NS Christeas Laboratory of Experimental Surgery and Surgical Research, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
Second Department of Propedeutic Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
In Vivo. 2021 Jan-Feb;35(1):61-68. doi: 10.21873/invivo.12232.
Statin intolerance refers to the inability of a patient to tolerate statin therapy, presenting muscle aches, pains, weakness and muscle inflammation. Thus, numerous patients are not treated with suitable statin-based therapy or take only very low doses. As a result, the desired decrease in low-density lipoprotein cholesterol (LDL-C) is not achieved, resulting in patients at a high risk for cardiovascular events, requiring an alternative lipid-lowering treatment. Common treatments manage to reduce the LDL-C level by up to 20%. Recently, new alternative treatment options have been proved to lower the LDL-C level by up to 70%. These treatment strategies are based on human monoclonal antibodies against protein convertase subtilisin/kexin 9 (PCSK9).
Herein, we review the efficiency of anti-PCSK9 in treatment of hypercholesterolemic patients with statin intolerance. We focused on the use of PCSK9 inhibitors in statin-intolerant patients and we estimated the clinical results concerning the reduction of the mean LDL-C concentration and the side effects that were observed.
In the majority of cases, treatment strategy based on PCSK9 was successful and achieved the end-points.
PCSK9 inhibition can be considered as a treatment of option for lipid-lowering in statin-intolerant patients.
他汀类药物不耐受是指患者不能耐受他汀类药物治疗,表现为肌肉疼痛、疼痛、无力和肌肉炎症。因此,许多患者没有接受合适的他汀类药物治疗,或者只服用非常低的剂量。结果,未能达到理想的降低低密度脂蛋白胆固醇(LDL-C)的目标,导致心血管事件风险高的患者需要替代降脂治疗。常见的治疗方法可将 LDL-C 水平降低多达 20%。最近,新的替代治疗方案已被证明可将 LDL-C 水平降低多达 70%。这些治疗策略基于针对蛋白转化酶枯草溶菌素/激肽释放酶 9(PCSK9)的人单克隆抗体。
本文综述了抗 PCSK9 在治疗他汀类药物不耐受的高胆固醇血症患者中的疗效。我们重点介绍了 PCSK9 抑制剂在他汀类药物不耐受患者中的应用,并评估了与 LDL-C 浓度平均降低和观察到的副作用相关的临床结果。
在大多数情况下,基于 PCSK9 的治疗策略是成功的,并达到了终点。
PCSK9 抑制可被视为他汀类药物不耐受患者降脂治疗的选择之一。