Peter Attia· MD
so that what the pcsk9 inhibitor is doing is it's inhibiting pcsk9 and therefore inhibiting the protein that degrades not just the LDL receptor but these other receptors that clear LP little a
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The evidence is convergent. Multiple independent sources reach the same conclusion, the underlying mechanism is well-characterized, and even the field's most cautious voices treat it as worth doing.
so that what the pcsk9 inhibitor is doing is it's inhibiting pcsk9 and therefore inhibiting the protein that degrades not just the LDL receptor but these other receptors that clear LP little a
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we're seeing about a 30% reduction in LP little a sometimes as high as a 50% reduction in LP little a when patients are taking pcsk9 inhibitors
pcsk9 they're finding has effects now on apoe receptors and three or four other lipoprotein clearing receptors that are expressed in liver and other cells or so so i mean that's there's got to be better clearance of the particles with the pcsk9 inhibitors than there is with ldl receptor expression with statins or statins plus whatever other apob lowering drug you're going to add to it or so
if you treat patients with a pcsk9 inhibitor and the statin you see the [Music] and that's probably what where the ldl receptor presence gets maximized at the surface of the liver cells you can actually see clearance uh or increment in the fractional catabolic rate of of lpa
one of the players that was an anticip unanticipated player in uh in april a pro lpa slash apoa production is actually pcsk9 because if you incubate cells liver cells with uh with with pcsk9 you'll see the expression of apoa going up
it is something that you know if somebody's elevated lipitual a kind of think about moving quickly to pcsk9 if they have another indication such as elevated LDL
it seems to be that lowering leopardial a May in part be uh you know important mediator in the benefits that we see with these agents and it may just not be all due to their LDL lowering effects but maybe also due to electrical a lowering effects