{"id":"d96aa598e27b","type":"article","url":"https://hartvaat.nl/2026/09/25/lerodalcibep-ligand-biedt-eenmaal-maandelijks-pcsk9-remming-met-50-tot-65-ldl-c-/","title":"Lerodalcibep-ligand biedt eenmaal maandelijks PCSK9-remming met 50 tot 65% LDL-C-verlaging","title_en":"Lerodalcibep-liga as an Injectable Proprotein Convertase Subtilisin/Kexin Type 9 (PCSK9)-Targeted Therapy for Patients With Hypercholesterolemia.","category":"cholesterol","category_label":"Cholesterol","professions":["apotheker","cardioloog","internist"],"tags":[],"journal":"The Annals of pharmacotherapy","doi":"10.1177/10600280261488073","source_url":"https://doi.org/10.1177/10600280261488073","authors":["Mohammad T Alashqar","Nikolas Lako","Milap C Nahata"],"significance":5,"published":"2026-10-03","source_date":"2026-09-25","image":"","kennis":["https://hartvaat.nl/kennis/lipiden/lpa-meten-wanneer-waarom/","https://hartvaat.nl/kennis/lipiden/lp-a-verhoogd/"],"congress":"","summary_en":"This narrative review synthesizes phase 1–3 trial data on lerodalcibep-ligand, a new once-monthly subcutaneous PCSK9 inhibitor. In patients with hypercholesterolemia, HeFH, or high cardiovascular risk, treatment lowered LDL-C by 50% to 65% with a manageable safety profile, though injection-site reactions were more common than with placebo. While efficacy mirrors existing PCSK9-directed therapies, dedicated cardiovascular outcomes data are still lacking. Clinically, it offers a convenient monthly injection option for patients requiring substantial LDL-C reduction, though established agents remain preferable when proven event reduction is the primary treatment goal.","created":"2026-09-26T01:18:10Z","updated":"2026-09-26T01:18:10Z","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":"Deze review analyseert de fase 1-3 trials van lerodalcibep-ligand, een nieuwe subcutane PCSK9-remmer die eenmaal maandelijks wordt toegediend. Bij patiënten met hypercholesterolemie, HeFH of hoog cardiovasculair risico resulteerde de behandeling in een LDL-C-daling van 50 tot 65%, vergeleken met een goed profiel van bijwerkingen waarbij injectieplaatsreacties het meest voorkwamen. Hoewel de werkzaamheid vergelijkbaar is met bestaande PCSK9-remmers, ontbreekt nog bewijs voor een directe cardiovasculaire eventreductie uit een dedicated trial. Voor de klinische praktijk biedt het middel een handige injectieoptie voor patiënten die een sterke LDL-C-daling nodig hebben, maar alirocumab of evolocumab blijven bij voorkeur het eerste keus bij een sterke focus op bewezen eventreductie.","abstract_original":"OBJECTIVE: To critically review the pharmacology, clinical efficacy, safety, and potential therapeutic role of lerodalcibep-liga within the expanding landscape of proprotein convertase subtilisin/kexin type 9 (PCSK9)-directed therapies for patients with hypercholesterolemia. DATA SOURCES: PubMed, the Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov were searched through August 2026. STUDY SELECTION AND DATA EXTRACTION: Clinical trials evaluating lerodalcibep-liga in patients with hypercholesterolemia were included. Full-text peer-reviewed publications underwent detailed evaluation; conference abstracts and posters were summarized descriptively. The search identified one phase 1 study, two phase 2 trials, and six phase 3 trials. DATA SYNTHESIS: Monthly subcutaneous lerodalcibep-liga produced low-density lipoprotein cholesterol (LDL-C) reductions of approximately 50% to 65% in patients with heterozygous familial hypercholesterolemia (HeFH), established cardiovascular disease, or high cardiovascular risk. Reductions in apolipoprotein B, non-high-density lipoprotein cholesterol, and lipoprotein(a) were also reported. Low-density lipoprotein cholesterol lowering was maintained through 72 weeks in an open-label extension. Treatment was generally well tolerated, although injection-site reactions occurred more frequently than with placebo.Relevance to patient care and clinical practice in comparison with existing drugs:Lerodalcibep-liga provides potent LDL-C lowering through a fixed, small-volume, once-monthly self-administered injection. Its efficacy is broadly comparable with other PCSK9-directed therapies, but direct comparative evidence remains limited. Analyses suggested a potential cardiovascular benefit, but this finding has not been confirmed in a dedicated, adequately powered cardiovascular outcomes trial. CONCLUSIONS: Lerodalcibep-liga is an additional potent injectable PCSK9-directed treatment for adults requiring substantial LDL-C reduction, including those with HeFH. However, alirocumab or evolocumab may remain preferable when demonstrated cardiovascular event reduction is a major consideration in treatment selection."}