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Alirocumab Administration Experience to Achieve Low Density Lipoprotein Cholesterol Target Levels in Secondary Prevention of Cardiovascular Disease

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Aim. To study the effects of proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor, alirocumab, on lipid levels in patients who receive secondary prevention of cardiovascular diseases (CVD) and require enhanced lipid-lowering therapy.

Material and methods. The study included 49 patients (aged of 61.53±1.14 years; 31 [63.3%] men) receiving alirocumab who did not reach the target low density lipoprotein cholesterol (LDL-C) concentrations despite the ongoing optimal lipid-lowering therapy. In all patients, the initial level of lipids was evaluated, as well as their parameters after subsequent alirocumab injections.

Results. LDL-C serum level significantly decreased after the first injection compared to the initial level from 2.92±0.22 to 1.65±0.19 mmol/L (p<0.001; Δ45.31±3.61%) and down to 1.74±0.17 mmol/L for the entire study period (p<0.001; Δ41.52±2.69%). The change in LDL-C level between injections did not show statistically significant differences (p=0.141). A direct strong statistically significant correlation between the LDL-C level after the first injection and its average values for the entire observation period was found (r=0.958, p<0.001).

Conclusion. The results of the study indicate that the PCSK9 inhibitor, alirocumab, in patients who need secondary prevention of CVD shows a significant additional decrease in the concentration of LDL-C after the first injection. At the same time, approximately half of the patients were able to achieve the recommended levels of LDL-C. The persistence of the achieved low LDL-C levels over time demonstrated that the average concentration of LDL-C during the observation corresponded to the values after the first injection. This finding shows that there is no need for constant monitoring of lipid metabolism parameters when prescribing such therapy.

About the Authors

A. E. Nikitin
Central Clinical Hospital of the Russian Academy of Sciences
Russian Federation

Alexey E. Nikitin – MD, PhD, Professor, Head Physician

Litovskiy bulvar 1A, Moscow, 117593

E. E. Averin
Central Clinical Hospital of the Russian Academy of Sciences
Russian Federation

Evgeny E. Averin – MD, PhD, Professor, Head of Research and Education Center

Litovskiy bulvar 1A, Moscow, 117593

D. E. Rozhkov
Central Clinical Hospital of the Russian Academy of Sciences
Russian Federation

Denis E. Rozhkov – MD, Head of the Admission Department

Litovskiy bulvar 1A, Moscow, 117593

A. V. Sozykin
Central Clinical Hospital of the Russian Academy of Sciences
Russian Federation

Alexey V. Sozykin – MD, PhD, Professor, Head of the Department of Interventional Radiology Diagnostic and Treatment Methods

Litovskiy bulvar 1A, Moscow, 117593

G. A. Procenko
Central Clinical Hospital of the Russian Academy of Sciences
Russian Federation

Gulnara A. Procenko – MD, Head of the 3rd Therapeutic Department

Litovskiy bulvar 1A, Moscow, 117593


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For citation:

Nikitin A.E., Averin E.E., Rozhkov D.E., Sozykin A.V., Procenko G.A. Alirocumab Administration Experience to Achieve Low Density Lipoprotein Cholesterol Target Levels in Secondary Prevention of Cardiovascular Disease. Rational Pharmacotherapy in Cardiology. 2020;16(1):33-39. (In Russ.)

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