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Updated: Jan 28, 2026

A High-Throughput Luciferase Assay to Evaluate Proteolysis of the Single-Turnover Protease PCSK9
Published on: August 28, 2018
[PCSK9 inhibitors: What place in the management of dyslipidemia?]
Pierre Sabouret1, Michel Farnier2, Etienne Puymirat3
1Pitié-Salpétrière Hospital and ACTION-Group, Heart Institute, Cardiology Department, 47-83, boulevard de l'Hôpital, 75013 Paris, France.
Abstract:
PCSK9 protein is a key regulator of LDL receptor activity. Gain-of-function mutations in PCSK9 are one of the genetic causes of familial hypercholesterolemia. Conversely, loss-of-function mutations are associated with lower levels of LDL cholesterol and reduced coronary heart disease. Monoclonal antibodies targeting PCSK9 are highly efficacious in lowering LDL-C levels, with a good tolerability and safety profile. Two PCSK9 inhibitors, alirocumab and evolocumab, have demonstrated a cardiovascular benefit in addition to statin therapy in patients with established cardiovascular disease. A recent European consensus has defined the candidates for PCSK9 inhibitors, e.g., patients with established cardiovascular disease and patients with familial hypercholesterolemia in primary prevention, with substantially elevated LDL-C levels despite maximally tolerated statin with or without ezetimibe therapy.
Insights
PCSK9 inhibitors, like alirocumab and evolocumab, effectively lower LDL cholesterol. These treatments offer cardiovascular benefits for high-risk patients, even with statin therapy.
Area of Science:
- Biochemistry
- Genetics
- Cardiology
Background:
- PCSK9 protein regulates LDL receptor activity.
- PCSK9 mutations cause familial hypercholesterolemia or lower LDL cholesterol.
- Loss-of-function PCSK9 mutations correlate with reduced heart disease risk.
Purpose of the Study:
- To review the efficacy and safety of PCSK9 inhibitors.
- To discuss the cardiovascular benefits of PCSK9 inhibition.
- To outline European consensus guidelines for PCSK9 inhibitor candidates.
Main Methods:
- Review of clinical trial data for PCSK9 inhibitors.
- Analysis of genetic studies on PCSK9 function.
- Synthesis of European consensus recommendations.
Main Results:
- PCSK9 monoclonal antibodies are highly effective in reducing LDL-C.
- Alirocumab and evolocumab show cardiovascular benefits alongside statins.
- European guidelines identify specific patient groups for PCSK9 inhibitor therapy.
Conclusions:
- PCSK9 inhibitors represent a significant advancement in managing hypercholesterolemia.
- These therapies offer a valuable option for high-risk cardiovascular patients.
- Targeted use of PCSK9 inhibitors is supported by clinical evidence and expert consensus.
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