Universität zu Köln

Schreml, Julia and Gouni-Berthold, Ioanna (2018). Role of Anti-PCSK9 Antibodies in the Treatment of Patients with Statin Intolerance. Curr. Med. Chem., 25 (13). S. 1538 - 1549. SHARJAH: BENTHAM SCIENCE PUBL LTD. ISSN 1875-533X

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Abstract

Statin intolerance is usually defined as the inability of a patient to tolerate statin-treatment due to muscle-related complaints. While randomised trials show that these complaints occure with similar frequency in patients receiving placebo, namely in up to similar to 5% of the subjects, and data from registries as well as clinical experience indicate a much higher frequency of up to similar to 30%. The lack of standard definition or of a diagnostic marker of statin intolerance confounds the problem. The diagnosis remains subjective based on the symptoms the patient reports. Therefore, a large number of patients who need a statin are not receiving it, or receiving only very-low and/or intermittent doses unable to achieve a robust decrease in low-density lipoprotein cholesterol (LDL-C), leaving patients at high or very high risk for cardiovascular events requiring an alternative form of lipid-lowering therapy. Until recently, the only available alternatives were niacin, ezetimibe, bile-acid sequestrants and fibrates that decrease LDL-C concentrations by up to 15-20%. Recently the fully human monoclonal antibodies against proprotein convertase subtilisin/kexin 9 (PCSK9), alirocumab (Praluent (R)) and evolocumab (Repatha (R)), which have been shown to decrease LDL-C by up to 70% have been approved in Europe for use in patients with primary hypercholesterolemia not at LDL-C target while on maximally tolerated lipid-lowering therapy and specifically for patients with statin intolerance and in the USA for patients with atherosclerotic cardiovascular disease or familial hypercholesterolemia requiring additional LDL-C lowering. Ongoing large clinical trials with cardiovascular endpoints will provide a definitive answer for the role of anti-PCSK9 antibodies in clinical practice.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Schreml, Julia UNSPECIFIED UNSPECIFIED UNSPECIFIED Gouni-Berthold, Ioanna UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-202791
DOI:	10.2174/0929867324666170616111647
Journal or Publication Title:	Curr. Med. Chem.
Volume:	25
Number:	13
Page Range:	S. 1538 - 1549
Date:	2018
Publisher:	BENTHAM SCIENCE PUBL LTD
Place of Publication:	SHARJAH
ISSN:	1875-533X
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language DENSITY-LIPOPROTEIN CHOLESTEROL; PRIMARY-PREVENTION TRIAL; BILE-ACID SEQUESTRANTS; CORONARY-HEART-DISEASE; ROUTINE CARE SETTINGS; DOUBLE-BLIND; CARDIOVASCULAR EVENTS; SECONDARY PREVENTION; MONOCLONAL-ANTIBODY; NETWORK METAANALYSIS Multiple languages Biochemistry & Molecular Biology; Chemistry, Medicinal; Pharmacology & Pharmacy Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/20279