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Case Report
PCSK9 inhibitors: A new improvement for health
Inhibidores de la PCSK9: una nueva mejora para la salud
Eva Perelló Camacho
Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario de Valencia, Valencia, Spain
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">We now have sufficient evidence to assert that lowering LDL cholesterol reduces the incidence of cardiovascular episodes&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">1</span></a> Until the appearance of PCSK9 inhibitors&#44; many patients found it difficult to achieve therapeutic targets with the available pharmacological treatment&#44; especially those with familial hypercholesterolaemia&#46; In some of these&#44; LDL apheresis was an effective alternative&#44; although as a therapy it requires a high degree of availability on the part of the patient&#46; Below&#44; we present the case of a patient with familial hypercholesterolaemia in whom treatment with a PCSK9 inhibitor was found to be an adequate alternative to LDL apheresis&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Case report</span><p id="par0010" class="elsevierStylePara elsevierViewall">The case is that of a 50-year-old male patient with a history of familial hypercholesterolaemia being followed up in primary care and treated with atorvastatin 40<span class="elsevierStyleHsp" style=""></span>mg&#47;1 tablet per day&#46; His medical history of interest also includes type 2 diabetes mellitus of seven years&#8217; evolution &#40;on treatment with metformin<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>sitagliptin 50&#47;1000<span class="elsevierStyleHsp" style=""></span>mg&#47;12<span class="elsevierStyleHsp" style=""></span>h&#44; well controlled&#44; with his latest HbA<span class="elsevierStyleInf">1c</span> being 6&#46;9&#37;&#41; and habitual alcohol consumption with an episode of <span class="elsevierStyleItalic">delirium tremens</span> in 2007&#46; With regard to family history&#44; his father died aged 71 of an acute myocardial infarction and he has a 56-year-old brother with dyslipidaemia of unknown origin and acute coronary syndrome&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">In October 2007&#44; the patient presented with an acute anteroseptal myocardial infarction and&#44; following this episode&#44; was referred for external consultations at the lipid clinic in our centre&#39;s endocrinology department for control of familial hypercholesterolaemia&#46; The physical examination revealed arcus senilis&#44; grade I obesity &#40;BMI&#58; 31&#46;44<span class="elsevierStyleHsp" style=""></span>kg&#47;m<span class="elsevierStyleSup">2</span>&#41;&#44; weight 103<span class="elsevierStyleHsp" style=""></span>kg&#44; height 181<span class="elsevierStyleHsp" style=""></span>cm and blood pressure 130&#47;80<span class="elsevierStyleHsp" style=""></span>mmHg&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">In terms of complementary tests&#44; a genetic diagnosis was carried out&#44; finding that the patient had LDL receptor mutations compatible with p&#46;Q92E and c&#46;313&#43;1G&#62;C compound heterozygous familial hypercholesterolaemia&#46; In the baseline analysis prior to starting cholesterol-lowering treatment with atorvastatin&#44; he had the following lipid profile values&#58; total cholesterol 513<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&#44; triglycerides 160<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&#44; HDL cholesterol 47<span class="elsevierStyleHsp" style=""></span>mg&#47;dl and LDL cholesterol 433<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&#46; In the latest available analysis&#44; he had the following figures&#58; total cholesterol 429<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&#44; triglycerides 119<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&#44; HDL cholesterol 40<span class="elsevierStyleHsp" style=""></span>mg&#47;dl and LDL cholesterol 365<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">Initially&#44; ezetimibe 10<span class="elsevierStyleHsp" style=""></span>mg per day and colesevelam 625<span class="elsevierStyleHsp" style=""></span>mg&#47;2 tablets&#47;12<span class="elsevierStyleHsp" style=""></span>h were added&#46; The dose of atorvastatin was not increased as the patient reported myalgia with doses above 40<span class="elsevierStyleHsp" style=""></span>mg&#47;day&#46; He also reported myalgia with other statins tried previously&#44; including rosuvastatin&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Nevertheless&#44; before the following visit the patient presented with a new episode of acute myocardial infarction&#46; This posed the problem of a patient in secondary prevention with a need for significant LDL cholesterol reduction in order to achieve therapeutic targets&#46; For this reason&#44; the haematology department was contacted and&#44; together with them&#44; LDL apheresis sessions were scheduled every 14 days&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">With this therapy&#44; the patient maintained pre-apheresis LDL cholesterol figures around 127&#8211;165<span class="elsevierStyleHsp" style=""></span>mg&#47;dl and post-apheresis figures around 45&#8211;53<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&#46; This regimen was continued together with the oral treatment as before &#40;atorvastatin&#44; ezetimibe and colesevelam&#41; for eight years&#44; with good evolution and no new cardiovascular events&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">In December 2016&#44; PCSK9 inhibitors had become available as a cholesterol-lowering treatment&#44; and he was prescribed evolocumab 140<span class="elsevierStyleHsp" style=""></span>mg every two weeks&#46; His LDL cholesterol figures reduced with this treatment&#44; and one month later his LDL cholesterol figures were 47<span class="elsevierStyleHsp" style=""></span>mg&#47;dl pre-apheresis and 26<span class="elsevierStyleHsp" style=""></span>mg&#47;dl post-apheresis&#46; Given the good evolution&#44; the decision was made to suspend the LDL apheresis sessions&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">Thus&#44; the patient continued treatment