New possibilities of dyslipidemiaa therapy in patients with familial hypercholesterolemia in secondary prevention - change in reimbursement for PCSK9 inhibitors
Abstract
Cardiovascular disease (despite a decline in the number of events over the last 30 years) is still the most common cause of mortality and morbidity in developed countries. Several factors contribute to this fact.
The population is still very abundant, the number of obese and thus the number of high-risk diabetics is growing, and last but not least we do not reach the recommended target values, which in the light of recent European recommendations of dyslipidemia have shifted back to lower values (LDL cholesterol target in patients in secondary prevention is 1.4 mmol/l). The drugs of choice for the treatment of hypercholesterolemia are statins, possibly potentiated by ezetimibe.
If we do not reach the recommended target values, we have a new modern therapy with proprotein convertase subtilisin/kexin type 9 inhibitors. From February 1, 2021, preparations (alirocumab and evolocumab) have been on the market for patients on maximally tolerated statin therapy (possibly in combination with ezetimibe), in patients with familial hypercholesterolemia and LDL cholesterol levels above 3.1 mmol/l and in patients in secondary prevention with LDL cholesterol above 2.5 mmol/l.