PCSK9 inhibitors – new possibilities in the treatment of hypercholesterolemia: For which patients will be indicated?
Czech atherosclerosis society statement

Česká verzia

Authors: Vladimír Soška ^1,2,3; Michal Vrablík ⁴; Vladimír Bláha ⁵; Renata Cífková ⁶; Richard Češka ⁴; Tomáš Freiberger ⁷; Pavel Kraml ⁸; Jan Piťha ⁹; Hana Rosolová ¹⁰; Tomáš Štulc ⁴; Helena Vaverková ¹¹; Zuzana Urbanová ¹²
Authors place of work: Oddělení klinické biochemie, ICRC – oddělení kardiovaskulárních chorob FN u sv. Anny v Brně ¹; II. interní klinika LF MU a FN U sv. Anny v Brně ²; Katedra laboratorních metod LF MU, Brno ³; Centrum preventivní kardiologie III. interní klinika 1. LF UK a VFN v Praze ⁴; III. interní gerontometabolická klinika LF UK a FN Hradec Králové ⁵; Centrum kardiovaskulární prevence 1. LF UK a Thomayerovy nemocnice, Praha ⁶; Centrum kardiovaskulární a transplantační chirurgie Brno ⁷; II. interní klinika 3. LF UK a FN Královské Vinohrady, Praha ⁸; Centrum experimentální medicíny IKEM, Praha ⁹; II. interní klinika LF UK a FN Plzeň ¹⁰; III. interní klinika – nefrologická, revmatologická a endokrinologická LF UP a FN Olomouc ¹¹; Klinika dětského a dorostového lékařství 1. LF UK a VFN v Praze ¹²
Published in the journal: Vnitř Lék 2016; 62(4): 329-333
Category: Guidelines

Summary

First line drug for the treatment of hypercholesterolemia are statins, which reduce LDL-cholesterol up to 50 %; such reduction is sufficient for most patients to achieve the target values. The exceptions are patients with familial hypercholesterolemia and patients with statin intolerance. To achieve target LDL-cholesterol in these two groups of patients will be possible with new drugs – PCSK9 inhibitors, which decrease LDL-cholesterol by an additional 50–60 %. The first two PCSK9 inhibitors (alirocumab and evolocumab) already had been approved for clinical use by European regulatory authorities. The primary indication for combination statin with PCSK9 inhibitor should be undoubtedly patients with a confirmed diagnosis of familial hypercholesterolemia, who are treated in the Czech Republic primarily in specialized centers of MedPed project. Furthermore, this treatment should be available for other patients at very high risk of cardiovascular diseases, who cannot achieve target LDL-cholesterol (eg. for statins intolerance).

Key words:
familial hypercholesterolemia – LDL-cholesterol – PCSK9 inhibitors – statins

Zdroje

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