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Proprotein Convertase Subtilisin/Kexin Type 9 (PCSK9) and Its Inhibitors: a Review of Physiology, Biology, and Clinical Data

  • Prevention (P Natarajan, Section Editor)
  • Published:
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Opinion statement

Atherosclerotic cardiovascular disease (ASCVD) remains the number one killer in the western world. Low-density lipoprotein cholesterol (LDL-C) reduction with statins and ezetimibe has been shown to reduce the risk of cardiovascular events. Now, proprotein convertase subtilisin/kexin type 9 (PCSK9) monoclonal antibodies (mabs) are available for high-risk individuals with ASCVD or familial hypercholesterolemia on maximally tolerated statin therapy but requiring greater LDL-C reduction. PCSK9 mab outcome trial results from the Further Cardiovascular Outcomes Research with PCSK9 Inhibitions in Subjects with Elevated Risk (FOURIER) study, which was presented at the American College of Cardiology in March 2017, which demonstrated a decrease of 15% in primary and 20% secondary end points over a 2-year period [1••]. These results firmly demonstrated additional benefit beyond maximally tolerated statin therapy in high-risk individuals. Thus, management of LDL-C will soon become more complex, as a new class of medication is added to our standard armamentarium. This review explores the discovery of PCSK9, its biology and physiology, and the development of the PCSK9 mabs.

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References and Recommended Reading

Papers of particular interest, published recently, have been highlighted as: •• Of major importance

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Authors and Affiliations

  1. Internal Medicine Resident, Florida Atlantic University (FAU), 11397 Water Oak Place, Davie, FL, 33330, USA

    Ashwin Durairaj MD

  2. Internal Medicine Resident, FAU, Boca Raton, FL, 33431, USA

    Alberto Sabates MD

  3. Internal Medicine Resident, FAU, Boca Raton, FL, 33431, USA

    Jonathan Nieves MD

  4. Nova Southeastern University, Fort Lauderdale, FL, 33314, USA

    Brian Moraes DO, FASPC

  5. College of Medicine, FAU, Boca Raton, FL, 33431, USA

    Seth Baum MD, FACC, FACPM, FAHA, FNLA, FASPC

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  1. Ashwin Durairaj MD
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  2. Alberto Sabates MD
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  4. Brian Moraes DO, FASPC
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  5. Seth Baum MD, FACC, FACPM, FAHA, FNLA, FASPC
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Correspondence to Ashwin Durairaj MD.

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Ashwin Durairaj, Alberto Sabates, Jonathan Nieves, and Brian Moraes declare that they have no conflicts of interest. Seth Baum reports Clinical Research, Consulting, Scientific Advisory Boards, and Speaking: Amgen, Regeneron/Sanofi, Lily, BI, Aegerion, AstraZeneca.

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Durairaj, A., Sabates, A., Nieves, J. et al. Proprotein Convertase Subtilisin/Kexin Type 9 (PCSK9) and Its Inhibitors: a Review of Physiology, Biology, and Clinical Data. Curr Treat Options Cardio Med 19, 58 (2017). https://doi.org/10.1007/s11936-017-0556-0

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