Experience with proprotein convertase subtilisin/kexine type 9 inhibitors (PCSK9i) in patients undergoing lipoprotein apheresis

4区 医学 Q1 Medicine
Sergey Tselmin, Ulrich Julius, Nadine Weinert, Stefan R. Bornstein, Ulrike Schatz
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引用次数: 4

Abstract

Purpose

We analyzed efficacy and safety of PCSK9i in patients undergoing lipoprotein apheresis (LA) and in patients treated at our outpatient department for metabolic disorders.

Methods

The medical records of 40 LA patients, taking PCSK9i were reviewed with respect to LDL-cholesterol (LDL-C) and lipoprotein(a) (Lp(a)) lowering as well as occurrence of adverse events. Furthermore, we analyzed the data of 152 patients of our outpatient department, undergoing PCSK9i therapy.

Results

Mean pre-apheresis LDL-C value was reduced by PCSK9i from 3.71 ± 1.19 to 1.78 ± 0.84 mmol/l (53 ± 12%). The relative lowering of the pre-apheresis Lp(a) was 20 ± 12% (from 191 ± 63.5 to 152 ± 51.9 nmol/l). 25% of LA patients could stop LA after reaching LDL-C target after initiation of PCSK9i. 75% of the patients are continuing the regular LA therapy, showing an insufficient LDL-C lowering following PCSK9i injections or/and additionally elevated Lp(a) or/and adverse effects of PCSK9i, leading to the discontinuation of injections. The number of LA patients has grown from 112 in 2016 to 128 nowadays due to an increasing percentage of patients with elevated Lp(a) (79% and 89% respectively). The mean reduction rate of LDL-C under PCSK9i therapy in outpatients was 53.03%. In 34% of patients the target value could not be reached. 43% of persons suffered from adverse effects.

Conclusions

3/4 of LA patients could not stop extracorporeal treatment after PCSK9i administration. In hypercholesterolemic patients with coexisting elevated Lp(a) and progressive cardiovascular disease the combination of LA and PCSK9i could be beneficial. The total patients’ number in LA units increases due to persons with Lp(a)-hyperlipoproteinemia.

蛋白转化酶枯草杆菌素/克辛9型抑制剂(PCSK9i)在脂蛋白分离患者中的应用经验
目的分析PCSK9i在接受脂蛋白分离(LA)治疗的患者和在我院门诊治疗的代谢紊乱患者中的疗效和安全性。方法回顾40例LA患者服用PCSK9i后,ldl -胆固醇(LDL-C)、脂蛋白(Lp(a))降低情况及不良事件发生情况。此外,我们还分析了门诊152例接受PCSK9i治疗的患者的数据。结果PCSK9i使采前LDL-C均值由3.71 ± 1.19降至1.78 ± 0.84 mmol/l(53 ± 12%)。分离前Lp(a)相对降低20 ± 12%(从191 ± 63.5降至152 ± 51.9 nmol/l)。25%的LA患者在开始PCSK9i治疗后达到LDL-C目标后可以停止LA。75%的患者继续常规LA治疗,显示注射PCSK9i后LDL-C降低不足或/和Lp(a)升高或/和PCSK9i的不良反应,导致停止注射。由于Lp(a)升高的患者比例增加(分别为79%和89%),LA患者的数量从2016年的112人增加到现在的128人。门诊患者接受PCSK9i治疗后LDL-C平均降低率为53.03%。34%的患者不能达到目标值。43%的人出现了不良反应。结论3/4的LA患者给予PCSK9i后不能停止体外治疗。在同时存在Lp(a)升高和进行性心血管疾病的高胆固醇血症患者中,LA和PCSK9i联合使用可能是有益的。由于Lp(a)-高脂蛋白血症患者,LA单位的总患者人数增加。
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来源期刊
Atherosclerosis. Supplements
Atherosclerosis. Supplements 医学-外周血管病
CiteScore
4.80
自引率
0.00%
发文量
0
审稿时长
>12 weeks
期刊介绍: Atherosclerosis brings together, from all sources, papers concerned with investigation on atherosclerosis, its risk factors and clinical manifestations.
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