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PCSK9 Inhibitors: The Hottest New Medications for High Cholesterol


Cardiovascular disease continues to be the number one killer of men and women in the United States. We have known for many years that risk factors such as diabetes, high blood pressure and high cholesterol play an important role in the occurrence of events related to cardiovascular disease such as heart attacks and strokes. Many lines of evidence indicate that when these risk factors are well controlled, that the incidence of these events decrease dramatically and death rates decline as well.


With respect to high cholesterol, most of the reduction in risk has focused on LDL cholesterol, the so-called “bad cholesterol.” Guidelines have been published indicating goal levels for LDL cholesterol, based on the likelihood that a person might have a cardiovascular event. Individuals are at the highest risk if they already have vascular disease (e.g. heart attack, stroke, peripheral vascular disease) or if they are diabetic. In this case, LDL cholesterol levels should be decreased the most, to at least 100 mg/dl and in many case to as low as 70 mg/dl. Individuals who are not in the highest risk category do not need such aggressive reductions in their cholesterol levels, but may still benefit from some reduction based on their other risk factors such as smoking and family history.


Statin medications (e.g. Lipitor, Zocor, Crestor, etc.) have been the cornerstone of therapy for high cholesterol. These medications have not only been shown to significantly lower LDL cholesterol, but also dramatically decrease the incidence of cardiovascular events and death. While they are used widely, many patients may not be able to tolerate them due to side effects or may have a high enough cholesterol levels to begin with such that they do not reach their goal cholesterol levels.


PCSK9 inhibitors are a new class of cholesterol lowering medication that work in an entirely different way than Statins. They have been shown to significantly reduce LDL cholesterol, in many cases more potently than the Statins. In addition, they appear to have few serious side effects. While these new medications are not yet available to be prescribed by physicians in the United States, the Metabolic Research Institute is doing several clinical trials on them. Please contact us if you have any questions about these studies or if you are interested in participating.

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