Meta Information

ID:pcsk9-inhibitors

Name:PCSK9 Inhibitors

Schema Version:1.5

Alternate Names

• Proprotein Convertase Subtilisin/Kexin type 9 Inhibitors

Active Compound

null

Intervention Type

therapeutic_agent

Delivery

Route:

subcutaneous_injection

Scope:

• systemic

Regulatory Status

• us:rx_drug
• eu:rx_drug

Indication

Focus:

disease_treatment

Description:

Treat primary hypercholesterolemia and reduce cardiovascular event risk in patients with established atherosclerotic cardiovascular disease or familial hypercholesterolemia.

Typical Protocol

• Alirocumab is typically administered as a 75 mg or 150 mg subcutaneous injection once every two weeks.
• Evolocumab is typically administered as a 140 mg subcutaneous injection once every two weeks or 420 mg once a month.

Expected Cost Mean

Low Cost:

500

High Cost:

600

Cost Type:

monthly

Description:

High monthly cost; usually covered by insurance for approved disease indications.

Summary

PCSK9-inhibitors are a class of biological drugs that block proprotein convertase subtilisin/kexin type 9, a protein that degrades LDL receptors. By inhibiting PCSK9, these drugs increase the number of LDL receptors on liver cells, leading to significantly lower levels of LDL-cholesterol. This reduction is highly effective in mitigating atherosclerotic plaque formation and reducing major adverse cardiovascular events, thereby extending healthy life years by preventing cardiovascular disease.

Purpose

Lower LDL-C significantly, reducing cardiovascular events to extend healthy life.

Card Summary

Potent LDL-C reduction by increasing liver LDL receptors, proven to lower cardiovascular risk.

Drug Class

null

Drugs In Class

• alirocumab
• evolocumab

Impact

Score:

7.8

Justification:

Significantly reduces cardiovascular disease, a major healthspan limiter.

Evidence

Grade:

A

Score:

9.5

Justification:

Multiple large-scale human RCTs and meta-analyses demonstrate robust efficacy.

Safety

Score:

4.5

Justification:

Generally well-tolerated; potential injection site reactions, rare serious adverse events.

Flags

• Requires subcutaneous injection, which some individuals may find uncomfortable.
• Potential for injection site reactions such as redness, pain, or bruising.
• Rare reported adverse events include allergic reactions, flu-like symptoms, and neurocognitive issues (though causality is debated).
• High cost of treatment may be a barrier without adequate insurance coverage.

Verdict

Effective for high-risk patients to lower cardiovascular events.