Clinical Medicine Reviews in Therapeutics

The role of low-density lipoprotein cholesterol (LDL-C) in the pathophysiology of atherosclerosis is well recognized, and statin therapy represents the standard of care for LDL-C lowering and reduction of cardiovascular risk. However, many patients fail to achieve LDL-C goals, whereas others are intolerant to statins due to side effects. Unfortunately, until recently, the efficacy of other nonstatin LDL-C–lowering agents was limited, achieving an LDL-C reduction of no more than 20%. Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors represent a new class of LDL-lowering agents, producing large reductions in LDL-C. Alirocumab is a PCSK9 inhibitor, which was recently approved by the Food and Drug Administration as an adjunct to diet and maximally tolerated statin therapy for treatment of adults with heterozygous familial hypercholesterolemia or clinical atherosclerotic cardiovascular disease who require additional lowering of LDL-C levels. This review aims to provide the current clinical and scientific data pertaining to the treatment of hypercholesterolemia with alirocumab.