title: [Anti-PCSK9 antibodies in type 2 diabetes and secondary prevention of cardiovascular diseases].
abstract: Patients with type 2 diabetes are considered to have the same cardiovascular risk as patients with ischemia. However, the degree of lipid control in diabetic and ischemic patients remains highly deficient. The availability of new agents, such as anti-PCSK9 monoclonal antibodies, could represent a notable advance in meeting this unmet need. Alirocumab and evolucumab, followed by bococizumab, are currently under the advanced phase of research. A growing database has demonstrated a relationship between glucose metabolism, body weight and PCSK9 function, but the clinical implications of this relationship have not been well defined. A broad programme of clinical trials has demonstrated that these agents decrease low-density lipoprotein cholesterol by more than 60% and also decrease apolipoprotein B and lipoprotein (a), showing a good tolerability and safety profile. In addition, post hoc analyses of phase 2 and 3 trials have observed that when these agents are associated with conventional lipid-lowering they reduce cardiovascular risk by more than 50%. Currently, 4 large clinical trials of cardiovascular prevention are underway in patients with ischemia or high cardiovascular risk. The aim of these trials is to define the role of anti-PCSK9 agents in the treatment of dyslipidemia and the prevention of cardiovascular disease in patients with ischemia and high cardiovascular risk.
authors.affiliation: Unidad de Lípidos y Arteriosclerosis, Departamento de Medicina, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Hospital Universitario Reina Sofía, Universidad de Córdoba, Córdoba, España; CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, España.
authors.forename: José
authors.initials: J
authors.lastname: López-Miranda
authors.affiliation: Unidad de Lípidos y Arteriosclerosis, Servicio de Medicina Interna, Hospital Universitario de Bellvitge, Universidad de Barcelona, L'Hospitalet de Llobregat, Barcelona, España; CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, España. Electronic address: xpinto@bellvitgehospital.cat.
authors.forename: Xavier
authors.initials: X
authors.lastname: Pintó
mesh_terms: D000818:Animals; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D000924:Anticholesteremic Agents / Q000494:pharmacology / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000209:etiology / Q000517:prevention & control*; D008078:Cholesterol, LDL / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000188:drug therapy*; D050171:Dyslipidemias / Q000150:complications / Q000188:drug therapy; D006801:Humans; D000091362:PCSK9 Inhibitors; D000071449:Proprotein Convertase 9 / Q000276:immunology; D012307:Risk Factors; D055502:Secondary Prevention
chemical_list: D000911:Antibodies, Monoclonal; D000924:Anticholesteremic Agents; D008078:Cholesterol, LDL; D000091362:PCSK9 Inhibitors; C472125:PCSK9 protein, human; D000071449:Proprotein Convertase 9
keywords: Alto riesgo cardiovascular; Anti-PCSK9 antibodies; Anticuerpos anti-PCSK9; Cardiovascular disease; Diabetes; Enfermedad cardiovascular; High cardiovascular risk; Prevención secundaria; Secondary prevention