Medicine Optimisation Using PCSK9 Monoclonal Antibodies (alirocumab and evolocumab) Concerning the European Atherosclerosis Society (EAS) of < 1.8 mmol/l LDL Cholesterol Target in a Secondary Care Lipid Clinic
DOI:
https://doi.org/10.14738/bjhmr.106.15955Keywords:
LDL-cholesterol, PCSK9 Inhibitors, Alirocumab, Evolocumab, Secondary care lipid clinic, Monoclonal antibodiesAbstract
Proprotein convertase subtilisin kexin type 9 (PCSK9) is an essential regulator of cholesterol metabolism. It was introduced as a monoclonal antibody to regulate LDL-R by recycling more LDLR onto the cell's surface. The clinically available PCSK9 monoclonal antibodies are alirocumab and evolocumab. This audit-based assessment aims to evaluate the impact of PCSK9 inhibitors on patient outcomes in achieving the European Atherosclerosis Society (EAS) recommended target for low-density lipoprotein cholesterol (LDL-C) levels (<1.8mmol/l) within a secondary care lipid clinic.
References
Sabatine, M. S. (2018) ‘PCSK9 inhibitors: clinical evidence and implementation.’ Nature Reviews Cardiology, 16(3) pp. 155–165.
Ji, E. and Lee, S. (2021) ‘Antibody-Based Therapeutics for Atherosclerosis and Cardiovascular Diseases.’ International Journal of Molecular Sciences, 22(11) p. 5770.
Suresh, A., Theodoraki, A., Ward, E. and Feher, M. (2022) ‘PCSK9 inhibitors and treatment targets: an auditbased evaluation of a specialist lipid clinic.’ British Journal of Diabetes, 22(1) pp. 30–35.
Stoekenbroek, R. M., Hartgers, M. L., Rutte, R., de Wijer, D. D., Stroes, E. S. G. and Hovingh, G. K. (2018) ‘PCSK9 inhibitors in clinical practice: Delivering on the promise?’ Atherosclerosis, 270, March, pp. 205–210.
Schwartz, G. G., Steg, P. G., Szarek, M., Bhatt, D. L., Bittner, V. A., Diaz, R., Edelberg, J. M., Goodman, S. G., Hanotin, C., Harrington, R. A., Jukema, J. W., Lecorps, G., Mahaffey, K. W., Moryusef, A., Pordy, R., Quintero, K., Roe, M. T., Sasiela, W. J., Tamby, J.-F. and Tricoci, P. (2018) ‘Alirocumab and Cardiovascular Outcomes after Acute Coronary Syndrome.’ New England Journal of Medicine, 379(22) pp. 2097–2107.
Sabatine, M. S., Giugliano, R. P., Keech, A. C., Honarpour, N., Wiviott, S. D., Murphy, S. A., Kuder, J. F., Wang, H., Liu, T., Wasserman, S. M., Sever, P. S. and Pedersen, T. R. (2017) ‘Evolocumab and Clinical Outcomes in Patients with Cardiovascular Disease.’ New England Journal of Medicine, 376(18) pp. 1713–1722.
Mach, F., Baigent, C., Catapano, A. L., Koskinas, K. C., Casula, M., Badimon, L., Chapman, M. J., De Backer, G. G., Delgado, V., Ference, B. A., Graham, I. M., Halliday, A., Landmesser, U., Mihaylova, B., Pedersen, T. R., Riccardi, G., Richter, D. J., Sabatine, M. S., Taskinen, M.-R. and Tokgozoglu, L. (2019) ‘2019 ESC/EAS Guidelines for the Management of dyslipidaemias: Lipid Modification to Reduce Cardiovascular Risk.’ European Heart Journal, 41(1).
NICE (2016) Overview | Alirocumab for treating primary hypercholesterolaemia and mixed dyslipidaemia | Guidance | NICE. www.nice.org.uk. [Online] [Accessed on 18th October 2023] https://www.nice.org.uk/guidance/ta393.
Ferri, N., Tibolla, G., Pirillo, A., Cipollone, F., Mezzetti, A., Pacia, S., Corsini, A. and Catapano, A. L. (2012) ‘Proprotein convertase subtilisin kexin type 9 (PCSK9) secreted by cultured smooth muscle cells reduces macrophages LDLR levels.’ Atherosclerosis, 220(2) pp. 381–386.
Robinson, J. G., Farnier, M., Krempf, M., Bergeron, J., Luc, G., Averna, M., Stroes, E. S., Langslet, G., Raal, F. J., El Shahawy, M., Koren, M. J., Lepor, N. E., Lorenzato, C., Pordy, R., Chaudhari, U. and Kastelein, J. J. P. (2015) ‘Efficacy and Safety of Alirocumab in Reducing Lipids and Cardiovascular Events.’ New England Journal of Medicine, 372(16) pp. 1489–1499.
Cicero, A. F., Tartagni, E. and Ertek, S. (2014) ‘Safety and tolerability of injectable lipid-lowering drugs: a review of available clinical data.’ Expert Opinion on Drug Safety, 13(8) pp. 1023–1030.
Bashir, B., Haslam, S., Ahmad, S., Elnaggar, M. N., Allcock, R., Ali, S., Kyi, N. M., Salazar, L., Gbegbaje, A. and Banerjee, M. (2022) ‘Protein Convertase Subtilisin/Kexin Type 9 Monoclonal Antibodies (PCSK9mab) in Clinical Practice at Secondary Care – Real World Multicentre Experience.’ Cureus. Cureus, Inc., December.
Kohli, M., Patel, K., MacMahon, Z., Ramachandran, R., Crook, M., Reynolds, T. M. and Wierzbicki, A. S. (2017) ‘Pro-protein subtilisin kexin-9 (PCSK9) inhibition in practice: lipid clinic experience in 2 contrasting UK centres.’ International Journal of Clinical Practice. Wiley-Blackwell, 71(11) pp. e13032–e13032.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 J Bolodeoku, T Gbaa, K Morris, S Whitehead
This work is licensed under a Creative Commons Attribution 4.0 International License.
