title: Emerging PCSK9 inhibitors for treating dyslipidaemia: buttressing the gaps in coronary prevention.
abstract: BACKGROUND
  Atherosclerotic cardiovascular disease (ACVD) is the leading cause of mortality worldwide. An abnormally high plasma level of low-density lipoprotein-cholesterol is a major contributor to ACVD, an effect that can be attenuated by cholesterol-lowering therapies, particularly statins. A new class of drugs, the proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors, will add another option for further reducing cardiovascular events in patients at high risk of ACVD, including those with familial hypercholesterolaemia (FH) and intolerance to statins. Patients with elevated levels of lipoprotein(a) (Lp(a)) are difficult to treat with conventional therapies, and may also benefit from PCSK9 inhibitors.
  
  
  METHODS
  This paper discusses the medical need for additional cholesterol-lowering therapies and the scientific rationale and current therapeutic status of PCSK9 inhibitors.
  
  
  CONCLUSIONS
  The use of anti-PCSK9 mAbs is the leading form of therapy for inhibiting PCSK9 and is likely to provide genuine hope for patients with FH, statin intolerance and elevated Lp(a). Their ability to reduce cardiovascular events in patients maximally treated with statins and other existing therapies remains to be proven, and is the subject of major ongoing clinical trials.
authors: Lipid Disorders Clinic, Cardiovascular Medicine, Royal Perth Hospital , Perth , Australia.
authors: Michael M
authors: MM
authors: Page
authors: Gerald F
authors: GF
authors: Watts
mesh_terms: D000818:Animals; D000924:Anticholesteremic Agents / Q000494:pharmacology / Q000627:therapeutic use*; D050197:Atherosclerosis / Q000209:etiology / Q000401:mortality / Q000517:prevention & control; D002318:Cardiovascular Diseases / Q000209:etiology / Q000401:mortality / Q000517:prevention & control; D015195:Drug Design; D050171:Dyslipidemias / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D000071449:Proprotein Convertase 9; D043484:Proprotein Convertases / Q000037:antagonists & inhibitors*; D012697:Serine Endopeptidases
chemical_list: D000924:Anticholesteremic Agents; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; C472125:PCSK9 protein, human; D000071449:Proprotein Convertase 9; D043484:Proprotein Convertases; D012697:Serine Endopeptidases
keywords: alirocumab; bococizumab; evolocumab; familial hypercholesterolemia; proprotein convertase subtilisin/kexin type 9 inhibitors; statins