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PCSK9 inhibitors in the prevention of cardiovascular disease

Lookup NU author(s): Dr Jonathan Batty, Dr R Neely, Dr Vijay Kunadian

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This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


Abstract

Reducing plasma levels of low-density lipoprotein cholesterol (LDL-C) remains the cornerstone in the primary and secondary prevention of cardiovascular disease. However, lack of efficacy and adverse effects mean that a substantial proportion of patients fail to achieve acceptable LDL-C levels with currently available lipid-lowering drugs. Over the last decade, inhibition of proprotein convertase subtilisin/kexin type 9 (PCSK9) has emerged as a promising therapeutic strategy to reduce residual cardiovascular disease risk. Binding of PCSK9 to the LDL receptor targets the receptor for lysosomal degradation. The recognition that inhibition of PCSK9 increases LDL receptor activity has led to the development of a number of approaches to directly target PCSK9. Numerous monoclonal antibodies against PCSK9 are currently being evaluated in phase 3 trials, involving various patient categories on different background lipid-lowering therapies. Current evidence shows reductions in LDL-C levels of up to 70 % may be achieved with PCSK9 inhibition, independent of background statin therapy. This review examines the most recent evidence and future prospects for the use of PCSK9 inhibitors in the prevention of cardiovascular disease.


Publication metadata

Author(s): Latimer J, Batty JA, Neely RD, Kunadian V

Publication type: Review

Publication status: Published

Journal: Journal of Thrombosis and Thrombolysis

Year: 2016

Volume: 42

Issue: 3

Pages: 405-419

Print publication date: 01/10/2016

Online publication date: 19/04/2016

Acceptance date: 19/04/2016

ISSN (print): 0929-5305

ISSN (electronic): 1573-742X

URL: http://dx.doi.org/10.1007/s11239-016-1364-1

DOI: 10.1007/s11239-016-1364-1


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