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New cholesterol drugs may beat statins, but price tag is high [ Op-ed ] 19/03/2017
New cholesterol drugs may beat statins, but price tag is high
Two different injectable drugs can lower cholesterol levels even further than statins do, potentially warding off future heart attacks or strokes, new research suggests. However, some heart experts question whether the pricey medications, one of which costs roughly $14,000 a year to take, perform well enough to make them worth the extra money. In fact, some cardiologists said the drugs should be reserved only for patients with the highest heart risks.

The drugs, evolocumab (Repatha) and inclisiran, both work by targeting PCSK9, an enzyme that regulates the liver\'s ability to remove "bad" LDL cholesterol from the bloodstream. By blocking the enzyme, the medications spur the body to screen out more cholesterol.

Clinical trial results showed that evolocumab was linked to a 15 percent reduction in the risk of major heart events in patients who are already taking statins due to heart disease. These events include sudden heart death, heart attack, stroke, hospitalization for angina, or surgery to reopen a blocked artery. Evolocumab was also associated with a 20 percent reduced risk of heart attack, stroke or sudden heart death, said lead researcher Dr. Marc Sabatine, chair of cardiovascular medicine at Brigham and Women\'s Hospital, in Boston. "In patients with heart and blood vessel disease who are already on a statin, we know now that adding evolocumab reduces the risk of future heart attack or stroke, and it does it safely," Sabatine said. Unfortunately, evolocumab did not reduce a person\'s overall risk of death, or their risk of dying from heart disease, noted Dr. Gregg Stone, director of cardiovascular research and education at NewYork-Presbyterian/Columbia University Medical Center.

"The disappointing thing to me was there was absolutely no difference in mortality," Stone said.

Sabatine said that evolocumab, which costs about $14,000 a year, has been on the market for about two years now. It works by using artificial antibodies to block the receptors for PCSK9 in the liver. By comparison, inclisiran is a next-generation PCSK9 inhibitor that works by reducing the ability of the liver to produce the enzyme, explained lead researcher Dr. Kausik Ray, a cardiologist at Imperial College London, in the United Kingdom.
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