PCSK9 Inhibitors: Cardiovascular Outcomes and Challenges to Patients’ Access

SAN ANTONIO — Randomized controlled trials (RCTs) have shown that non-statin lipid-lowering therapies—particularly the proprotein convertase subtilsin-kexin type 9 (PCSK9) inhibitors—are associated with reduction in cardiovascular events, according to James A. Underberg, MD, who presented today about these medications at the Cardiometabolic Risk Summit, an official meeting of Consultant360.

Dr. Underberg is a clinical assistant professor of medicine at the NYU School of Medicine and NYU Center for Prevention of Cardiovascular Disease and director of the Bellvue Hospital Lipid Clinic in New York, New York. He is also president of the National Lipid Association.

Dr. Underberg stepped in to present on the topic for Pamela B. Morris, MD, whose travel to San Antonio was prevented by Hurricane Florence, which battered the Southeast coastal states during this year's CRS. Dr. Morris is director of the Seinsheimer Cardiovascular Health Program and codirector of Women’s Heart Care at the Medical University of South Carolina in Charleston.

The presentation was titled, “PCSK9 Inhibitors: Update on CV Events and Access Challenges.”

Dr. Underberg discussed the most recent cardiovascular outcomes evidence for the PCSK9 inhibitors from RCTs and correlated their implications with daily clinical practice. He explained how these recent findings might affect the currently published expert recommendations for combination lipid-lowering therapy in at-risk patients, and he reviewed strategies to improve access to therapy for appropriate patients.

Dr Underberg explained in his presentation that the RCTs have shown that the PCSK9 inhibitors alirocumab and evolocumab, as well as the selective cholesterol-absorption inhibitor ezetimibe, are safe and well-tolerated, and given that very low levels of low-density lipoprotein cholesterol (LDL-C) are safe, these non-statin agents can provide additional LDL-C lowering when added to moderate-, high-, and maximally tolerated statin therapy. They also are associated with a reduction in cardiovascular events.

—Michael Gerchufsky

Reference:

Morris PB. PCSK9 inhibitors: update on CV events and Access Challenges [presented at Cardiometabolic Risk Summit 2018]. San Antonio, Texas. September 15, 2018.