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Case reports of proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibition nonresponse |
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| Authors: | Anum Saeed Salim S. Virani Peter H. Jones Christie M. Ballantyne Vijay Nambi |
| Affiliation: | 1. Section of Cardiovascular Research, Department of Medicine, Baylor College of Medicine, Houston, TX, USA;2. Center for Cardiovascular Disease Prevention, Methodist DeBakey Heart and Vascular Center, Houston, TX, USA;3. Section of Cardiology, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA;4. Health Policy, Quality & Informatics Program, Michael E. DeBakey Veterans Affairs Medical Center Health Services Research and Development Center for Innovations, Houston, TX, USA;5. Section of Health Services Research, Department of Medicine, Baylor College of Medicine, Houston, TX, USA;6. Section of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, TX, USA |
| Abstract: | Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors, a novel class of monoclonal antibodies, reduces low-density lipoprotein cholesterol levels and improves cardiovascular outcomes. Given the short time frame, these agents have been available for use; reports of nonresponse to the PCSK9 inhibitor therapy are scarce in literature. We describe 2 cases with substantially lesser than expected low-density lipoprotein cholesterol lowering on PCSK9 therapy. Nonresponse to PCSK9 inhibition was attributed to autosomal recessive hypercholesterolemia (secondary to low-density lipoprotein receptor adaptor protein 1 mutation) and plasmapheresis after PCSK9 inhibitor drug injections. Additional PCSK9 inhibitor nonresponders are likely to emerge as the use of these agents increases overtime. |
| Keywords: | Coronary artery disease Cardiovascular diseases Dyslipidemia Hypercholesterolemia PCSK9 inhibitors |
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