What you need to know about the latest vaccine for cholesterol control (PCSK9 Inhibitors)

Are you also struggling with cholesterol ? Maybe you are taking the medicine prescribed by your doctor, controlling your diet , and exercising. But it is still difficult to lower your cholesterol levels, isn't it? Sometimes, no matter how hard you try, the bad cholesterol levels in your body can remain high. In this article, we are going to talk about a relatively new class of drugs that can help such people.

Simply put, what are these PCSK9 Inhibitors?

This may sound like a complicated name, but it works very simply. PCSK9 inhibitors are a class of drugs that lower cholesterol. Specifically, they target LDL (Low-Density Lipoprotein) cholesterol , which is the “bad cholesterol” that is harmful to our bodies. Some people have high cholesterol levels throughout their lives. For those people, this type of drug can be very helpful.

Okay, now let's see what the name `PCSK9` means. `PCSK9` is a special type of protein produced by our liver. The name of this protein is `proprotein convertase subtilisin/kexin type 9`. What it does is control things called `LDL receptors` in our body. Medical studies have found that if a person's body naturally produces more `PCSK9` protein, that person is more likely to have high cholesterol .

Who needs this medicine?

This is a very important question. Because this drug is not given to everyone with high cholesterol. There are generally two main situations in which your doctor may prescribe this `PCSK9 inhibitor` drug:

1. When cholesterol is not controlled by other medications: If you are already using other cholesterol-lowering medications, such as `(statins),` but your cholesterol levels are still high, you may consider this medication as the next step.

2. In certain genetic conditions: Some people have a hereditary, congenital condition of high cholesterol. This is called ``familial hypercholesterolemia`` in medical science.This medicine is also very helpful for people with this condition.

How does this medicine work inside the body?

To understand this, let's take a small example.

Imagine that your body has “cholesterol-catching hands.” We call these “LDL receptors.” These “receptors” are mostly found on the surface of our liver cells. These “hands” grab the bad cholesterol floating in the blood (LDL cholesterol) and take it into the liver. The liver then breaks down that cholesterol and removes it from the body. This is a normal process.

But there's a little villain here. That's the `(PCSK9)` protein we talked about earlier. This `PCSK9` protein works like a `scissors`. What it does is destroy those cholesterol-catching hands, that is, `LDL receptors`, and reduce their activity. When the `PCSK9` protein increases in the body, the number of `hands` that catch cholesterol decreases. Then the bad cholesterol in the blood cannot be removed by the liver and accumulates in the blood.

Now you probably understand what the `PCSK9 inhibitor` drug does. To be precise, this drug inhibits the `PCSK9` protein that works like a scissor. That means, when this drug is taken, the `PCSK9` protein cannot destroy those cholesterol-grabbing hands (LDL receptors).

What happens then?

• There are more active LDL receptors.
• These active 'hands' capture a lot of the bad cholesterol in the blood and deliver it to the liver.
• The liver removes that cholesterol from the body.

The end result is a significant reduction in the level of bad cholesterol in your blood.

How effective is this medicine? And what are the types?

PCSK9 inhibitors are a class of drugs that have been shown to be very effective for some people. Some studies have found that these drugs can reduce bad cholesterol (LDL cholesterol) levels by up to 70% and can also reduce the risk of heart attack by about a third.

There are two types of `PCSK9 inhibitors` that are currently most commonly used in Sri Lanka and the world:

• `Alirocumab` (brand name: Praluent®)
• `Evolocumab` (brand name: Repatha®)

How do you take the medicine?

This is not a pill to take every day. `PCSK9 inhibitors` are given as an injection.You will usually need to get this vaccine every few weeks or every few months, as determined by your doctor.

While taking this treatment, your doctor will do regular blood tests to check how well the medicine is working. Sometimes this medicine may be given alone, and other times it may be given in combination with a medicine you are already taking, such as a statin.

What are the benefits and possible side effects?

Like any medicine, this medicine can have both benefits and minor side effects. However, most people do not experience serious side effects.

Is the medicine alone enough? No, this is part of a bigger plan.

This is very important. Whether you take a PCSK9 inhibitor or another cholesterol-lowering medication, it's only one part of your overall treatment plan. There are many other things you can do to protect your heart health, without relying solely on medication.

• A good diet: Eat less oil, sugar, and salt, and more vegetables, fruits, greens, and foods high in fiber.
• Exercise: Engage in heart-healthy exercise, such as brisk walking, running, or cycling, at least a few days a week.
• Stress management: Relaxing your mind through things like meditation and yoga.
• Good sleep: Get at least 7-8 hours of sleep every night.
• Avoid smoking: If you smoke, stop it completely.

You will get the best results when you combine these lifestyle changes with medication.

PCSK9 inhibitors, cholesterol, cholesterol, LDL cholesterol, heart attack, stroke, familial hypercholesterolemia, statin, Alirocumab, Evolocumab