Abstract
The use targeted therapy with monoclonal antibodies is not yet the standard care in cardiology. However, this approach seems feasible for a number of reasons (e.g. high therapeutic efficacy, lower potential for drug-drug interactins, the possibility of alternate dosing).
The identification of a novel protein (proprotein convertase subtilisin/kexin 9 - PCSK9) grossly impacting on serum LDL-cholesterol levels led to the preparation of specific monoclonal antibodies blocking its function. This interaction results in a dramatic decrease of LDL-cholesterol (and other atherogenic lipoproteins) in the serum by 50-70% above the level achievable by currently available therapies.
The safety and efficacy of PCSK9 inhibitors is being tested in a large research program of several manufactures. This new therapeutic option may offer hope for difficult-to-treat patients with familial hypercholesterolemia or statin intolerance, anjd, in the future, possibly also for patients at high cardiovascular risk not achieving LDL-cholesterol targets with currently avaible therapies.