Proprotein convertase subtilisin/kexin type 9 inhibitors: prospects for cholesterol-lowering therapy in type 2 diabetes

Diabetic dyslipoproteinemia (DLP), characterized by quantitative, qualitative, and kinetic changes in all major circulating lipids, contributes to an increased risk of atherosclerotic cardiovascular disease patients with type 2 diabetes mellitus (DM). Inhibition proprotein convertase subtilisin/kexin 9 (PCSK9) human monoclonal antibodies is a promising treatment for diabetic DLP. Several drugs differ their mechanisms inhibition PCSK9 activity. The following groups are conditionally distinguished: (anti-PCSK9 antibodies): evolocumab, alirocumab, bococizumab (injectable); other injectable medications different mechanism actions (inclisiran, SPC4061, SPC5001, adnectin BMS-962476, LIB003, anti-PCSK9 vaccine; vaccine (nanoparticle-based); orally administered (PF-06446846, DS-9001a, SRT3025); cholesteryl ester transfer protein/PCSK9 inhibitors (anacetrapib, evacetrapib, torcetrapib, K-312). This review aims discuss the role alirocumab fully humanized antibodies, DM DLP consider effectiveness safety. Strategy search. Scopus, Science Direct (from Elsevier), PubMed, including Medline databases, were searched. keywords used: autonomic nervous system, heart rate variability, baroreflex sensitivity, cardiac neuropathy, MeSH terms. A manual search bibliography publications was used identify research results that could not be found online Statins first line choice treating reduce disease. Ezetimibe next drug added if patients’ low-density lipoprotein cholesterol levels higher than acceptable. In cases failure combination statins ezetimibe, inhibitor reasonable rational choice. Overall, clinical data suggest well tolerated provide significant reduction addition high-intensity statin therapy. use associated impaired glycemic control or development individuals without previously diagnosed may prevent subsequent events.