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Is the once-a-month lipid-lowering injection better than statins and when should I use it?

Time:2022-12-08 07:35:34 source:psychiatricethics.com author:Prevent anxiety Read:561次
Is the once-a-month lipid-lowering injection better than statins and when should I use it?

An elderly friend told Hua Zi that he has high blood lipids, and he has a side effect of low back muscle pain after taking statins, but he heard that there is a lipid-lowering injection once a month. Can I get that injection and not take statins? Hua Zi said that the lipid-lowering injection he was talking about was a "pre-protein convertase subtilisin Kexin-9 inhibitor", abbreviated as PCSK9 inhibitor. Currently, there are ilovolumab and alicitabine on the market in China. Resist both drugs.

I. How PCSK9 inhibitors work

Low-density lipoprotein cholesterol (LDL-C) in blood lipids is the cause of atherosclerosis The main cause of sclerosis, lowering the level of LDL-C can reduce the risk of cardiovascular and cerebrovascular diseases. LDL-C is mainly produced by the liver, and the liver also has corresponding LDL receptors that can degrade LDL-C. PCSK9 in the human body binds to LDL receptors, resulting in a decrease in the number of LDL receptors, resulting in reduced LDL-C degradation and increased LDL-C levels in the blood. PCSK9 inhibitors will bind to PCSK9 and inactivate it, thereby increasing the number of LDL receptors and increasing the degradation of LDL-C, which can reduce LDL-C levels by about 50% to 70%.

Second, for enhanced treatment when statins are not effective

Statins alone can usually reduce LDL-C levels by 50%. Although PCSK9 inhibitors reduce LDL-C levels more strongly than statins, they cannot completely replace the effects of statins. Because statins can not only reduce LDL-C levels, but also improve arterial intima metabolism, antioxidant, anti-inflammatory responses, increase the stability of atherosclerotic plaques, prevent rupture, and promote their reversal. Therefore, statins are still the main drugs for controlling LDL-C levels. If statins alone cannot make blood lipids reach the target, they are usually used in combination with a cholesterol absorption inhibitor (ezetimibe) first. When the LDL-C level cannot be controlled to reach the target, PCSK9 inhibitors should be added. Typically, PCSK9 inhibitors are not used alone, but only in combination with statins. However, if statin intolerance is complete, PCSK9 inhibitors can also be used alone. Statins alone can reduce LDL-C levels by about 50%; statin plus ezetimibe can reduce LDL-C levels by about 65%; statins plus PCSK9 inhibitors can reduce LDL-C levels by about 75%; Statins, ezetimibe, and PCSK9 inhibitors can reduce LDL-C levels by about 85%.

III. Precautions for PCSK9 inhibitors

All PCSK9 inhibitors need to be administered by subcutaneous injection. Uzumumab is injected every 2 weeks. Common adverse reactions of PCSK9 inhibitors are erythema, pain, and bruising at the injection site. In clinical trials, the risk of developing upper respiratory tract infections, influenza, gastroenteritis, and nasopharyngitis was increased after taking the drug. The drug may cause allergies and should be disabled in the event of a severe allergic reaction. The drug contains protein, which may stimulate the body's immune system to produce neutralizing antibodies, which will increase local reactions during injection, but will not affect its lipid-lowering effect. During the use of PCSK9 inhibitors, the adverse reactions such as muscle damage, abnormal liver function, and elevated blood sugar caused by statins will not be increased. To sum up, PCSK9 inhibitors are novel lipid-lowering drugs, but cannot replace statins. When the use of statins cannot make LDL-C reach the target, it can be used in combination with PCSK9 inhibitors. Only those who cannot tolerate statins can use PCSK9 inhibitors alone for treatment. Some people are prone to adverse reactions when using high-intensity statins, and can also be treated with moderate-intensity statins plus PCSK9 inhibitors. The medicine should be used under the guidance of a doctor. If you have any doubts about the medicine, please consult your doctor or pharmacist. I am Huazi, a pharmacist. Welcome to follow me and share more health knowledge.

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