(This is part 3 of a 4 part series. Sorry for the interruption yesterday. But, given the events in Charlston- and the world- I felt no choice but to interrupt the series.)
We are about to approve some new drugs to lower cholesterol. These drugs won’t require a daily swallow. Nope- instead, these require biweekly injections. They are the first new class of drugs that we can use to lower our cholesterol levels in about 3 decades.
Tons (OK, millions) of folks take statins now as a means to control their cholesterol levels. That’s not surprising since 1/3 of all adults (73 million) in the US are considered to have high LDL levels. These proposed new drugs seem to do a better job of lowering our “bad” cholesterol levels. (Of course, we don’t know which of the four “bad” cholesterol levels- or how much of each- are really in question…)
But, it’s not just lowering the LDL level- it’s the fact that a significant number of folks can’t tolerate some of the statins. Others develop liver damage from continued use of the statin therapies. These proposed new drugs are PCSK9 inhibitors; I’m sure that makes their actions crystal clear.
A PCSK9 inhibitor works on a subject’s liver. Because the liver is critical in the body’s actions to exude cholesterol from our blood. And, for those with reduced capabilities to self-regulate their cholesterol levels, this inhibitor works on the PCSK9 protein that interferes with the liver clearing the cholesterol levels in the blood.
There are actually two competing drugs- one offered by Sonfi and Regeneron and the other made by Amgen. They both seem to lower LDL levels by about 60%. (Pfizer’s version- a third choice- is not yet ready for prime time.) But, as I’ve said (see the other two articles in this mini-series that started last Thursday), lowered cholesterol levels do not directly translate to fewer strokes, to fewer heart attacks, or even to improve cardiovascular performance.
And, there’s another problem with electing to use these new drugs. We have no clues as to the long-term effects of the injections. They haven’t been around long enough.
Which means it’s time for me to mention the potentially more important issue. These drugs cost a fortune. You can expect to drop $ 10K a year should you elect to use them to keep your cholesterol in check. Compare that to (I am assuming you have conventional health insurance) less than $ 50 your statin therapy costs a year now.
The panel counters my argument by saying the new drugs are cheaper than the cost of bypass surgery or a coronary stent. But, that’s like saying it’s cheaper to take the shuttle between New York and DC (where Amtrak and Vamoose Bus offer the best deals) because the alternative is a private jet.
But, if someone IS truly monitoring their diet, taking statins, and still has elevated cholesterol, then maybe these drugs could have merit. (Which is why I still call for us to use Dr. Robert Krauss’ test to discern which of the four LDL are present in a subject.)
