Treatment with a PCSK9 inhibitor is well tolerated and improves cardiovascular outcomes .
Although no overall benefit was noted in all-cause or cardiovascular mortality , such benefit may be achievable in patients with higher baseline low-density lipoprotein cholesterol
BACKGROUND We sought to examine the efficacy and safety of 2 PCSK9 ( proprotein convertase subtilisin/kexin type 9 ) inhibitors : alirocumab and evolocumab .
Randomized trial of the effects of simvastatin on cognitive functioning in hypercholesterolemic adults.
PURPOSE In our initial study of the potential effects of cholesterol-lowering interventions on cognitive functioning , treatment with lovastatin as compared with placebo caused performance decrements on several neuropsychological tests , whereas scores on other tests were unaffected . The current study was design ed to confirm and extend those findings . METHODS The study comprised 308 hypercholesterolemic adults between 35 and 70 years of age . Employing a r and omized double-blind design , we assigned participants to daily treatment with placebo , 10 mg of simvastatin , or 40 mg of simvastatin for 6 months . A neuropsychological test battery was administered to assess cognitive functioning at baseline and at the end of the treatment period . RESULTS A total of 283 subjects completed the study : 94 subjects on placebo , 96 taking 10 mg of simvastatin , and 93 taking 40 mg of simvastatin . Compared with placebo , decremental effects of simvastatin treatment were found on tests previously observed to be sensitive to statins ( P = 0.008 ; difference in summary z scores = 0.18 ; 95 % confidence interval [ CI ] : 0.07 to 0.29 ) and on tests not previously administered ( P = 0.04 ; difference in summary z scores = 0.17 ; 95 % CI : 0.05 to 0.29 ) , but not on tests previously observed to be insensitive to statins ( P = 0.84 ; difference in summary z scores = 0.02 ; 95 % CI : -0.07 to 0.10 ) . For the three tests specifically affected by simvastatin , effects on cognitive performance were small , manifest only as failure to improve during the 6 months of treatment ( compared with placebo ) , and were confounded by baseline differences on one test . CONCLUSION This study provides partial support for minor decrements in cognitive functioning with statins . Whether such effects have any long-term sequelae or occur with other cholesterol-lowering interventions is not known
Treatment with a PCSK9 inhibitor is well tolerated and improves cardiovascular outcomes .
Although no overall benefit was noted in all-cause or cardiovascular mortality , such benefit may be achievable in patients with higher baseline low-density lipoprotein cholesterol
BACKGROUND We sought to examine the efficacy and safety of 2 PCSK9 ( proprotein convertase subtilisin/kexin type 9 ) inhibitors : alirocumab and evolocumab .