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PCSK9 Inhibitor
Aka: PCSK9 Inhibitor, Praluent, Alirocumab, Repatha, Evolocumab
- See Also
- AntiHyperlipidemic
- Hyperlipidemia Management
- Inclisiran (Leqvio)
- Mechanism
- Monoclonal antibodies (PCSK9 Inhibitor)
- Indications
- Severe familial Hypercholesterolemia (e.g. LDL Cholesterol >190 mg/dl)
- Background
- Available in U.S. as of 2015
- Preparations
- Praluent (Alirocumab)
- Repatha (Evolocumab)
- Efficacy
- See disadvantages below
- Lower LDL Cholesterol up to 60%
- Repatha added to Statin for 2 years prevents one more CV event per 74 treated ($2,000,000 per CV event prevented)
- Alkhalil (2017) JAMA 317(16):1690-1691 +PMID: 28444271 [PubMed]
- Disadvantages
- Very expensive agents ($14,000 per year)
- Contrast with Statins which cost $250 per year
- Statin alone for 5 years prevents one more fatal CV event per 39 treated ($48,000 per fatal CV event prevented)
- New, with only short-term data
- Unknown longterm safety
- Unknown mortality reduction (contrast with proven Statin efficacy)
- References
- (2015) Presc Lett 22(9): 50-1
- Robinson (2015) N Engl J Med 372(16):1489-99 +PMID:25773378 [PubMed]
- Stroes (2014) J Am Coll Cardiol 63(23):2541-8 [PubMed]