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Review
. 2022 Jun 6;11(11):3247.
doi: 10.3390/jcm11113247.

Proprotein Convertase Subtilisin/Kexin Type 9 Inhibitors Use for Atherogenic Dyslipidemia in Solid Organ Transplant Patients

Gianluigi Cuomo  1 , Giuseppe Cioffi  1 , Anna Di Lorenzo  1 , Francesca Paola Iannone  2 , Giuseppe Cudemo  1 , Anna Maria Iannicelli  1 , Mario Pacileo  3 , Antonello D'Andrea  3 , Carlo Vigorito  1 , Gabriella Iannuzzo  2 , Francesco Giallauria  1
Affiliations
Review

Proprotein Convertase Subtilisin/Kexin Type 9 Inhibitors Use for Atherogenic Dyslipidemia in Solid Organ Transplant Patients

Gianluigi Cuomo et al. J Clin Med. .

Abstract

Dyslipidemia is a widespread risk factor in solid organ transplant patients, due to many reasons, such as the use of immunosuppressive drugs, with a consequent increase in cardiovascular diseases in this population. PCSK9 is an enzyme mainly known for its role in altering LDL levels, consequently increasing cardiovascular risk. Monoclonal antibody PCSK9 inhibitors demonstrated remarkable efficacy in the general population in reducing LDL cholesterol levels and preventing cardiovascular disease. In transplant patients, these drugs are still poorly used, despite having comparable efficacy to the general population and giving fewer drug interactions with immunosuppressants. Furthermore, there is enough evidence that PCSK9 also plays a role in other pathways, such as inflammation, which is particularly dangerous for graft survival. In this review, the current evidence on the function of PCSK9 and the use of its inhibitors will be discussed, particularly in transplant patients, in which they may provide additional benefits.

Keywords: PCSK9; PCSK9 inhibitors; alirocumab; dyslipidemia; evolocumab; immunosuppressants; transplant.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Mechanisms by which PCSK9 leads to atherosclerosis. FVIII: coagulation factor VIII; LDL: low-density lipoprotein; LDL-R: low-density lipoprotein receptor; PCSK9: proprotein convertase subtilisin/kexin type 9.
Figure 2
Figure 2
Cardiovascular disease mechanisms in transplant patients. CVD: cardiovascular disease; PTDM: post-transplant diabetes mellitus. LDL: low-density lipoprotein.
See this image and copyright information in PMC

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