In clinical practice, it may at times prove difficult to attain the recommended LDL cholesterol levels due to either high initial levels or low drug tolerance. The 2003 discovery of a new protein named PCSK9 (proprotein convertase subtilisin/kexine Type 9), involved in the metabolism of LDL particles, led to the development of several monoclonal antibodies that neutralize this protein (evolocumab from Amgen, alirocumab from Sanofi/REGENERON, and bocozicumab from Pfizer). When combined with statins and ezetimibe, these agents cause a highly significant reduction in LDL cholesterol levels, associated with very good safety profiles and tolerance, along with significant benefits in terms of cardiovascular prevention. Therefore, they constitute an additional therapeutic strategy to help patients reach their LDL cholesterol targets, especially those with severely elevated cholesterol levels, as observed in familial hypercholesterolemia cases.
What is already known about the topic?
Despite the prescription of conventional therapies like statins and ezetimibe, it may at times prove difficult to attain the recommended LDL cholesterol levels due to either high initial levels, as observed in familial hypercholesterolemia, or low drug tolerance.
What does this article bring up for us?
When combined with statins and ezetimibe, monoclonal antibodies directed against the PCSK9 protein cause a highly significant reduction in LDL cholesterol levels. From a clinical point of view, they offer a good safety profile and good tolerance, along with significant benefits in cardiovascular prevention.
Key words
Cardiovascular diseases, cardiovascular prevention, genetic diseases, cholesterol, statins, lipoprotein, atherosclerosis, drug intolerance, side effects.