Some recent studies have demonstrated a strong reduction of the cLDL with diverse molecules that have this activity. But does someone know about studies directed to the cardiovascular effect of the inhibiting PCSK9? What do you think about possible collateral effects?
To my knowledge at least two antibodies against PCSK9 are now in phase III studies (AMG145 or evolocumab and REGN727or alirocumab) and we have to wait until 2016/7 for the answer whether the reduction of LDL-C corresponds to a similar reduction in cardiovascular endpoints.
At the moment a strong reduction in LDL-C on top of statins has been published for all inhibitors, in some patients even below 50 mg/dl. Whether this strong reduction in LDL-C might lead to other problems is not clear. Some years ago it was discussed whether strong LDL-C lowering by statins might increase the risk for certain cancers but in the meantime this is no longer a topic.
Please find attached a paper from 2012 published in Circulation research where the authors are expressing caution both in relation to phase III results and further potential clinical application in patient population as in using the reduction of LDL and its relation to some CV parameters- see ENHANCE trial-. Time will say.
Check in the atached file the results of the very recently presented "Odissey Long Term" (ESC 2014). In a post hoc analysis, alirocumab was associated with a significant reduction in the risk of cardiovascular events.
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