The PCSK9 inhibitors alirocumab and evolocumab appear to be generally safe and well-tolerated therapies, which are able to reduce elevated LDL-C by at least 50%. This is associated with a significant reduction in cardiovascular disease events in patients with prior cardiovascular disease who are already receiving standard therapy. Cost pressures may prevent more widespread use of these drugs.
In the October 2016 issue of Medicine Today,1 an unfolding era in cholesterol control through the availability of inhibitors of the enzyme proprotein convertase subtilisin-kexin type 9 (PCSK9), namely alirocumab and evolocumab, was described. New findings from landmark studies with these products have appeared over the intervening period and it is timely to revisit this subject.