PCSK9 inhibition is associated with regression of tendon xanthomas in FH
Effect of intensive LDL cholesterol lowering with PCSK9 monoclonal antibodies on tendon xanthoma regression in familial hypercholesterolemiaLiterature - Bea AM, Perez-Calahorra S, Marco-Benedi V, et al. - Atherosclerosis 2017 Jun 8;263:92-96.
- LDL-C levels decreased from 326±60.4 mg/dL to 61.0±20.2 mg/dL (-80.8±7.66%; P <0.001) in HeFH subjects receiving PCSK9 inhibitors and from 314±65.0 mg/dL to 131±26.9 mg/dL (-56.9±11.1%; P <0.001) in the control group. The mean percentage reduction in LDL-C was higher with PCSK9 inhibitors (P <0.001).
- Similar differences between groups were observed in total-C, non-HDL-C and Apo-B. No differences were found between cases and controls in triglycerides, HDL-C and Apo-A1.
- The mean percentage change in maximum and mean TX thickness in cases was -5.03% and -5.32%, respectively. There was a non-significant increase in controls (+3.97% and +3.16, respectively), with significant differences between groups (P=0.01).
- In the regression analysis, the PCSK9 inhibitor treatment was independently associated with percentage reduction of TX thickness after adjustment for age, gender, baseline TX thickness and baseline LDL-C (Beta: -6.081; 95% CI: -10.431 to -1.730; P = 0.007).
In a prospective case-control study with HeFH patients treated with potent statins, addition of a PCSK9 antibody resulted in a greater decrease in LDL-c and TX thickness after on average 3 years of treatment.