Key result
Add-on PCSK9 inhibitor therapy linked to a ~20% reduction in PWV in familial hypercholesterolemia.
Why the study?
Subjects with familial hypercholesterolemia have increased LDL-C promoting continuous inflammation, and the effect of PCSK9 inhibitors on inflammatory biomarkers and early atherosclerosis damage was evaluated.
Do PCSK9 inhibitors improve inflammatory biomarkers and pulse wave velocity in subjects with familial hypercholesterolemia with off-target LDL-C?
Observational (n=56)
Open-label
No
Do PCSK9 inhibitors improve inflammatory biomarkers and pulse wave velocity in subjects with familial hypercholesterolemia with off-target LDL-C?
Effect estimate: Δ -20.4%
Absolute Event Rate: 7.55% vs 9.48%
p-value: p=<0.01
PCSK9 inhibitors significantly improve lipid profiles, inflammatory markers, and arterial stiffness in familial hypercholesterolemia patients with off-target LDL-C on maximal oral therapy.
PCSK9 inhibitors were associated with reduced arterial stiffness in FH; hypothesis-generating and should not yet change practice.
AIMS: Subjects with familial hypercholesterolemia (FH) are characterized by an increased amount of low-density lipoprotein cholesterol (LDL-C) that promotes a continuous inflammatory stimulus. Our aim was to evaluate the effect of PCSK9-i on inflammatory biomarkers, neutrophil-to-lymphocyte ratio, monocyte-to-high-density lipoprotein ratio (MHR), and on early atherosclerosis damage analyzed by pulse wave velocity (PWV) in a cohort of FH subjects. METHODS: In this prospective observational study, we evaluated 56 FH subjects on high-intensity statins plus ezetimibe and with an off-target LDL-C. All subjects were placed on PCSK9-i therapy and obtained biochemical analysis as well as PWV evaluation at baseline and after six months of PCSK9-i therapy. RESULTS: After six months of add-on PCSK9-i therapy, only 42.9% of FH subjects attained LDL-C targets. As expected, a significant reduction of LDL-C (- 49.61%, p < 0.001) was observed after PCSK9-i therapy. Neutrophil count (NC) and MHR were reduced by PCSK9-i (-13.82% and -10.47%, respectively, p value for both < 0.05) and PWV significantly decreased after PCSK9-i therapy (- 20.4%, p < 0.05). Finally, simple regression analyses showed that ∆ PWV was significantly associated with ∆ LDL-C (p < 0.01), ∆ NC and ∆ MHR (p value for both < 0.05). CONCLUSIONS: In conclusion, PCSK9-i therapy significantly improved lipid and inflammatory profiles and PWV values in FH subjects; our results support the positive effect of PCSK9-i in clinical practice.
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Scicali et al. (2021) conducted an observational in Familial hypercholesterolemia (n=56). PCSK9 inhibitors vs. Baseline was evaluated on Pulse wave velocity (PWV) (Δ -20.4%, p=<0.01). Add-on PCSK9 inhibitor therapy for six months significantly reduced pulse wave velocity by 20.4% compared to baseline in subjects with familial hypercholesterolemia.
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