Evolocumab, proproteine convertase subtilisin/kexin type 9 inhibitor for intensive treatment of dyslipidemia
Abstract
There is a major remaining potential to improve the quality of primary and secondary cardiovascular prevention including achievement of the recommended lipid levels. New lipid modifying drugs PCSK9 (proprotein convertase subtilisin/kexin type 9) inhibitors seem to be a great chance for that improvement.
Evolocumab represents one of PCSK9 inhibitors; it is a human monoclonal antibody that inhibits the interaction between the enzyme PCSK9 and LDL receptors and that is why number of LDL receptors enhances on the hepatocytes surface and plasma LDL-C concentration significantly decreases (in average about 60%). Agent Repatha is administered subcutaneously in dose 140 mg twice a month or 420 mg once a month.
It is applicable in patients with severe hypercholesterolemia and/or in mixed dyslipidemia, in which current lipid modifying therapy is not successful. Repatha may be added to the usual lipid modifying drugs or may be used as monotherapy in statin intolerant patients.
On the background of all clinical studies including PROFICIO Project and OSLER Program is known, that evolocumab side effects are comparable with placebo and the evolocumab therapy seems to be safe and well tolerated. Results of the long term ongoing studies are on the way and let's hope that the expected evolocumab cardioprotectivity will be assessed.
Also new unexpected side effects as impacts of longterm Evolocumab therapy or very low plasma LDL-C level achievement may occure.