Parra-Virto Alejandro, Torres do Rego Ana, Demelo-Rodríguez Pablo, Millán Núñez-Cortés Jesús, Álvarez-Sala Luis A
Internal Medicine, Lipids Unit, Gregorio Marañón University Hospital, Madrid, Spain.
Internal Medicine, Lipids Unit, Gregorio Marañón University Hospital, Madrid, Spain; Department of Medicine, School of Medicine, Universidad Complutense de Madrid, Madrid, Spain; Instituto de Investigaciones Sanitarias Gregorio Marañón, Madrid, Spain.
Clin Investig Arterioscler. 2018 Nov-Dec;30(6):268-270. doi: 10.1016/j.arteri.2018.06.003. Epub 2018 Oct 9.
Many patients with familial hypercholesterolaemia (FH) or in secondary prevention situations and with statin intolerance do not achieve LDL-C targets, and require treatment with PCSK9 inhibitors (iPCSK9) and ezetimibe. The case is presented on a patient with FH and total intolerance to statins. Treatment with iPCSK9 and ezetimibe failed to achieve her LDL-C target. A compound with red yeast rice derivatives containing 3mg of monacolin K was added, with good therapeutic compliance, and a very good control of LDL-C. The addition of red yeast rice derivatives containing low doses of monacolin K, together with IPCSK9 in patients with total intolerance to statins, may open a new path to obtain LDL-C targets in patients with high/very high cardiovascular risk.
许多患有家族性高胆固醇血症（FH）或处于二级预防阶段且对他汀类药物不耐受的患者无法达到低密度脂蛋白胆固醇（LDL-C）目标，需要使用前蛋白转化酶枯草溶菌素9抑制剂（iPCSK9）和依折麦布进行治疗。本文介绍了一位患有FH且对他汀类药物完全不耐受的患者。使用iPCSK9和依折麦布治疗未能达到她的LDL-C目标。添加了一种含有3毫克莫纳可林K的红曲米衍生物化合物，治疗依从性良好，且对LDL-C有很好的控制效果。在对他汀类药物完全不耐受的患者中，添加低剂量莫纳可林K的红曲米衍生物与iPCSK9一起使用，可能为心血管风险高/极高的患者实现LDL-C目标开辟一条新途径。
