medicina61巻1号

2024年01月発行

特集 その知見は臨床を変える?—エキスパートが解説! 内科における最新論文 糖尿病・内分泌・代謝

新たな脂質異常症治療薬—PCSK9阻害薬とベムペド酸のエビデンスと展望

著者： 若菜紀之¹

所属機関： ¹医療法人社団石鎚会京都田辺中央病院

ページ範囲：P.94 - P.98

Point
◎脂質異常症治療薬として従来はスタチンやエゼチミブが主流であったが，PCSK9阻害薬とベムペド酸が登場した．
◎PCSK9阻害薬は長期投与の安全性も確認されている．また，動脈硬化性心血管病（ASCVD）の二次予防で効果が示されており，心血管死や主要心血管イベント（MACE）の発症率低下も示されている．
◎急性冠症候群（ACS）患者は非責任病変を有しその予後が懸念されているが，PCSK9阻害薬によりプラークの安定化効果が示され薬物インターベンションが新たな治療法として期待されている．
◎CLEAR-OUTCOME試験でベムペド酸の効果と安全性が示唆され，スタチン不耐性患者の選択肢として期待されている．

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