Update on the use of PCSK9 inhibitors in adults: Recommendations from an Expert Panel of the National Lipid Association

J Clin Lipidol. 2017 Jul-Aug;11(4):880-890. doi: 10.1016/j.jacl.2017.05.001. Epub 2017 May 19.

Abstract

An Expert Panel convened by the National Lipid Association was charged with updating the recommendations on the use of proprotein convertase subtilisin/kexin type 9 (PCSK9) antibody therapy that were provided by the 2015 National Lipid Association Recommendations for the Patient-Centered Management of Dyslipidemia: Part 2. Recent studies have demonstrated the efficacy of these agents in reducing low-density lipoprotein cholesterol and non-high-density lipoprotein cholesterol and have confirmed their excellent safety profile. A cardiovascular outcomes study has shown that these agents reduce incident atherosclerotic cardiovascular disease (ASCVD) events in patents with stable ASCVD and concomitant risk factors. The current update provides the Expert Panel's evidence-based recommendations on the clinical utility of PCSK9 inhibitors in patients with stable ASCVD, progressive ASCVD, LDL-C ≥ 190 mg/dL (including polygenic hypercholesterolemia, heterozygous familial hypercholesterolemia and the homozygous familial hypercholesterolemia phenotype) and very-high-risk patients with statin intolerance.

Keywords: Alirocumab; Dyslipidemia; Evolocumab; Familial hypercholesterolemia; Hypercholesterolemia; Lipid treatment guidelines; PCSK9 inhibitors; Statin intolerance.

MeSH terms

  • Adult
  • Atherosclerosis / blood
  • Atherosclerosis / drug therapy
  • Clinical Trials as Topic
  • Evidence-Based Medicine
  • Expert Testimony*
  • Homozygote
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / adverse effects
  • Hypercholesterolemia / blood
  • Hypercholesterolemia / drug therapy
  • Hypercholesterolemia / genetics
  • PCSK9 Inhibitors*
  • Phenotype
  • Protease Inhibitors / pharmacology*
  • Protease Inhibitors / therapeutic use
  • Risk
  • Societies, Medical*

Substances

  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • PCSK9 Inhibitors
  • Protease Inhibitors