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Tag: PCSK9 Inhibitors

PCSK9 Inhibitors May Benefit Patients with Acute Coronary Syndrome

Results of a recent study published in the Annals of Internal Medicineshowed that patients with acute coronary syndrome (ACS) who were treated with PCSK9 inhibitors benefited not only from LDL-cholesterol reduction but plaque stabilization as well. Currently, the PCSK9 inhibitors evolocumab and alirocumab are approved for lowering of LDL in patients with familial hypercholesterolemia or clinical atherosclerotic cardiovascular disease who are not at goal despite maximally tolerated statin therapy.

According to the study authors, acute coronary events result in a dynamic increase of PCSK9 levels that may have an effect on plaque vulnerability of both culprit and nonculprit coronary vessels, thus leading to a potential role for PCSK9 inhibitors in managing ACS. Further, formal study on the timing of PCSK9 inhibitor administration to patients with ACS and their effects on inflammatory and thrombosis pathways will be necessary. For more perspective on the study, read here.

To learn more on managing high-risk patients in the PCSK9 era, don’t miss the Best of the CMHC Regional Conference Series taking place in Atlanta, GA on May 7 and in Chicago, IL on June 18, as well as the 11th Annual CMHC in Boston, MA October 5- 8, 2016.

References:
Navarese EP et al. Proprotein convertase subtilisin/kexin type 9 monoclonal antibodies for acute coronary syndrome: a narrative review. Ann Intern Med. Published online 22 March 2016 doi:10.7326/M15-2994.

Healio. PCSK9 inhibitors may be appropriate for use in patients with ACS.

As PCSK9 Inhibitors Come to Market, Concern Over 2013 Guidelines Resurfaces

Now that the first PCSK9 inhibitors have received FDA approval, the ambiguity of the 2013 ACC/AHA cholesterol-treatment guidelines are again being called into question. Because the new class of LDL-lowering agents are expensive specialty medications, with alirocumab priced at about $14,600 per year, payers are expressing concern that the removal of specific LDL-C targets from the 2013 guidelines will complicate treatment choices and inhibit utilization management tools, such as step therapy and prior authorization, to manage costs. Consequently, they are asking the American College of Cardiology and American Heart Association to return specific LDL targets to the guidelines.

In a recent publication in the European Heart Journal, however, Drs. Jennifer G. Robinson and Neil J. Stone explain the concept of net benefit, which was introduced in the 2013 ACC/AHA guidelines, and how net benefit can be used to identify patients most likely to benefit from statin therapy and which patients may benefit from the addition of a non-statin agent, such as ezetimibe or another LDL-lowering medication. Read more