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Dtsch Med Wochenschr 2018; 143(20): 1430-1434
DOI: 10.1055/a-0635-7114
Klinischer Fortschritt
Endokrinologie und Diabetologie
© Georg Thieme Verlag KG Stuttgart · New York

Hyperlipidämie: Welche Rolle spielen PCSK9-Inhibitoren?

Hyperlipidemia: What role do PCSK9 inhibitors play?
Dirk Meyer
  MVZ endokrinologikum Hamburg
,
Martin Merkel
  MVZ endokrinologikum Hamburg
› Author Affiliations
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Publication History

Publication Date:
04 October 2018 (online)

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Was ist neu?

Risikostratifizierung Die zielwertgerechte Senkung des LDL-Cholesterins (LDL-C) ist eine effektive Maßnahme zur kardiovaskulären Prävention. Derzeit erreicht ein Großteil der Patienten in Deutschland ihren individuellen LDL-C-Zielwert nicht.

Therapie Durch konsequente Anwendung von Statinen in Kombination mit Ezetimib lässt sich bei vielen Patienten der entsprechende LDL-C-Zielwert erreichen. Inhibitoren der Proproteinkonvertase Subtilisin/Kexin Typ 9 (PCSK9) sind eine neue, nebenwirkungsarme Möglichkeit der intensiven LDL-C-Senkung. Zwei große Endpunktstudien konnten die Wirksamkeit und Sicherheit bereits belegen. Bei ausgewählten kardiovaskulären Höchstrisikopatienten ermöglicht der Einsatz von PCSK9-Inhibitoren eine sichere und effektive LDL-C-Senkung.

Abstract

PCSK9 inhibitors are a new and safe option of lowering LDL cholesterol. This article summarizes current recommendations for the use of PCSK9 inhibitors. Statins and ezetimibe are still the basis of cholesterol-lowering therapy. Through their use, the largest proportion of patients can be adequately treated. PCSK9 inhibitors should be used in patients at very high cardiovascular risk if, despite the maximum tolerated statin/ezetimibe therapy, an LDL-C reduction of more than 50 % would be needed to achieve the recommended LDL-C target. The use in patients with familial hypercholesterolemia is usually carried out according to this scheme as well. For statin intolerance, PCSK9 inhibitors should be considered in patients at very high cardiovascular risk who have not tolerated low doses of at least two different statins/ezetimibe.

Schlüsselwörter

LDL-Cholesterin - PCSK9-Antikörper - Prävention - Dyslipidämie

Key words

LDL cholesterol - PCSK9 antibodies - prevention - dyslipidemia
 

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