Ogata Atsushi, Oho Kazuhiko, Matsumoto Noriaki, Masuoka Jun, Inoue Kohei, Koguchi Motofumi, Yoshioka Fumitaka, Abe Tatsuya
Department of Neurosurgery, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga-shi, Saga, 849-8501, Japan.
Department of Neurosurgery, Yanagawa Hospital, Yanagawa, Japan.
Acta Neurochir (Wien). 2019 Mar;161(3):597-600. doi: 10.1007/s00701-019-03825-4. Epub 2019 Feb 7.
Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors, a novel class of monoclonal antibodies, reduce low-density lipoprotein cholesterol levels and improve outcomes of myocardial infarction and stroke. However, the effects of PCSK9 inhibitors on carotid plaques remain unclear. We describe three patients treated with PCSK9 inhibitor alirocumab for progressive carotid stenosis despite lipid-lowering statin therapy. All three patients had vulnerable plaques on magnetic resonance (MR) plaque imaging. After alirocumab treatment initiation, no patients suffered stroke or adverse events, and the stabilization of the carotid plaques was observed on MR plaque imaging.
前蛋白转化酶枯草溶菌素/kexin 9型（PCSK9）抑制剂是一类新型单克隆抗体，可降低低密度脂蛋白胆固醇水平，并改善心肌梗死和中风的预后。然而，PCSK9抑制剂对颈动脉斑块的影响仍不清楚。我们描述了3例尽管接受了降脂他汀类药物治疗但仍有进行性颈动脉狭窄的患者，他们接受了PCSK9抑制剂阿利西尤单抗治疗。所有3例患者在磁共振（MR）斑块成像上均有易损斑块。在开始阿利西尤单抗治疗后，没有患者发生中风或不良事件，并且在MR斑块成像上观察到颈动脉斑块稳定。
