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Statins and PCSK9 inhibitors: A new lipid-lowering therapy
Abstract
The clinical benefit of lipid-lowering therapies is to reduce circulating levels of atherogenic particles and to ameliorate the risk of atherosclerotic cardiovascular disease (ASCVD). The completion of two major clinical trials on PCSK9 inhibitors (PCSK9i), the FOURIER and the ODYSSEY outcome trials, has marked the beginning of a new era of lipid-lowering drugs. PCSK9i, evolocumab and alirocumab, are monoclonal antibodies that inactivate the liver proprotein convertase subtilisin kexin 9 (PCSK9). Inhibition of PCSK9 increases the number of low-density lipoprotein (LDL) receptors available leading to a profound reduction in circulating LDL particles. By preventing LDL receptor destruction, PCSK9i as adjunct to statin therapy can reduce LDL-C by 50-60% above that achieved by statin therapy alone. In addition, PCSK9i in combination with high-dose statins may reduce cardiovascular events and all-cause mortality in patients with clinical ASCVD. Based on evidence from clinical trials, the 2019 European Society of Cardiology (ESC)/European Atherosclerosis Society (EAS) guidelines for the management of dyslipidemias now include the use of PCSK9i to very high-risk ASCVD patients who are not achieving treatment goals on a maximum tolerated dose of a statin and ezetimibe. However, the cost-effectiveness of PCSK9i therapy is limited to secondary prevention in high-risk patients. This review outlines the main clinical trials leading to a change in the guidelines, clinical practice as well…
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Lowering circulating LDL cholesterol with statins has shown inconsistent results in improving MASH outcomes despite their potent effect in reducing the risk of ASCVD.
“However, lowering circulating LDL cholesterol with statins has shown inconsistent results in improving MASH outcomes despite their potent effect in reducing the risk of ASCVD.90”
From EHBP1 suppresses liver fibrosis in metabolic dysfunction-associated steatohepatitis (2025) · cites this paper as [90]
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Metadata
- Authors
- Gallego-Colon, E., Daum, A., & Yosefy, C.
- Venue
- European Journal of Pharmacology
- Publisher
- Elsevier BV
- Published
- 2020-07
- Volume
- 878
- Pages
- 173114
- ISSN
- 0014-2999
- Cited by
- 156
- References
- 19
- Language
- en
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