Efficacy and Safety of PCSK9 Inhibitors in Stroke Prevention

Bayan Moustafa; Fernando D Testai

doi:10.1016/j.jstrokecerebrovasdis.2021.106057

Efficacy and Safety of PCSK9 Inhibitors in Stroke Prevention

J Stroke Cerebrovasc Dis. 2021 Nov;30(11):106057. doi: 10.1016/j.jstrokecerebrovasdis.2021.106057. Epub 2021 Aug 24.

Authors

Bayan Moustafa¹, Fernando D Testai²

Affiliations

¹ University of Illinois College of Medicine, Department of Neurology and Rehabilitation, 912 S Wood St, Chicago, IL, United States. Electronic address: bmoust2@UIC.EDU.
² University of Illinois College of Medicine, Department of Neurology and Rehabilitation, 912 S Wood St, Chicago, IL, United States. Electronic address: testai@uic.edu.

PMID: 34450482
DOI: 10.1016/j.jstrokecerebrovasdis.2021.106057

Abstract

Proprotein convertase subtilisin/kexin type 9 (PCSK9) interacts with the low-density lipoprotein (LDL) receptor and, by enhancing its degradation, has a pivotal role in the regulation of cholesterol homeostasis. Two fully humanized monoclonal antibodies targeting PCSK9, evolocumab and alirocumab, are available for clinical use. PCSK9 inhibitors reduce LDL-C 30% more than ezetimibe and 60% more than placebo when added to statins. This reduction in LDL-C is accompanied by a decrease in the risk of major cardiovascular and cerebrovascular events. However, questions have been raised in relation to the cost-effectiveness of these medications. In this article, we review the clinical evidence on the use of PCSK9 inhibitors in lowering LDL-C and their effect on cerebrovascular health.

Keywords: LDL-C; PCSK9 inhibitors; Stroke prevention; dyslipidemia.

Publication types

Review

MeSH terms

Humans
PCSK9 Inhibitors* / adverse effects
Stroke* / prevention & control
Treatment Outcome

Substances

PCSK9 Inhibitors