LDL-cholesterol reduction in chronic kidney disease: options beyond statins
| Autor: | Richard Haynes, M Mafham, Michelle A Goonasekera |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Drug
Oncology medicine.medical_specialty medicine.drug_class media_common.quotation_subject 030232 urology & nephrology 030204 cardiovascular system & hematology 03 medical and health sciences 0302 clinical medicine Ezetimibe Internal medicine Internal Medicine medicine Humans Cholesterol absorption inhibitor Renal Insufficiency Chronic media_common Ldl cholesterol Atherosclerotic cardiovascular disease business.industry PCSK9 PCSK9 Inhibitors Antibodies Monoclonal Cholesterol LDL Atherosclerosis medicine.disease Increased risk Nephrology lipids (amino acids peptides and proteins) Hydroxymethylglutaryl-CoA Reductase Inhibitors business Kidney disease medicine.drug |
| Zdroj: | Current Opinion in Nephrology & Hypertension. 29:480-488 |
| ISSN: | 1473-6543 1062-4821 |
| DOI: | 10.1097/mnh.0000000000000628 |
| Popis: | Purpose of review Individuals with chronic kidney disease (CKD) are at increased risk of atherosclerotic cardiovascular disease (ASCVD) events. LDL cholesterol (LDL-C) is a key modifiable cause of ASCVD and lowering LDL-C with statins reduces the risk of ASCVD events in a wide range of populations, including those with CKD. This review considers the utility of recently developed nonstatin LDL-C-lowering therapies in CKD. Recent findings The cholesterol absorption inhibitor, ezetimibe, reduces LDL-C by 15-20% and is well tolerated in CKD. Monoclonal antibodies (mAbs) targeting proprotein convertase subtilisin kexin type 9 (PCSK9) reduce LDL-C by 50-60% and reduce the risk of ASCVD events. However, these agents require self-administration by subcutaneous injection every 2-4 weeks. The PCSK9 synthesis inhibitor, inclisiran, is administered approximately 6 monthly and may be more suitable for widespread use, although outcome trials are awaited. These PCSK9 targeting therapies require no dose adjustment in CKD and have no drug interactions. Summary Statins and ezetimibe are safe and reduce ASCVD risk in CKD populations. PCSK9 targeting agents may be useful in high-risk CKD patients, including those with prior ASCVD. |
| Databáze: | OpenAIRE |
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