PCSK9 Inhibitor
Injectable ApoB lowering. The most powerful tool in the class.
Approved Verified 27 August 2026
What it does
The largest ApoB reductions of any available therapy — typically 50 to 60 percent on top of a statin. Constrained by cost and the injection format; reserved for high-risk cases where aggressive lowering is required.
PCSK9 normally targets hepatic LDL receptors for degradation. Inhibiting it preserves LDL-receptor density, increasing clearance of ApoB particles from circulation.
What the evidence shows
Overall evidence strength: High certainty
Who it's for, who should skip
High cardiovascular risk, statin intolerance, or familial hypercholesterolemia when ApoB stays elevated despite stacked first-line therapy. An escalation layer, not a starting point.
Running it
- Form
- injectable
- Dose
- injection every 2 weeks
Measuring it
Retest ApoB — 4–12 weeks after starting or changing the dose, then every 6–12 months — ApoB follows the lipid-panel schedule..
- LDL-C
- LDL-C
- ApoB
- ApoB
Safety
- injection-site reactions; rare hypersensitivity
Stacking & alternatives
Access & cost
Prescription or clinician order — typically via cardiology or lipid specialist.
Last reviewed 27 August 2026. Regulatory status verified 27 August 2026.