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.

中文翻译：

---

他汀类药物不耐受患者的基于 PCSK9 抗体的治疗策略

背景：他汀类药物不耐受是指患者无法耐受他汀类药物治疗，表现为肌肉酸痛、疼痛、虚弱和肌肉炎症。因此，许多患者没有接受合适的基于他汀类药物的治疗或仅服用非常低的剂量。因此，低密度脂蛋白胆固醇 (LDL-C) 没有达到预期的降低，导致患者发生心血管事件的风险很高，需要替代的降脂治疗。常见的治疗方法可将 LDL-C 水平降低多达 20%。最近，新的替代治疗方案已被证明可将 LDL-C 水平降低多达 70%。这些治疗策略基于针对蛋白质转化酶枯草杆菌蛋白酶/kexin 9 (PCSK9) 的人单克隆抗体。材料和方法：在此，我们回顾了抗 PCSK9 在治疗患有他汀类药物不耐受的高胆固醇血症患者中的有效性。我们专注于 PCSK9 抑制剂在他汀类药物不耐受患者中的使用，并评估了有关降低平均 LDL-C 浓度和观察到的副作用的临床结果。结果：在大多数情况下，基于PCSK9的治疗策略成功并达到了终点。结论：PCSK9抑制可作为他汀不耐受患者降脂的一种治疗选择。基于PCSK9的治疗策略成功并达到了终点。结论：PCSK9抑制可作为他汀不耐受患者降脂的一种治疗选择。基于PCSK9的治疗策略成功并达到了终点。结论：PCSK9抑制可作为他汀不耐受患者降脂的一种治疗选择。