with&#58; evolocumab 140<span class="elsevierStyleHsp" style=""></span>mg every two weeks&#44; atorvastatin 40<span class="elsevierStyleHsp" style=""></span>mg&#47;day&#44; ezetimibe 10<span class="elsevierStyleHsp" style=""></span>mg&#47;day and colesevelam 625<span class="elsevierStyleHsp" style=""></span>mg&#47;2 tablets&#47;12<span class="elsevierStyleHsp" style=""></span>h&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">Over the subsequent months the lower LDL cholesterol figures were maintained&#44; with values between 51 and 61<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&#44; within the desirable therapeutic targets for the patient&#46; This is maintained at one year from the start of treatment with the PCSK9 inhibitor&#44; with total cholesterol levels of 101<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&#44; LDL cholesterol 51<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&#44; HDL cholesterol 51<span class="elsevierStyleHsp" style=""></span>mg&#47;dl and triglycerides 53<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&#46; The evolution of the LDL cholesterol levels is shown in <a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0055" class="elsevierStylePara elsevierViewall">The patient is clinically well with no adverse reactions to the treatment and no new cardiovascular episodes&#46; Moreover&#44; he subjectively reports being very satisfied with the treatment and that his quality of life has improved through not having to make fortnightly visits to the hospital for LDL apheresis&#44; which allows him to more easily fit the treatment around his work and personal life&#46; The remaining cardiovascular risk factors are also well-controlled&#44; maintaining an HbA<span class="elsevierStyleInf">1c</span> of 6&#46;4&#37; and blood pressure within normal limits&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Discussion</span><p id="par0060" class="elsevierStylePara elsevierViewall">The relationship between cardiovascular disease and high LDL cholesterol figures is clearly established&#46; Some patients&#44; especially those with familial hypercholesterolaemia&#44; do not achieve the desirable therapeutic targets for LDL cholesterol with the oral treatment available&#44; either due to intolerance to it or insufficient efficacy&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">2</span></a></p><p id="par0065" class="elsevierStylePara elsevierViewall">LDL apheresis allows LDL cholesterol to be reduced by at least 60&#37; and is therefore an efficacious therapeutic alternative in these patients&#46;<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">3&#44;4</span></a> However&#44; LDL apheresis treatment requires a high degree of availability on the part of the patient&#44; as each apheresis session lasts 3&#8211;5<span class="elsevierStyleHsp" style=""></span>h and they must take place every 7&#8211;14 days&#46;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">5</span></a> Moreover&#44; it can only be performed in certain specialised centres&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">4</span></a></p><p id="par0070" class="elsevierStylePara elsevierViewall">We now have available new treatments&#44; PCSK9 inhibitors &#40;alirocumab or evolocumab&#41;&#44; that when combined with statins have demonstrated LDL cholesterol reductions similar to those achieved with LDL apheresis&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">6</span></a> Moreover&#44; treatment with PCSK9 inhibitors achieves a more constant reduction in LDL cholesterol&#44; as the effect of apheresis is cyclical between sessions&#46;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">7</span></a> This treatment also offers a better quality of life for the patient&#44; avoiding numerous hospital visits&#46; It is a well-tolerated and safe treatment&#44; for which&#44; as yet&#44; few side effects have been described&#44; and none of them severe&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">For all of these reasons&#44; the introduction of treatment with PCSK9 inhibitors could successfully reduce the frequency of LDL apheresis sessions or even be an alternative to apheresis sessions in many patients&#44;<a class="elsevierStyleCrossRefs" href="#bib0050"><span class="elsevierStyleSup">2&#44;7&#44;8</span></a> as has occurred in our patient&#39;s case&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Conclusion</span><p id="par0080" class="elsevierStylePara elsevierViewall">To conclude&#44; we can affirm that treatment with PCSK9 inhibitors is efficacious&#44; well-tolerated&#44; safe and offers a good quality of life for patients&#46; They represent an important advance in the treatment of hypercholesterolaemia&#44; as they allow apheresis sessions to be reduced or replaced entirely in patients with heterozygous familial hypercholesterolaemia&#44; alone or in combination with other oral treatments&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Conflicts of interest</span><p id="par0085" class="elsevierStylePara elsevierViewall">The author declares that she has no conflicts of interest&#46;</p></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">It is a patient with heterozygous familial hypercholesterolemia and a personal history of acute myocardial infarction&#44; which is referred to our lipid unit for hypocholesterolemic treatment adjustment&#46; Since he does not reach therapeutic goals with oral medication&#44; he starts a treatment with fortnightly sessions of LDL-apheresis&#44; which he keeps for 8 years&#46; With the introduction and availability of PCSK9 inhibitors&#44; a new treatment option is possible for this patient&#46;</p></span>"
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        "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Se trata de un paciente con hipercolesterolemia familiar heterocigota y antecedentes de infarto agudo de miocardio&#44; que es remitido a la unidad de l&#237;pidos de nuestro centro para ajuste del tratamiento hipocolesterolemiante&#46; Dado que no alcanza los objetivos terap&#233;uticos con tratamiento oral&#44; comienza tratamiento con sesiones quincenales de af&#233;resis de colesterol LDL&#44; que mantiene durante 8 a&#241;os&#46; Con la introducci&#243;n y disponibilidad de los inhibidores de la PCSK9&#44; se presenta una nueva opci&#243;n de tratamiento para este paciente&#46;</p></span>"
