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PCSK9 抑制剂:降低致动脉粥样硬化脂蛋白颗粒和心血管风险的新治疗选择和观点。

PCSK9 Inhibition: New Treatment Options and Perspectives to Lower Atherogenic Lipoprotein Particles and Cardiovascular Risk.

机构信息

Department of Medicine I, University Hospital RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Germany.

出版信息

Curr Atheroscler Rep. 2019 Jul 27;21(10):40. doi: 10.1007/s11883-019-0802-x.

Abstract

PURPOSE OF REVIEW

To summarize latest clinical studies and to put them into perspectives for clinical relevant subgroups and new therapeutic options.

RECENT FINDINGS

Have investigated PCSK9 inhibitors in patients with very high cardiovascular risk and insufficient LDL cholesterol lowering under current maximal tolerated lipid-lowering therapy, patients with statin intolerance, or genetic forms of familiar hypercholesterolemia, and patients on LDL apheresis. Purpose of recent cardiovascular endpoint trials has proven cardiovascular benefit of this new approach. PCSK9 inhibition with fully humanized antibodies has proven to be effective, safe, and well-tolerated in reducing cardiovascular risk by LDL cholesterol lowering. Therefore, research interests are to elucidate additional roles and effects of PCSK9 modulation on inflammation and cellular processes of the atherosclerotic plaque and to develop alternative therapeutic strategies addressing PCSK9 as a proven and therefore promising drug target.

摘要

目的综述

总结最新的临床研究,并从临床相关亚组和新的治疗选择的角度对其进行分析。

最新发现

研究人员已经在以下患者中调查了 PCSK9 抑制剂的应用:极高心血管风险且当前最大耐受降脂治疗未能充分降低 LDL 胆固醇患者、他汀类药物不耐受患者或家族性高胆固醇血症的遗传形式患者,以及接受 LDL 吸附治疗的患者。最近心血管终点试验的目的证明了这种新方法的心血管获益。完全人源化抗体的 PCSK9 抑制被证明可通过降低 LDL 胆固醇有效、安全且耐受良好地降低心血管风险。因此,研究兴趣在于阐明 PCSK9 调节对动脉粥样硬化斑块炎症和细胞过程的其他作用和影响,并开发针对 PCSK9 的替代治疗策略,因为 PCSK9 是一个已被证实的、有前途的药物靶点。

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