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PCSK9 Inhibition: New Treatment Options and Perspectives to Lower Atherogenic Lipoprotein Particles and Cardiovascular Risk

  • Nonstatin Drugs (R. Carmena, Section Editor)
  • Published:
Current Atherosclerosis Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

To summarize latest clinical studies and to put them into perspectives for clinical relevant subgroups and new therapeutic options.

Recent Findings

Have investigated PCSK9 inhibitors in patients with very high cardiovascular risk and insufficient LDL cholesterol lowering under current maximal tolerated lipid-lowering therapy, patients with statin intolerance, or genetic forms of familiar hypercholesterolemia, and patients on LDL apheresis. Purpose of recent cardiovascular endpoint trials has proven cardiovascular benefit of this new approach.

Summary

PCSK9 inhibition with fully humanized antibodies has proven to be effective, safe, and well-tolerated in reducing cardiovascular risk by LDL cholesterol lowering. Therefore, research interests are to elucidate additional roles and effects of PCSK9 modulation on inflammation and cellular processes of the atherosclerotic plaque and to develop alternative therapeutic strategies addressing PCSK9 as a proven and therefore promising drug target.

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Summary

A key for cardiovascular risk reduction by lowering LDL cholesterol and load of atherogenic lipoproteins in serum is to increase the number of LDL receptors in the liver. This is a key mechanism of PCSK9 inhibitors. A clinical option is to use antibodies for the treatment of hypercholesterolemia preventing degradation of hepatic LDL receptors.

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Correspondence to Dirk Müller-Wieland.

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Conflict of Interest

Julia Brandts declares no conflict of interest. Dirk Müller-Wieland has received speaker’s bureau and consultant/advisory board fees from Amgen, AstraZeneca, Boehringer Ingelheim, MSD (Merck), Novartis, Novo Nordisk, and Sanofi.

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Brandts, J., Müller-Wieland, D. PCSK9 Inhibition: New Treatment Options and Perspectives to Lower Atherogenic Lipoprotein Particles and Cardiovascular Risk. Curr Atheroscler Rep 21, 40 (2019). https://doi.org/10.1007/s11883-019-0802-x

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