{"id":"77581300f867","type":"article","url":"https://hartvaat.nl/2026/02/06/voorbij-lipidenverlaging-pcsk9-remming-vermindert-ook-inflammatie-en-verbetert-h/","title":"Voorbij lipidenverlaging: PCSK9-remming vermindert ook inflammatie en verbetert HDL-functie","title_en":"Beyond lipid lowering: Effects of PCSK9 inhibition on inflammation and HDL function.","category":"cholesterol","category_label":"Cholesterol","professions":["apotheker","cardioloog","internist"],"tags":["cetp-remmers","dyslipidemie","enlicitide","ezetimibe","ldl-cholesterol","lipide-aferese","lipidenverlaging","lipoproteïne-a","niet-statine-therapie","obicetrapib","pcsk9-remmers","pcsk9-remmers-nieuwe-generatie","pelacarsen"],"journal":"Journal of clinical lipidology","doi":"10.1016/j.jacl.2026.02.003","source_url":"https://doi.org/10.1016/j.jacl.2026.02.003","authors":["Maximilian Seidel","Felix S Seibert","Adrian Doevelaar","Benjamin Rohn","Sebastian Bertram","Jonas F Kolodziej","Nikolaos Pagonas","Johannes Korth","Nina Babel","Timm H Westhoff"],"significance":5,"published":"2026-02-06","source_date":"2026-02-06","image":"","kennis":["https://hartvaat.nl/kennis/lipiden/ldl-cholesterol-mechanisme/","https://hartvaat.nl/kennis/lipiden/pcsk9-mechanisme/"],"congress":"","summary_en":"Beyond LDL-C lowering, this real-world study demonstrated that PCSK9 inhibition reduces vascular and systemic inflammation and improves HDL antioxidant function. The pleiotropic effects include Lp(a) reduction and decreased inflammatory markers.","created":"2026-07-03T10:24:58Z","updated":"2026-07-03T13:24:26Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Naast de bekende LDL-C-verlaging beïnvloedt PCSK9-remming ook vasculaire en systemische inflammatie en de antioxidatieve functie van HDL. De studie toont verlaagde Lp(a)-spiegels, verbeterde HDL-kwaliteit en afname van ontstekingsmarkers, wat pleiotrope voordelen van PCSK9-remmers ondersteunt.","abstract_original":"BACKGROUND: Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibition effectively lowers low-density lipoprotein cholesterol (LDL-C) and cardiovascular risk, but its pleiotropic effects remain insufficiently defined. This study examined whether PCSK9 inhibition influences vascular and systemic inflammation and high-density lipoprotein (HDL) antioxidant function. OBJECTIVE: To investigate the effects of PCSK9 inhibition on vascular inflammation, systemic inflammatory markers, and high-density lipoprotein (HDL) antioxidant function in a real-world patient cohort. MATERIAL AND METHODS: In this monocentric, prospective study, blood samples from 89 patients were collected before and 3 to 6 months after initiation of PCSK9 inhibitor therapy. Lipoprotein-associated phospholipase A2 (LpPLA2) was measured as a marker of vascular inflammation. HDL antioxidant function was assessed by HDL lipid peroxide content (HDLox). Systemic inflammation was evaluated via high-sensitivity C-reactive protein (hsCRP) and a predefined cytokine panel. RESULTS: Seventy-three patients (82.0%) received alirocumab or evolocumab, and 16 (18.0%) received inclisiran. LDL-C decreased by 46.7% (120-64.5 mg/dL, P < .0001). LpPLA2 declined significantly (443.5-265.5 IU/L, P < .0001) and correlated with LDL-C reduction (R² = 0.58, P < .0001). HDLox did not change (1.190-1.210, P = .3438). Interferon gamma-induced protein (IP) 10 (P = .0141) and interleukin (IL)-2 (P = .0371) decreased, whereas hsCRP and other cytokines-including IL-1β, IL-4, IL-6, IL-8, IL-10, IL-17A, tumor necrosis factor-α, monocyte chemotactic protein-1, interferon-γ, and free radicals-remained unchanged (all P > .05). CONCLUSION: PCSK9 inhibition reduces LpPLA2 and IP-10 without changing global inflammatory response or antioxidant function of HDL, which might indicate a decrease in chronic vascular inflammation without an undesired broad systemic immune alteration."}