Department of Internal Medicine/Cardiology, Campus Benjamin Franklin, Charité- Universitätsmedizin Berlin, Berlin, Germany.
Institute for Pharmacology and Preventive Medicine, Cloppenburg, Germany.
Expert Opin Biol Ther. 2020 Jan;20(1):35-47. doi: 10.1080/14712598.2020.1677604. Epub 2019 Oct 18.
: Dyslipidemia, particularly elevated low-density lipoprotein cholesterol (LDL-C), is a key risk factor for atherosclerotic cardiovascular disease (ASCVD), and lipid-lowering drugs are beneficial for the primary and secondary prevention of cardiovascular (CV) disease. While statins are clear first-line drugs, new drug developments such as proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors have been shown to improve cardiovascular outcomes when added to statins. Evolocumab reduced the risk of cardiovascular events in patients with ASCVD when added to maximally tolerated statin therapy (± ezetimibe), and recent data from the ODYSSEY OUTCOMES trial indicate that alirocumab added to maximally tolerated statin therapy (± other lipid-lowering drugs) reduces the risk of cardiovascular events in patients with a recent acute coronary syndrome. In this article the authors review the available data on the effect of PCSK9 inhibitors on cardiovascular outcomes.: This article reviews the available data on the effect of PCSK9 inhibitors on CV outcomes. Relevant papers were identified from a search of PubMed/Medline and the Cochrane Central Register of Controlled Trials (CENTRAL).: The authors conclude that PCSK9 inhibitors provide substantial and durable reductions in LDL-C levels and improve cardiovascular outcomes.
血脂异常，尤其是低密度脂蛋白胆固醇（LDL-C）升高，是动脉粥样硬化性心血管疾病（ASCVD）的一个关键危险因素，降脂药物有益于心血管疾病（CV）的一级和二级预防。他汀类药物是明确的一线药物，但新型药物如前蛋白转化酶枯草溶菌素 9（PCSK9）抑制剂，与他汀类药物联合应用可改善心血管结局。依洛尤单抗与最大耐受剂量的他汀类药物（±依折麦布）联合应用，可降低 ASCVD 患者的心血管事件风险，最近 ODYSSEY OUTCOMES 试验的数据表明，阿利罗单抗与最大耐受剂量的他汀类药物（±其他降脂药物）联合应用，可降低近期急性冠状动脉综合征患者的心血管事件风险。本文作者回顾了 PCSK9 抑制剂对心血管结局影响的现有数据。
