Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

PCSK9 Inhibitors Reduce Risk of CV Events

Nat Rev Cardiol; ePub 2018 Nov 12; Sabatine, et al

Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors can lower plasma low-density cholesterol (LDL-C) by approximately 60%, even in patients already receiving maximum-dose statin therapy. This according to a recent review that examined clinical evidence, including 3 recent cardiovascular (CV) outcomes trials, and implementation of PSCK9 inhibitors, and found them to reduce the risk of major vascular events. Other findings and conclusions included:

  • Monoclonal antibodies targeting PCSK9 can lower plasma LDL-C levels by ~60%, even in patients already receiving maximum-dose statin therapy.
  • PCSK9 inhibitors significantly reduced the risk of major adverse CV events in dedicated CV outcome trials.
  • This benefit was consistent in patients with a baseline LDL-C level <70 mg/dL, who achieved an LDL-C level of ~20 mg/dL, which is well below the current guideline-recommended targets.
  • There were no offsetting adverse events.


Sabatine MS. PCSK9 inhibitors: Clinical evidence and implementation. [Published online ahead of print November 12, 2018]. Nat Rev Cardiol. doi:10.1038/s41569-018-0107-8.