mg/dl have been accompanied by even lower rates of atherosclerotic cardiovascular disease events, thus supporting the concept that there may be no lower limit for LDL-C. Aggressive LDL-C lowering with fully human PCSK9 monoclonal antibodies has been accompanied by a safety profile that has been very favorable. On the basis of clinical trial evidence, LDL lowering with PCSK9 inhibitors is recommended for high-risk patients with LDL-C levels ≥70 mg/dl on maximally tolerated oral therapies including statins and/or ezetimibe.
Rosenson et al. (Sun,) conducted a review in Atherosclerotic cardiovascular disease and elevated LDL cholesterol. PCSK9 inhibitors was evaluated on LDL cholesterol reduction and atherosclerotic cardiovascular disease events. PCSK9 inhibitors lower LDL-C levels by 55% to 72% and reduce atherosclerotic cardiovascular disease events in high-risk patients, demonstrating a favorable safety profile.