Journal article
Nonstatins and Proprotein Convertase Subtilisin/Kexin Type 9 (PCSK9) Inhibitors: Role in Non‐Familial Hypercholesterolemia
Progress in cardiovascular diseases, Vol.59(2), pp.165-171
09/2016
DOI: 10.1016/j.pcad.2016.07.011
PMID: 27498088
Abstract
After maximizing statin and lifestyle adherence, some patients may benefit from additional low-density lipoprotein cholesterol (LDL-C) lowering. The potential for net benefit from added therapy can inform nonstatin decision-making. Considering patient risk and the LDL-C level on statin, the additional potential cardiovascular disease (CVD) risk reduction benefit from further lowering LDL-C depends on the magnitude of LDL-C lowering from the nonstatin. Ezetimibe is the only nonstatin shown to reduce atherosclerotic CVD events added to a statin, albeit modestly, since it modestly reduces LDL-C by about 20%. Proprotein Convertase Subtilisin-Like/Kexin Type 9 mononclonal antibodies lower LDL-Cby 45–65%, but definitive CVD outcomes and safety trials are pending. Niacin and fenofibrate do not clearly reduce CVD events in statin-treated patients, and may increase adverse events. Bile acid sequestrants have not been evaluated in CVD outcome trials in statin-treated patients, and have an excess of adverse effects. Cost also plays a role in access to nonstatin therapy. These considerations may inform shared decision-making.
Details
- Title: Subtitle
- Nonstatins and Proprotein Convertase Subtilisin/Kexin Type 9 (PCSK9) Inhibitors: Role in Non‐Familial Hypercholesterolemia
- Creators
- Jennifer G Robinson - Departments of Epidemiology & Medicine, Colleges of Public Health & Medicine, University of Iowa, Iowa City, Iowa
- Resource Type
- Journal article
- Publication Details
- Progress in cardiovascular diseases, Vol.59(2), pp.165-171
- Publisher
- Elsevier Inc
- DOI
- 10.1016/j.pcad.2016.07.011
- PMID
- 27498088
- ISSN
- 0033-0620
- eISSN
- 1532-8643
- Language
- English
- Date published
- 09/2016
- Academic Unit
- Epidemiology; Internal Medicine
- Record Identifier
- 9983995173102771
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