If you need medicine to lower your cholesterol, chances are your doctor will prescribe a statin. But these drugs aren’t always enough. And some people can’t take them because of their side effects. That’s why experts are calling new drugs known
If you need medicine to lower your cholesterol, chances are your doctor will prescribe a statin. But these drugs aren’t always enough. And some people can’t take them because of their side effects. That’s why experts are calling new drugs known as PCSK9 inhibitors a game-changer.
Studies show that PCSK9 inhibitors have a powerful effect and in some cases can actually prevent heart attacks or strokes. They can be taken on their own or in addition to a statin. But they’re also much more expensive than other cholesterol drugs.
How Do They Work?
PCSK9 inhibitors are proteins made in a laboratory. They target other proteins in your body, specifically your liver.
Your liver cells have receptors that sweep away excess cholesterol. But another protein called PCSK9 destroys them. That’s where inhibitors come in. They latch onto PCSK9 proteins and block them from acting. The result: More receptors are able to do their job. This lowers the amount of LDL cholesterol in your blood.
In fact, one review of studies found that PCSK9 inhibitors slash LDL levels by an average of 47%. This protects your heart: The drugs were shown to reduce the risk of heart attack by 27%.
What Makes Them Different?
Statins work in a different way. One main way they work is to block an enzyme that your liver needs to make cholesterol. This lowers your LDL level. Statins are taken as pills, while PCSK9 inhibitors come only as shots.
PCSK9 inhibitors can be used with statins to boost their benefit. The combination can lower LDL levels by more than half.
Who Should Take Them?
Statins are the most common drug that lowers cholesterol. Doctors usually prescribe them first because they get the job done and most people can afford them.
But they don’t work for everyone. You may want to ask your doctor about PCSK9 inhibitors if:
- You have genetic high cholesterol: About 600 thousand Americans have a genetic disorder called familial hypercholesterolemia. It affects how your body processes cholesterol. For most people with this condition, even the highest dose of statins won’t bring their LDL cholesterol down to a healthy level.
- You’re at risk for heart attack or stroke: If you already have heart disease and other medications, like statins, aren’t working, your doctor may consider PCSK9 inhibitors.
- You can’t take statins: About 10% to 20% of people who do have side effects, like muscle pain, cramps, or weakness. They can also cause liver damage, confusion, memory loss, or a rise in blood sugar.
Who Shouldn’t Take Them?
Most people with high cholesterol don’t need PCSK9 inhibitors. The FDA has only approved alirocumab and evolocumab for people with genetic high cholesterol or serious heart disease including those who’ve already had a heart attack or stroke and who need their LDL cholesterol lower. If you don’t have either of these conditions, your doctor will likely recommend another treatment.
When Will the Doctor Prescribe Them?
He’ll try different treatments before he gives you PCSK9 inhibitors. The first is usually lifestyle changes. He’ll tell you to eat right and get more exercise. Both will help lower your cholesterol. You’ll likely need 