PCSK9 inhibitor, ezetimibe, and bempedoic acid: Evidence-based therapies for statin-intolerant patients Article

Full Text via DOI: 10.1016/j.pcad.2023.02.007 Web of Science: 001075556100001

Cited authors

  • Gunta SP, O'Keefe JH, O'Keefe EL, Lavie CJ

Abstract

  • Statins are first-line therapy for treating dyslipidemia because of their low-density lipoprotein cholesterol (LDL-C) lowering efficacy, superior event-reduction data and unrivaled cost-effectiveness. Yet, many people are intol-erant of statins, whether due to true adverse events or the nocebo effect, so within one year about two-thirds of primary prevention patients and one-third of secondary prevention patients are no longer taking their prescrip-tion. Statins still dominate this landscape, but other agents, often used in combination, potently reduce LDL-C levels, regress atherosclerosis and lower risk of major adverse cardiovascular events (MACE). Ezetimibe lowers LDL-C by reducing intestinal absorption of cholesterol. Proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9i) lower LDL-C by increasing the number and durability of hepatic LDL receptors. Bempedoic acid reduces hepatic cholesterol synthesis. Ezetimibe, PCSK9i and bempedoic are evidence-based, non-statin therapies that synergistically lower LDL-C and reduce risk of MACE; they also have benign side-effect profiles and are generally well tolerated.(c) 2023 Elsevier Inc. All rights reserved.

Publication date

  • 2023

Published in

International Standard Serial Number (ISSN)

  • 0033-0620

Number of pages

  • 7

Start page

  • 12

End page

  • 18

Volume

  • 79