The recent U.S. Food and Drug Administration (FDA) approval of two new drugs, alirocumab (Praluent®) and evolocumab (Repatha®) is a breakthrough in the treatment of familial hypercholesterolemia. These drugs are a part of a new class called the proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors that act by increasing the number of low density lipoprotein receptors (LDL-R) recycled to hepatocyte membranes. The increased density of LDL-R facilitates greater clearance of low density lipoproteins from the blood. Numerous clinical trials have demonstrated the efficacy of these agents, particularly for patients in whom standard cholesterol-lowering therapy is insufficient. However, data on long-term health outcomes in patients on PCSK9 inhibitors will not be known for several years. Opportunities for pharmacists include counseling on how to store and administer the medication, helping patients receive access to therapy and advocating for healthy lifestyle changes. Pharmacists should also be aware of insurance coverage and emerging indications for each agent in order to provide the best care for patients.
Chu A, Hilverding A, Kramer E, Rasor B, Rorabaugh B. PCSK9 Inhibitors: A Novel Class of Pharmacotherapy for Hypercholesterolemia. PAW Review. 2016 Jan 01; 7(1):Article 2 8-11 . Available from: https://digitalcommons.onu.edu/paw_review/vol7/iss1/2. Free full text article.