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LDL-cholesterol reduction in chronic kidney disease: options beyond statins
- Source :
- Current Opinion in Nephrology & Hypertension. 29:480-488
- Publication Year :
- 2020
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2020.
-
Abstract
- Purpose of review Individuals with chronic kidney disease (CKD) are at increased risk of atherosclerotic cardiovascular disease (ASCVD) events. LDL cholesterol (LDL-C) is a key modifiable cause of ASCVD and lowering LDL-C with statins reduces the risk of ASCVD events in a wide range of populations, including those with CKD. This review considers the utility of recently developed nonstatin LDL-C-lowering therapies in CKD. Recent findings The cholesterol absorption inhibitor, ezetimibe, reduces LDL-C by 15-20% and is well tolerated in CKD. Monoclonal antibodies (mAbs) targeting proprotein convertase subtilisin kexin type 9 (PCSK9) reduce LDL-C by 50-60% and reduce the risk of ASCVD events. However, these agents require self-administration by subcutaneous injection every 2-4 weeks. The PCSK9 synthesis inhibitor, inclisiran, is administered approximately 6 monthly and may be more suitable for widespread use, although outcome trials are awaited. These PCSK9 targeting therapies require no dose adjustment in CKD and have no drug interactions. Summary Statins and ezetimibe are safe and reduce ASCVD risk in CKD populations. PCSK9 targeting agents may be useful in high-risk CKD patients, including those with prior ASCVD.
- Subjects :
- Drug
Oncology
medicine.medical_specialty
medicine.drug_class
media_common.quotation_subject
030232 urology & nephrology
030204 cardiovascular system & hematology
03 medical and health sciences
0302 clinical medicine
Ezetimibe
Internal medicine
Internal Medicine
medicine
Humans
Cholesterol absorption inhibitor
Renal Insufficiency, Chronic
media_common
Ldl cholesterol
Atherosclerotic cardiovascular disease
business.industry
PCSK9
PCSK9 Inhibitors
Antibodies, Monoclonal
Cholesterol, LDL
Atherosclerosis
medicine.disease
Increased risk
Nephrology
lipids (amino acids, peptides, and proteins)
Hydroxymethylglutaryl-CoA Reductase Inhibitors
business
Kidney disease
medicine.drug
Subjects
Details
- ISSN :
- 14736543 and 10624821
- Volume :
- 29
- Database :
- OpenAIRE
- Journal :
- Current Opinion in Nephrology & Hypertension
- Accession number :
- edsair.doi.dedup.....6182c3c0a8d652039140245655d19c7f