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                        "fecha" => "2018"
                        "volumen" => "270"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "How effectively will PCSK9 inhibitors allow retrieval of freedom from apheresis in cardiovascular high risk patients&#63; Estimates form a large single center"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
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                            2 => "S&#46;R&#46; Bornstein"
                            3 => "U&#46; Julius"
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                        ]
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                        "tituloSerie" => "Atheroscler Suppl"
                        "fecha" => "2017"
                        "volumen" => "30"
                        "paginaInicial" => "28"
                        "paginaFinal" => "32"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29096851"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0055"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Current insights into the German lipoprotein apheresis standard&#58; PCSK9-inhibitors&#44; lipoprotein apheresis or both&#63;"
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                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
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                            3 => "U&#46; Julius"
                            4 => "R&#46; Klingel"
                            5 => "F&#46; Heigl"
                          ]
                        ]
                      ]
                    ]
                  ]
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                        "fecha" => "2017"
                        "volumen" => "30"
                        "paginaInicial" => "44"
                        "paginaFinal" => "49"
                        "link" => array:1 [
                          0 => array:2 [
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              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Alirocumab in patients with heterozygous familial hypercholesterolaemia undergoing lipoprotein apheresis&#58; the ODYSSEY ESCAPE trial"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
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                            2 => "S&#46;P&#46; Babirak"
                            3 => "M&#46;A&#46; Cornier"
                            4 => "P&#46;B&#46; Duell"
                            5 => "B&#46; Hohenstein"
                          ]
                        ]
                      ]
                    ]
                  ]
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                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Eur Herat J"
                        "fecha" => "2016"
                        "volumen" => "37"
                        "paginaInicial" => "3588"
                        "paginaFinal" => "3595"
                      ]
                    ]
                  ]
                ]
              ]
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              "identificador" => "bib0065"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
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                    0 => array:2 [
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                    ]
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                    0 => array:2 [
                      "doi" => "10.1016/j.jjcc.2017.07.002"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Cardiol"
                        "fecha" => "2018"
                        "volumen" => "71"
                        "paginaInicial" => "1"
                        "paginaFinal" => "7"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28784313"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
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                    0 => array:2 [
                      "titulo" => "Outcomes&#44; access&#44; and cost issues involving PCSK9 inhibitors to coger LDL-cholesterol"
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                        "fecha" => "2018"
                        "volumen" => "78"
                        "paginaInicial" => "287"
                        "paginaFinal" => "291"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29396831"
                            "web" => "Medline"
                          ]
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                      ]
                    ]
                  ]
                ]
              ]
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              "etiqueta" => "7"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Toward and international consensus &#8211; integrating lipoprotein apheresis and new lipid-lowering drugs"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
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                            4 => "M&#46; Cossu"
                            5 => "V&#46;J&#46; Schettler"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jacl.2017.04.114"
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                        "tituloSerie" => "J Clin Lipidol"
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                        "volumen" => "11"
                        "paginaInicial" => "858"
                        "paginaFinal" => "871"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28572002"
                            "web" => "Medline"
                          ]
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                    ]
                  ]
                ]
              ]
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                          "autores" => array:1 [
                            0 => "U&#46; Julius"
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Article information
ISSN: 25299123
Original language: English
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es en pt

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