In a viewpoint released today in The Journal of the American Medical Association Cardiovascular Special Issue, Mayo Clinic endocrinologists and researchers are warning against the “premature and widespread adoption” of a new type of drug that reduces cholesterol, PCSK-9 inhibitors. They argue that little is known about their long-term safety and efficacy on outcomes that matter to patients. Given the long track record of efficacy and safety and the low cost of statins, they think that it is premature to adopt PCSK-9 inhibitors as alternatives to statins.
The Food and Drug Administration has recently approved the new class of drugs for patients with high LDL-cholesterol who also have familial hypercholesterolemia or with clinical cardiovascular disease who are seeking secondary prevention or cannot tolerate statins. The Mayo experts are predicting four situations that will fuel abandoning statins in favor of the PCSK-9 inhibitors:
Patients who have muscle problems or other symptoms suggestive of statin intolerance.
Patients who have a heart attack or a stroke while using a statin.
Patients who may not to be taking statins every day.
Patients who have cholesterol levels that remain high despite statins.