{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,3]],"date-time":"2025-08-03T04:37:01Z","timestamp":1754195821084},"reference-count":15,"publisher":"Oxford University Press (OUP)","issue":"14","license":[{"start":{"date-parts":[[2017,9,1]],"date-time":"2017-09-01T00:00:00Z","timestamp":1504224000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"},{"start":{"date-parts":[[2017,9,1]],"date-time":"2017-09-01T00:00:00Z","timestamp":1504224000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2017,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Familial hypercholesterolemia is the elective clinical condition that deserves the maximal personalisation in lipid-lowering therapy, especially in the presence of statin intolerance. Proprotein convertase subtilisin\/kexin type 9 (PCSK9) inhibitors represent a promising approach to lower low-density lipoprotein (LDL) cholesterol.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We enrolled 18 patients (mean age 62\u2009\u00b1\u20098 years, 72% men) affected by heterozygous familial hypercholesterolemia and cardiovascular disease, with a history of statin intolerance assigned to PCSK9 inhibitors. Six patients were also on LDL apheresis. Associated Lp(a)-hyperlipoproteinemia (defined as &amp;gt;60\u2009mg\/dl) was observed in two out of 18 subjects. PCSK9 inhibitor injectable monoclonal antibodies were administered, every 2 weeks, on top of patient therapy for 12\u2009\u00b1\u20094 weeks (evolocumab in 15 subjects, alirocumab in three subjects).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>After 3 months (12\u2009\u00b1\u20094 weeks) of therapy, a decrease in total cholesterol (\u201335%), LDL cholesterol (\u201351%) and Lp(a) levels (\u201320%) was observed. Five out of 18 patients reached LDL cholesterol levels of &amp;lt;70\u2009mg\/dl, seven showed LDL cholesterol values between 71 and 100\u2009mg\/dl, and six out of 18 still had LDL cholesterol levels above 100\u2009mg\/dl. Among the six patients with LDL cholesterol levels &amp;gt;100\u2009mg\/dl, three were already on LDL apheresis before the PCSK9 inhibitor treatment, while three were referred to LDL apheresis treatment. Adverse events were reported in two out of 18 patients on evolocumab: one presented with flu-like syndrome and the other reported episodes of mild difficulty in maintaining concentration.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>PCSK9 inhibitors represent a novel therapeutic tool for patients with familial hypercholesterolemia who are intolerant to statins. However, more data are needed before cleaning up the old therapeutic armamentarium, such as LDL apheresis, which is likely to preserve its valuable role also in the new lipid-lowering era.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1177\/2047487317712419","type":"journal-article","created":{"date-parts":[[2017,5,30]],"date-time":"2017-05-30T10:38:07Z","timestamp":1496140687000},"page":"1528-1531","update-policy":"http:\/\/dx.doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":11,"title":["Statin intolerance in heterozygous familial hypercolesterolemia with cardiovascular disease: After PCSK-9 antibodies what else?"],"prefix":"10.1093","volume":"24","author":[{"given":"Francesco","family":"Sbrana","sequence":"first","affiliation":[{"name":"U.O. Lipoapheresis and Center for Inherited Dyslipidemias, Fondazione Toscana Gabriele Monasterio, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Beatrice","family":"Dal Pino","sequence":"additional","affiliation":[{"name":"U.O. Lipoapheresis and Center for Inherited Dyslipidemias, Fondazione Toscana Gabriele Monasterio, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Federico","family":"Bigazzi","sequence":"additional","affiliation":[{"name":"U.O. Lipoapheresis and Center for Inherited Dyslipidemias, Fondazione Toscana Gabriele Monasterio, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Ripoli","sequence":"additional","affiliation":[{"name":"U.O. Lipoapheresis and Center for Inherited Dyslipidemias, Fondazione Toscana Gabriele Monasterio, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claudio","family":"Passino","sequence":"additional","affiliation":[{"name":"U.O. Cardiologia e Medicina Cardiovascolare, Fondazione Toscana Gabriele Monasterio, Italy"},{"name":"Institute of Life Science, Scuola Superiore Sant\u2019Anna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alessandra","family":"Gabutti","sequence":"additional","affiliation":[{"name":"U.O. Cardiologia e Medicina Cardiovascolare, Fondazione Toscana Gabriele Monasterio, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emilio M","family":"Pasanisi","sequence":"additional","affiliation":[{"name":"U.O. Cardiologia e Medicina Cardiovascolare, Fondazione Toscana Gabriele Monasterio, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christina","family":"Petersen","sequence":"additional","affiliation":[{"name":"U.O. 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