Université Paris-Cité, Paris, France.
French Alliance for Cardiovascular Trials (FACT), INSERM U_1148/LVTS, AP-HP, Hôpital Bichat, Paris, France.
Curr Atheroscler Rep. 2024 Dec;26(12):721-732. doi: 10.1007/s11883-024-01243-1. Epub 2024 Oct 10.
This review examines the pivotal role of monoclonal antibodies against PCSK9 in lipid-lowering therapy, emphasizing their biological and clinical impact.
Randomized controlled trials have validated that PCSK9 monoclonal antibodies (Mabs) effectively reduce LDL-c levels by approximately 50%, even when added to maximal statin therapy. They moreover produce a notable 15-20% relative decrease in major cardiovascular events, with a greater reduction among high-risk patients and no evidence for serious adverse effects, assuaging previous concerns. This review highlights the benefits of PCSK9 Mabs in high cardiovascular risk patients. Despite their efficacy and safety, these therapies are hindered by limited access, and require broader integration into clinical practice to optimize therapeutic outcomes.
本文综述了针对 PCSK9 的单克隆抗体在降脂治疗中的关键作用,重点探讨了其生物学和临床影响。
随机对照试验证实,PCSK9 单克隆抗体(Mabs)在最大剂量他汀类药物治疗的基础上,可使 LDL-c 水平有效降低约 50%。此外,它们还使主要心血管事件的相对风险降低 15-20%,高危患者的降幅更大,且无严重不良反应的证据,缓解了之前的担忧。本文综述了 PCSK9 Mabs 在高心血管风险患者中的获益。尽管这些治疗方法有效且安全,但由于可及性有限,仍需要更广泛地纳入临床实践,以优化治疗效果。