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The New Face of Hyperlipidemia and the Role of PCSK9 Inhibitors

  • Management of Acute Coronary Syndromes (H Jneid, Section Editor)
  • Published:
Current Cardiology Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

To review the clinical rationale for use of proprotein convertase subtilisin kexin type 9 (PCSK9) inhibitors in clinical practice.

Recent Findings

Despite widespread use of statins for lipid lowering, many patients at high cardiovascular risk continue to demonstrate unsatisfactory cholesterol levels and experience clinical events. This highlights the ongoing need to develop additional strategies to achieve more effective risk reduction in a greater number of patients. Proprotein convertase subtilisin kexin type 9 (PCSK9) plays an important role in the regulation of low-density lipoprotein metabolism. Inhibitory approaches that reduce PCSK9 activity have been demonstrated to produce substantive reductions in LDL cholesterol levels, when administered as either monotherapy or in addition to statin therapy. More recently, PCSK9 monoclonal antibodies have been reported to reduce cardiovascular event rates in large scale clinical trials.

Summary

Increasing evidence suggests that PCSK9 inhibitors can produce effective lipid lowering in high risk patients. Ongoing work will identify those patients most likely to derive cost effective risk reduction with their use.

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Authors and Affiliations

  1. South Australian Health and Medical Research Institute, University of Adelaide, PO Box 11050, Adelaide, SA, 5001, Australia

    Stephen J. Nicholls

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  1. Stephen J. Nicholls
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Correspondence to Stephen J. Nicholls.

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Conflict of Interest

Stephen J. Nicholls has received research support from AstraZeneca, Amgen, Anthera, Athernova, CSL Behring, Cerenis, Eli Lilly, Esperion, Resverlogix, Novartis, InfraReDx and Sanofi-Regeneron; and is a consultant for Amgen, AstraZeneca, Boehringer-Ingelheim, CSL Behring, Eli Lilly, Esperion, Kowa, Merck, Omthera, Roche, Takeda, Pfizer, Sanofi-Regeneron and Novo Nordisk.

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Nicholls, S.J. The New Face of Hyperlipidemia and the Role of PCSK9 Inhibitors. Curr Cardiol Rep 21, 18 (2019). https://doi.org/10.1007/s11886-019-1103-2

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