Errika Voutyritsa1, Christos Damaskos2, Paraskevi Farmaki3, Georgios Kyriakos4, Evangelos Diamantis5, Lourdes Victoria Quiles-SÁnchez6, Anna Garmpi7, Nikolaos Garmpis2, Alexandros Patsouras8, Athanasia Stelianidi3, Spyridon Savvanis9. 1. NS Christeas Laboratory of Experimental Surgery and Surgical Research, Medical School, National and Kapodistrian University of Athens, Athens, Greece. 2. Second Department of Propedeutic Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece. 3. First Department of Pediatrics, Agia Sofia Children's Hospital, National and Kapodistrian University of Athens, Athens, Greece. 4. Sección de Endocrinología y Nutrición, Hospital General Universitario Santa Lucia, Cartagena, Spain; giorgos6@yahoo.com. 5. Department of Endocrinology and Diabetes Center, G. Gennimatas General Hospital, Athens, Greece. 6. Centro de Salud Beniel, Murcia, Spain. 7. Internal Medicine Department, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece. 8. Second Department of Internal Medicine, Tzaneio General Hospital of Piraeus, Piraeus, Greece. 9. Department of Internal Medicine, Elpis General Hospital of Athens, Athens, Greece.
Abstract
BACKGROUND: Statin intolerance refers to the inability of a patient to tolerate statin therapy, presenting muscle aches, pains, weakness and muscle inflammation. Thus, numerous patients are not treated with suitable statin-based therapy or take only very low doses. As a result, the desired decrease in low-density lipoprotein cholesterol (LDL-C) is not achieved, resulting in patients at a high risk for cardiovascular events, requiring an alternative lipid-lowering treatment. Common treatments manage to reduce the LDL-C level by up to 20%. Recently, new alternative treatment options have been proved to lower the LDL-C level by up to 70%. These treatment strategies are based on human monoclonal antibodies against protein convertase subtilisin/kexin 9 (PCSK9). MATERIALS AND METHODS: Herein, we review the efficiency of anti-PCSK9 in treatment of hypercholesterolemic patients with statin intolerance. We focused on the use of PCSK9 inhibitors in statin-intolerant patients and we estimated the clinical results concerning the reduction of the mean LDL-C concentration and the side effects that were observed. RESULTS: In the majority of cases, treatment strategy based on PCSK9 was successful and achieved the end-points. CONCLUSION: PCSK9 inhibition can be considered as a treatment of option for lipid-lowering in statin-intolerant patients. Copyright
BACKGROUND: Statin intolerance refers to the inability of a patient to tolerate statin therapy, presenting muscle aches, pains, weakness and muscle inflammation. Thus, numerous patients are not treated with suitable statin-based therapy or take only very low doses. As a result, the desired decrease in low-density lipoprotein cholesterol (LDL-C) is not achieved, resulting in patients at a high risk for cardiovascular events, requiring an alternative lipid-lowering treatment. Common treatments manage to reduce the LDL-C level by up to 20%. Recently, new alternative treatment options have been proved to lower the LDL-C level by up to 70%. These treatment strategies are based on human monoclonal antibodies against protein convertase subtilisin/kexin 9 (PCSK9). MATERIALS AND METHODS: Herein, we review the efficiency of anti-PCSK9 in treatment of hypercholesterolemicpatients with statin intolerance. We focused on the use of PCSK9 inhibitors in statin-intolerant patients and we estimated the clinical results concerning the reduction of the mean LDL-C concentration and the side effects that were observed. RESULTS: In the majority of cases, treatment strategy based on PCSK9 was successful and achieved the end-points. CONCLUSION:PCSK9 inhibition can be considered as a treatment of option for lipid-lowering in statin-intolerant patients. Copyright
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