Over the last 30 years, powerful drugs have become available to prevent or reduce plaque build up. Statins were first introduced in 1987, and have quickly become the cornerstone treatment. Statins are among the most widely used drugs, and most are available as generics and are very affordable at around $100 per year. Most people can markedly reduce their levels of bad cholesterol (LDL-C) to well below 100mg/dl.
In 2015, a new class of drug, known as PCSK9 inhibitors, was approved. These are powerful drugs that can reduce LDL to levels previously not thought possible. Many patients achieve levels of 30mg or less. The biggest concern of the injectable PCSK9 drugs is cost. They cost close to $40 per day.
We believe that patients who have a high plaque burden for their age could be an important target group for intensive preventive therapy. For some patients, that may require inclusion of PCSK9 inhibitors.