PCSK9 and Lipoprotein(a)

Tóth, Peter P.

doi:10.1161/circresaha.116.309011

Cited by 6 publications

(2 citation statements)

References 25 publications

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“…Interestingly, after treatment with an anti-Lp(a) antibody, total PCSK9 levels did not change, whereas there was a steady decrement in PCSK9 bound to Lp(a) [PCSK9-Lp(a)] [ 79 ]. However, since only 1 out of 175 Lp(a) particles binds to PCSK9, this would represent a very small percentage of total Lp(a) that is complexed [ 80 ]. Moreover, a study by our group showed that, irrespective of the presence of Lp(a), the analysis of PCSK9 lipoprotein distribution by Fast Protein Liquid Chromatography (FPLC) is not affected [ 81 ].…”

Section: Pcsk9 Inhibitorsmentioning

confidence: 99%

Lipoprotein(a) Lowering—From Lipoprotein Apheresis to Antisense Oligonucleotide Approach

Greco

Sirtori

Corsini

et al. 2020

JCM

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It is well-known that elevated lipoprotein(a)—Lp(a)—levels are associated with a higher risk of cardiovascular (CV) mortality and all-cause mortality, although a standard pharmacotherapeutic approach is still undefined for patients with high CV risk dependent on hyperlipoproteinemia(a). Combined with high Lp(a) levels, familial hypercholesterolemia (FH) leads to a greater CVD risk. In suspected FH patients, the proportion of cases explained by a rise of Lp(a) levels ranges between 5% and 20%. In the absence of a specific pharmacological approach able to lower Lp(a) to the extent required to achieve CV benefits, the most effective strategy today is lipoprotein apheresis (LA). Although limited, a clear effect on Lp(a) is exerted by PCSK9 antagonists, with apparently different mechanisms when given with statins (raised catabolism) or as monotherapy (reduced production). In the era of RNA-based therapies, a new dawn is represented by the use of antisense oligonucleotides APO(a)Lrx, able to reduce Lp(a) from 35% to over 80%, with generally modest injection site reactions. The improved knowledge of Lp(a) atherogenicity and possible prevention will be of benefit for patients with residual CV risk remaining after the most effective available lipid-lowering agents.

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Section: Pcsk9 Inhibitorsmentioning

confidence: 99%

Lipoprotein(a) Lowering—From Lipoprotein Apheresis to Antisense Oligonucleotide Approach

Greco

Sirtori

Corsini

et al. 2020

JCM

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“…Elevated Lp(a) levels have seen associated with an increased risk of coronary heart disease, stroke, and aortic stenosis. 81 –83 Commonly used hypolipidemic drugs, including statins, do not affect Lp(a) concentration, 84,85 whereas the cardiovascular benefit of the newer CETP inhibitors that significantly lower Lp(a) concentration has not been established. 68…”

Section: Effects Of Pcsk9 Inhibitors On Lp(a) Concentrationsmentioning

confidence: 99%

Effects of PCSK9 Inhibitors on Other than Low-Density Lipoprotein Cholesterol Lipid Variables

Filippatos

Kei

Rizos

et al. 2017

J Cardiovasc Pharmacol Ther

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Low-density lipoprotein cholesterol (LDL-C) is a major cardiovascular risk factor, but other lipid variables such as triglycerides (TRGs), high-density lipoprotein cholesterol (HDL-C) and lipoprotein a [Lp(a)] also affect cardiovascular risk. Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors significantly lower LDL-C concentration but also modestly improve the concentrations of TRGs and HDL-C and more robustly decrease Lp(a) levels. The review presents the associated mechanisms of the beneficial effects of PCSK9 inhibitors on the other than LDL-C lipid variables, including the effects on lipid/apolipoprotein secretion and clearance and the heteroexchange between lipoproteins, as well as the possible effects on other variables involved in lipid metabolism such as sortilin. Proprotein convertase subtilisin/kexin type 9 inhibitors improve the overall lipid profile, and these beneficial effects may play a role in the reduction of cardiovascular risk.

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Proprotein Convertase Subtilisin/Kexin Type 9: Functional Role in Lipid Metabolism and Its Therapeutic Inhibition

Tóth

2020

Contemporary Cardiology

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PCSK9 and Lipoprotein(a)

Cited by 6 publications

References 25 publications

Lipoprotein(a) Lowering—From Lipoprotein Apheresis to Antisense Oligonucleotide Approach

Lipoprotein(a) Lowering—From Lipoprotein Apheresis to Antisense Oligonucleotide Approach

Effects of PCSK9 Inhibitors on Other than Low-Density Lipoprotein Cholesterol Lipid Variables

Proprotein Convertase Subtilisin/Kexin Type 9: Functional Role in Lipid Metabolism and Its Therapeutic Inhibition

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