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Evolocumab – antibody against PCSK9 with a profound lipid-lowering effect


Authors: M. Vráblík
Authors‘ workplace: Centrum preventivní kardiologie, III. interní klinika 1. LF UK a VFN v Praze
Published in: Kardiol Rev Int Med 2015, 17(4): 362-366
Category: Cardiology Review

Overview

About 10 years ago a new protein –  proprotein subtilisin kexin convertase 9 (PCSK9) –  was discovered as another mechanism determining plasma LDL‑cholesterol levels. Therapeutic targeting of the protein using monoclonal antibodies has followed shortly after its discovery. Inhibition of PCSK9 results in a marked increase of recirculating LDL‑receptor protein expression on the surface of hepatocytes with a consequent decrease of LDL‑cholesterol (and other atherogenic lipids) in the plasma. Evolocumab is a fully human monoclonal antibody against PCSK9. Its lipid lowering effect is significant and reaches 50– 70% additional LDL‑c lowering when added to standard therapies. Evolocumab is being tested in a large research programme PROFICIO. This new therapeutic option represents a new hope for difficult‑ to‑ treat patients with familial hypercholesterolemia or with statin intolerance. In the near future we may anticipate its use also in patients with high and very high cardiovascular risk and inadequately controlled LDL‑cholesterol levels.

Keywords:
cardiovascular risk –  LDL‑cholesterol –  evolocumab –  PCKS9 –  monoclonal antibodies


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