Practical guide for the use of PCSK9 inhibitors in Portugal

Rev Port Cardiol (Engl Ed). 2019 Jun;38(6):391-405. doi: 10.1016/j.repc.2019.05.005. Epub 2019 Jul 16.
[Article in English, Portuguese]

Abstract

Reducing low-density lipoprotein cholesterol (LDL-C) levels is one of the most important strategies for reducing the risk of cardiovascular events. However, in clinical practice, a high proportion of patients do not achieve recommended LDL-C levels through lifestyle and lipid-lowering therapy with statins and ezetimibe. PCSK9 inhibitors (PCSK9i) are a new therapeutic option that significantly (50-60%) reduces LDL-C levels, which in clinical trials translates into an additional reduction in risk for cardiovascular events, and has a good safety profile. However, it is a high-cost therapy, and therefore its use in clinical practice should take its cost-effectiveness into account. Priority should be given to use in patients at higher cardiovascular risk and those in whom high LDL-C levels persist despite optimal lipid-lowering therapy. This consensus document aims to summarize the main data on the clinical use of PCSK9i and to make recommendations for Portugal on the profile of patients who may benefit most from this therapy.

Keywords: Cholesterol; Colesterol; Dislipidemia; Dyslipidemia; Estatinas; Inibidores PCSK9; PCSK9 inhibitors; Statins.

Publication types

  • Review

MeSH terms

  • Anticholesteremic Agents / therapeutic use
  • Cholesterol, LDL / blood*
  • Cholesterol, LDL / drug effects
  • Dyslipidemias / blood
  • Dyslipidemias / drug therapy*
  • Dyslipidemias / epidemiology
  • Ezetimibe / therapeutic use*
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use*
  • Incidence
  • PCSK9 Inhibitors*
  • Portugal / epidemiology

Substances

  • Anticholesteremic Agents
  • Cholesterol, LDL
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • PCSK9 Inhibitors
  • Ezetimibe