Alirocumab is a PCSK9 (Proprotein Convertase Subtilisin Kexin Type 9) inhibitor antibody indicated as an adjunct to diet and maximally tolerated statin therapy for the treatment of adults with heterozygous familial hypercholesterolemia or clinical atherosclerotic cardiovascular disease, who require additional lowering of LDL-cholesterol. Alirocumab is prescribed to adult patients with primary hypercholesterolemia (non-familial and heterozygous familial) or mixed dyslipidemia.

Variations in the SLCO1B1 gene indicates the risk for statin-induced myopathy. European Society of Cardiology recommends, but does not require, a genetic test prior to statin treatment. PCSK9 inhibitors are approved for patients with Familial Hyperlipidemia and could be used as alternative cholesterol reducing drug in statin-intolerant patients.

Population pharmacokinetic analysis indicated that weight, gender, race and creatinine clearance do not significantly influence alirocumab pharmacokinetics; however, alirocumab has not been studied in pediatric patients. As monoclonal antibodies are not known to be eliminated via renal pathways, renal function is not expected to impact the pharmacokinetics of alirocumab.

• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5055560/
• https://www.pharmgkb.org/chemical/PA166159961/labelAnnotation
• https://www.ema.europa.eu/en/documents/product-information/praluent-epar-product-information_en.pdf
• https://academic.oup.com/ehjcvp/article/8/1/85/6151754