Minireviews
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Cardiol. Jul 26, 2024; 16(7): 397-401
Published online Jul 26, 2024. doi: 10.4330/wjc.v16.i7.397
Proprotein convertase subtilisin/kexin type 9 inhibitors in peripheral artery disease: A review of efficacy, safety, and outcomes
Moiud Mohyeldin, Ahmed S Abuelgasim, Ahmed MG Mustafa
Moiud Mohyeldin, Ahmed S Abuelgasim, Ahmed MG Mustafa, Department of Internal Medicine, University of Medical Sciences and Technology, Khartoum 11111, Sudan
Author contributions: Mohyeldin M contributed to conceptualization, methodology, visualization, supervision, and project administration; Mohyeldin M was responsible for the overall integrity of the work, from inception to the published article; Mohyeldin M, Abuelgasim AS, and Mustafa AMG contributed to the investigation, writing of the original draft and writing, reviewing, and editing; Abuelgasim AS and Mustafa AMG contributed to the resources; All authors have read and approved the final version of the manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Moiud Mohyeldin, MD, Doctor, Staff Physician, Department of Internal Medicine, University of Medical Sciences and Technology, Ebed Khatim St, Khartoum 11111, Sudan. moiudahmed@gmail.com
Received: April 16, 2024
Revised: May 20, 2024
Accepted: June 5, 2024
Published online: July 26, 2024
Processing time: 98 Days and 20.8 Hours
Abstract

Peripheral artery disease (PAD) is a common condition characterized by atherosclerosis in the peripheral arteries, associated with concomitant coronary and cerebrovascular diseases. Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors are a class of drugs that have shown potential in hypercholesterolemic patients. This review focuses on the efficacy, safety, and clinical outcomes of PCSK9 inhibitors in PAD based on the literature indexed by PubMed. Trials such as FOURIER and ODYSSEY demonstrate the efficacy of evolocumab and alirocumab in reducing cardiovascular events, offering a potential treatment option for PAD patients. Safety evaluations from trials show few adverse events, most of which are injection-site reactions, indicating the overall safety profile of PCSK9 inhibitors. Clinical outcomes show a reduction in cardiovascular events, ischemic strokes, and major adverse limb events. However, despite these positive findings, PCSK9 inhibitors are still underutilized in clinical practice, possibly due to a lack of awareness among care providers and cost concerns. Further research is needed to establish the long-term effects and cost-effectiveness of PCSK9 inhibitors in PAD patients.

Keywords: Peripheral artery disease, Proprotein convertase subtilisin/kexin type 9 inhibitors, Cardiovascular risk reduction, Evolocumab, Alirocumab, Lipid-lowering therapy, Major adverse limb events, Clinical outcomes, Cost-effectiveness, Safety profile

Core Tip: Evolocumab and alirocumab, which belong to the class of proprotein convertase subtilisin/kexin type 9 inhibitors, are effective in reducing cardiovascular events and major adverse limb events in peripheral artery disease patients. Despite their proven benefits, these inhibitors are underutilized in clinical practice, often due to providers’ lack of awareness and concerns about cost. This highlights the need for further research to assess the long-term effects of these inhibitors and their cost-effectiveness for specific patient groups.