And diabetes. Let us talk about familial
First and foremost you pay attention to cholesterolemia.
What does that mean to you? It means that you cannot
help it, especially if it is familial. So
genetically speaking, there is something taking
place in your patient in which there is going
to be accumulation of LDL. Next, if there is
accumulation of LDL, that means hypercholesterolemia,
remember a couple of things here. This brings
us to type II hyperlipidemia. If you are unclear
about that, please make sure that you go back
to some of our discussions where I specifically
have told you how to take care of LDL receptors.
Now the biggest drug that has now come out
in terms of proper management of hypercholesterolemia.
In many times, this will be the first place where
you're hearing this, which is good for you.
Because you will be on top of all of your medicine.
There is something called PCSK-9 and this
is what I was attempting to enunciate, well
it is proprotein convertase subtilisin kexin 9.
Now this is one of your monoclonal antibodies
and on your licensing boards that is one of
your monoclonal antibody either known as alirocumab
or the other one is evolocumab. You pay attention
to the suffix -locumab. What does this do? It
is a serum protease. What about this? This
is not a pharmocology lecture, but I need
to introduce this to you because this is a
vital discussion. Now, this patient is probably
been on a statin already, maybe proven to the
refractory. Is that clear? I need you to pay attention.
Many of you, this may be very much new information,
but absolutely mandatory. So the patient is
already on statin, that you know everything
about. If you don't well you'll learn about in pharm.
But now what is important is the fact that this
particular type of mutation then results in
diminishment or decreased activity
of LDL receptors. If there is a way in which
you could then inhibit this particular mutation,
known as proprotein convertase subtilisin kexin,
then you will be able to improve
the patient's prognosis dramatically actually
and that is what researchers now shown us.
As you go through here, you will learn a little
bit more of loss of function mutation most
commonly associated with reduction in both
LDL, cholesterol and risk of IHD. LDL, cholesterol,
IHD is ischemic heart disease. And if there
is a way in which you can inhibit this, then
you will increase the outcome. Take a look
at this. Reduces LDL cholesterol by up to
70 percent. If there is one particular point
that you want to take away from this lecture,
with this drug, is the fact that you are going
to have an amazing decrease, a dramatic decrease
in LDL cholesterol and, therefore, reduce
the event of ischemic heart disease. Is that
important? Oh! My goodness yes.