Pune: The recently concluded International Diabetes Summit at the city-based Chellaram Diabetes Institute (CDI) shed light on the use of PCSK9 inhibitors (PCSK9i) to lower cholesterol levels and reduce the risk of heart attacks.
The PCSK9i are a new class of injectable drugs that reportedly reduce ‘bad’ cholesterol levels by up to 60% when combined with a statin (another class of drugs prescribed to help lower cholesterol levels).
“Statins are said to reduce the risk of heart attack by 25% to 30%. These block the enzyme that control production of LDL cholesterol. However, they do not completely remove the risk of heart attacks, which makes research of new products necessary,” said Dr. Vinaya Simha, consultant, Endocrinology, and assistant professor, Department of Internal Medicine at the U.S.-based Mayo Clinic.
Low-density lipoprotein cholesterol, abbreviated as LDL-c, is considered the ‘bad’ variant of cholesterol as it contributes to plaque deposition, leading to the hardening and narrowing of arteries or ‘atherosclerosis’ (thickening of artery walls owing to accumulation of white blood cells).
Function of the drugs
The drugs inactivate a protein in the liver called proprotein convertase subtilisin/kexin type 9 (PCSK9). The protein de-activates the receptors on the liver cell surface that transport LDL into the liver for break down. Without these receptors, more ‘bad’ cholesterol remains and accumulates in the blood.
PCSK9 inhibitors may be used alone or in combination with statins to lower the ‘bad’ cholesterol levels in patients who cannot tolerate any statin drug.
Dr. A. G. Unnikrishnan, CEO and chief Endocrinologist at CDI, said, “Controlling cholesterol level with diet and exercise is important. PCSK9 inhibitors are not available in India as of now, [but] they seem to be a promising mode of reducing risk of heart attacks.”
PCSK9 inhibitors are currently under clinical trial in India.