Expanding the Role of PCSK9 Inhibitors in ASCVD Treatment

The panelists discuss how PCSK9 inhibitors are reshaping ASCVD treatment, highlighting data from pivotal trials such as FOURIER and ODYSSEY Outcomes, which demonstrated significant reductions in cardiovascular events with evolocumab and alirocumab. The experts explain that these monoclonal antibodies effectively neutralize circulating PCSK9, producing substantial and sustained reductions in LDL-C when added to statin therapy. They also discuss the emergence of inclisiran, an siRNA therapy that inhibits hepatic PCSK9 synthesis and allows for twice-yearly dosing, offering a practical advantage for adherence and sustained lipid control. The panel notes that these therapies are now being considered earlier in the ASCVD treatment algorithm, especially for patients with recurrent events or persistently elevated LDL-C despite maximally tolerated statins and ezetimibe. They acknowledge ongoing challenges with access and reimbursement, but agree that broader, earlier integration of PCSK9-targeted therapies represents a key opportunity to improve long-term outcomes in high-risk patients.