How do different cholesterol medicines work?

Original Title

Therapeutic PCSK9 targeting: Inside versus outside the hepatocyte?

Not medical advice. For informational purposes only. Always consult a healthcare professional. Terms

Summary

Some medicines grab bad cholesterol helpers in the blood, while others stop the body from making them in the liver. Both help lower bad cholesterol even more when used with regular pills.

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Surprising Findings

Monoclonal antibodies cause a compensatory rise in plasma PCSK9 levels, while inclisiran reduces them.

It’s counterintuitive that blocking a protein outside the cell would make the body produce more of it — like stepping on the brake and the car accelerating.

Practical Takeaways

For high-risk patients not reaching cholesterol goals on statins, PCSK9 inhibitors can provide up to an extra 50% LDL-C reduction.

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