Alirocumab is a monoclonal antibodies medication that inhibits activity on proprotein convertase subtilisin keexin type 9 (PCSK9). It has been approved by the US FDA as an adjunct to diet and as a maximum tolerated statins. For the treatment of adults with heterozygous familial hypercholesterolemia (HeFH) or clinical atherosclerotic cardiovascular disease requiring additional reduction of LDL-C. Whether used as monotherapy or in combination with a statin, they typically reduce LDL cholesterol levels by 50 to 60 percent. Studies have shown that transgenic mice that overexpress PCSK9 have decreased LDL-R function and elevated LDL-cholesterol, while PCSK9 knockout mice have increased LDL-R activity and low LDL cholesterol levels. A longitudinal epidemiological study found that subjects with the deletion of the PCSK9 functional mutation had a slight reduction in LDL cholesterol levels and a significant reduction in coronary heart disease.
