Journal of Stroke & Cerebrovascular Diseases ( IF 2.0 ) Pub Date : 2021-08-24 , DOI: 10.1016/j.jstrokecerebrovasdis.2021.106057 Bayan Moustafa 1 , Fernando D Testai 1
Proprotein convertase subtilisin/kexin type 9 (PCSK9) interacts with the low-density lipoprotein (LDL) receptor and, by enhancing its degradation, has a pivotal role in the regulation of cholesterol homeostasis. Two fully humanized monoclonal antibodies targeting PCSK9, evolocumab and alirocumab, are available for clinical use. PCSK9 inhibitors reduce LDL-C 30% more than ezetimibe and 60% more than placebo when added to statins. This reduction in LDL-C is accompanied by a decrease in the risk of major cardiovascular and cerebrovascular events. However, questions have been raised in relation to the cost-effectiveness of these medications. In this article, we review the clinical evidence on the use of PCSK9 inhibitors in lowering LDL-C and their effect on cerebrovascular health.
中文翻译:
PCSK9 抑制剂在卒中预防中的功效和安全性
前蛋白转化酶枯草杆菌蛋白酶/kexin 9 型 (PCSK9) 与低密度脂蛋白 (LDL) 受体相互作用,通过增强其降解,在调节胆固醇稳态中起关键作用。两种靶向 PCSK9 的完全人源化单克隆抗体 evolocumab 和 alirocumab 可用于临床。与他汀类药物联合使用时,PCSK9 抑制剂比依折麦布降低 30% 以上的 LDL-C,比安慰剂多 60%。LDL-C 的降低伴随着主要心血管和脑血管事件风险的降低。然而,人们对这些药物的成本效益提出了质疑。在本文中,我们回顾了使用 PCSK9 抑制剂降低 LDL-C 的临床证据及其对脑血管健康的影响。