PCSK9 inhibitors have significantly reshaped the management of hypercholesterolemia and cardiovascular disease risk. Agents such as evolocumab and alirocumab facilitate increased hepatic clearance of LDL cholesterol by enhancing LDL receptor recycling, resulting in substantial reductions in LDL-C. This is particularly beneficial for patients with statin intolerance or familial hypercholesterolemia, where traditional therapies may fall short.
In addition to PCSK9 inhibitors, newer agents—including bempedoic acid, inclisiran, and advanced fibrates—target diverse pathways to further lower LDL-C, triglycerides, and non-HDL cholesterol. These novel therapies are especially relevant for individuals with established atherosclerotic cardiovascular disease who require more intensive lipid-lowering strategies.
Clinical implementation involves tailoring these therapies within personalized treatment regimens, alongside lifestyle interventions such as dietary modification, increased physical activity, and weight management. Evidence from recent studies demonstrates that aggressive LDL-C reduction with these agents can meaningfully reduce the risk of myocardial infarction, stroke, and cardiovascular death. Ongoing monitoring of lipid profiles, medication adherence, and potential adverse effects remains critical to optimizing patient outcomes.
In summary, the integration of advanced pharmacological agents with comprehensive cardiovascular prevention strategies allows clinicians to more effectively manage dyslipidemia, slow atherosclerosis progression, and improve long-term cardiovascular prognosis in high-risk populations.