PCSK9 inhibitors may be especially helpful if you’ve had high cholesterol throughout your life or if you have a genetic condition causing high cholesterol.

Story by: David Steen Martin on January 2, 2024

PCSK9 inhibitors are an injectable, cholesterol-lowering medication for people who have tried other treatments and still have high cholesterol.

This medication may be especially helpful if you’ve had high cholesterol throughout your life or if you have a genetic condition called hypercholesterolemia that is causing high cholesterol.

PCSK9 inhibitors reduce your low-density lipoprotein cholesterol, also known as LDL or “bad” cholesterol. Too much LDL cholesterol in the bloodstream can clog your arteries with plaque, increasing your risk of heart attack and stroke.

Research has shown PCSK9 inhibitors reduce LDL cholesterol levels by an average of 50% to 60% and cut your risk of heart attack by almost one-third. There are two Food and Drug Administration-approved PCSK9 inhibitors, which sell under the brand names Praluent and Repatha.

“Most people don’t need PCKS9 inhibitors, because they are able to control their high cholesterol either through dietary interventions or other medications. Statin drugs are typically the first-line medication for patients with high LDL cholesterol, said Loyal W. Walker, M.D., family medicine provider at Norton Community Medical Associates primary care offices in Middletown and Taylorsville.

Statins were first introduced in the 1980s and have been shown to be safe and effective for most people.

PCSK9 inhibitors are relatively new medications, approved by the FDA in 2015. They are also more expensive than statins.

If you are prescribed PCSK9 inhibitors, you’ll receive an injection under the skin every two weeks or every month, depending on the dose. You can receive the injection in the abdomen, thigh or upper arm.

The injections can be done by your provider, or you can do them yourself. You also will receive periodic blood tests so your provider can see how well the medication is working.

If you are injecting the medication yourself, your provider will teach you how to prepare and inject the medication. Praluent can be self-injected using an autoinjector, which is a single-dose pre-filled pen, or a single-dose pre-filled syringe. Repatha comes in three forms: an autoinjector, pre-filled pen and single-use Pushtronex system, which is an on-body infuser with a pre-filled cartridge.

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If PSCK9 inhibitors are effective in lowering your LDL, your provider may prescribe the drugs long term. You should continue taking the medication as long as your provider prescribes them.

Common side effects of PCSK9 inhibitors include fatigue and muscle pain. Rarer side effects include kidney or liver issues.

PCSK9 inhibitors work by increasing the body’s natural ability to clear LDL cholesterol from the bloodstream.

Typically, PCSK9 inhibitors are one part of an overall treatment plan that includes healthy lifestyle habits. This includes eating a healthy diet, exercising, managing stress and quitting smoking if you smoke. You may be prescribed a statin drug in addition to PCSK9 inhibitors.

Talk to your primary care provider to get tested for high cholesterol as part of an annual visit or discuss how to manage high cholesterol. Test results are always available via a free Norton MyChart account, and Norton Healthcare Express Services offers drive-thru lab work with a provider’s lab order.