Abstract
Background: Evolocumab is an expensive proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor which has been shown to significantly improve cardiovascular outcomes in high risk patients. Methods: This is a case study describing a stepwise approach to “PCSK9 inhibitor non-response” in a patient with familial hypercholesterolaemia. There are a few described pathophysiological mechanisms for “PCSK9 inhibitor non-response” including homozygous LDL-C receptor-negative mutations and alteration in the binding site of PCSK9 inhibitors. Results: We report the case of a 41-year-old woman with familial hypercholesterolaemia and premature cardiovascular disease, who was non-responsive to the action of PCSK9 inhibitor solely due to the incorrect subcutaneous injection technique. Conclusions: This case study highlights the importance of reviewing the accuracy of SC injection technique in patients with minimal or no response to PCSK9 inhibitors prior to proceeding to costly genetic testing.
| Original language | English |
|---|---|
| Pages (from-to) | e21–e22 |
| Number of pages | 2 |
| Journal | Heart Lung and Circulation |
| Volume | 28 |
| DOIs | |
| Publication status | Published - Mar 2019 |
Keywords
- Coronary artery disease
- Evolocumab
- Familial hypercholesterolaemia
- PCSK9 inhibitor
Cite this
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A Small Change Can Make a Big Difference : A Lesson from Evolocumab. / Mirzaee, Sam; Thein, Paul M.; Wong, Dennis; Nasis, Arthur.
In: Heart Lung and Circulation, Vol. 28, 03.2019, p. e21–e22.Research output: Contribution to journal › Article › Other › peer-review
TY - JOUR
T1 - A Small Change Can Make a Big Difference
T2 - A Lesson from Evolocumab
AU - Mirzaee, Sam
AU - Thein, Paul M.
AU - Wong, Dennis
AU - Nasis, Arthur
PY - 2019/3
Y1 - 2019/3
N2 - Background: Evolocumab is an expensive proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor which has been shown to significantly improve cardiovascular outcomes in high risk patients. Methods: This is a case study describing a stepwise approach to “PCSK9 inhibitor non-response” in a patient with familial hypercholesterolaemia. There are a few described pathophysiological mechanisms for “PCSK9 inhibitor non-response” including homozygous LDL-C receptor-negative mutations and alteration in the binding site of PCSK9 inhibitors. Results: We report the case of a 41-year-old woman with familial hypercholesterolaemia and premature cardiovascular disease, who was non-responsive to the action of PCSK9 inhibitor solely due to the incorrect subcutaneous injection technique. Conclusions: This case study highlights the importance of reviewing the accuracy of SC injection technique in patients with minimal or no response to PCSK9 inhibitors prior to proceeding to costly genetic testing.
AB - Background: Evolocumab is an expensive proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor which has been shown to significantly improve cardiovascular outcomes in high risk patients. Methods: This is a case study describing a stepwise approach to “PCSK9 inhibitor non-response” in a patient with familial hypercholesterolaemia. There are a few described pathophysiological mechanisms for “PCSK9 inhibitor non-response” including homozygous LDL-C receptor-negative mutations and alteration in the binding site of PCSK9 inhibitors. Results: We report the case of a 41-year-old woman with familial hypercholesterolaemia and premature cardiovascular disease, who was non-responsive to the action of PCSK9 inhibitor solely due to the incorrect subcutaneous injection technique. Conclusions: This case study highlights the importance of reviewing the accuracy of SC injection technique in patients with minimal or no response to PCSK9 inhibitors prior to proceeding to costly genetic testing.
KW - Coronary artery disease
KW - Evolocumab
KW - Familial hypercholesterolaemia
KW - PCSK9 inhibitor
UR - http://www.scopus.com/inward/record.url?scp=85045731998&partnerID=8YFLogxK
U2 - 10.1016/j.hlc.2018.03.009
DO - 10.1016/j.hlc.2018.03.009
M3 - Article
VL - 28
SP - e21–e22
JO - Heart Lung and Circulation
JF - Heart Lung and Circulation
SN - 1443-9506
ER -