PCSK9 Monoclonal Antibodies Have Come a Long Way

Curr Atheroscler Rep. 2024 Dec;26(12):721-732. doi: 10.1007/s11883-024-01243-1. Epub 2024 Oct 10.

Abstract

Purpose of the review: This review examines the pivotal role of monoclonal antibodies against PCSK9 in lipid-lowering therapy, emphasizing their biological and clinical impact.

Recent findings: Randomized controlled trials have validated that PCSK9 monoclonal antibodies (Mabs) effectively reduce LDL-c levels by approximately 50%, even when added to maximal statin therapy. They moreover produce a notable 15-20% relative decrease in major cardiovascular events, with a greater reduction among high-risk patients and no evidence for serious adverse effects, assuaging previous concerns. This review highlights the benefits of PCSK9 Mabs in high cardiovascular risk patients. Despite their efficacy and safety, these therapies are hindered by limited access, and require broader integration into clinical practice to optimize therapeutic outcomes.

Keywords: Alirocumab; Bococizumab; Evolocumab; Inclisiran; LDL cholesterol; PCSK9.

Publication types

  • Review

MeSH terms

  • Antibodies, Monoclonal* / therapeutic use
  • Anticholesteremic Agents / therapeutic use
  • Cardiovascular Diseases / drug therapy
  • Cholesterol, LDL / blood
  • Humans
  • PCSK9 Inhibitors*
  • Proprotein Convertase 9* / immunology

Substances

  • PCSK9 protein, human
  • Antibodies, Monoclonal
  • Proprotein Convertase 9
  • PCSK9 Inhibitors
  • Cholesterol, LDL
  • Anticholesteremic Agents