Application of a PCSK9 inhibitor in the treatment of lipid disorders – a comprehensive literature

Lipid disorders stem from imbalances in the levels of cholesterol, low-density lipoproteins (LDL), high-density lipoproteins (HDL), and triglycerides (TG). Among Polish adults over the age of 18, these conditions may affect as many as 60–80% of individuals. Such high prevalence is closely linked to the occurrence of cardiovascular diseases, for which dyslipidemias serve as a key contributing factor. Unfortunately, these disorders are also the leading cause of premature death in Poland. Consequently, the appropriate management of blood lipid concentrations—through both well-selected pharmacotherapy and supportive non-pharmacological measures—plays a vital role in reducing related risks. The primary class of lipid-lowering drugs comprises 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase inhibitors, commonly known as statins. Their principal mechanism involves lowering LDL-C to levels commensurate with the patient’s cardiovascular risk profile. Should these targets remain unmet, additional agents can be employed, such as ezetimibe in conjunction with statins, or a newer group of lipid-lowering medications known as PCSK9 inhibitors, used either as monotherapy or in combination. These drugs are monoclonal antibodies directed against proprotein convertase subtilisin/kexin type 9 (PCSK9). Purpose: This paper briefly examines the role of PCSK9 inhibitors in managing dyslipidemia and their impact on reducing LDL cholesterol and preventing cardiovascular events. Material and Methods: We reviewed available literature, clinical trials, and guidelines on PCSK9 biology and the effectiveness and safety of PCSK9 inhibitors compared to other lipid-lowering therapies. Findings: PCSK9 inhibitors (alirocumab, evolocumab) can lower LDL-C by up to 60%. They can be used alone or with statins/ezetimibe, offer a favorable safety profile, and significantly reduce cardiovascular risk.