ArticleCureus2026
Dose Up-Titration of a Proprotein Convertase Subtilisin/Kexin Type 9 Inhibitor for Markedly Elevated Lipoprotein(a) in a Patient With Familial Hypercholesterolemia: A Case Report.
Article in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
2 authors.
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Abstract
Lipoprotein(a) (Lp(a)) is an independent risk factor for atherosclerotic cardiovascular disease. Although proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors modestly reduce Lp(a) levels, evidence regarding their dose-dependent effects on patients with extremely high Lp(a) levels is limited. A 69-year-old woman was diagnosed with dyslipidemia because of high low-density lipoprotein cholesterol (LDL-C) levels (>180 mg/dL) and was initiated on atorvastatin at a dose of 10 mg/day. Two years later, she developed a myocardial infarction, and heterozygous familial hypercholesterolemia was subsequently diagnosed. Eight years later, despite achieving optimal LDL-C levels using high-intensity statin therapy, ezetimibe, and a half-dose of a PCSK9 inhibitor (evolocumab 140 mg monthly), her Lp(a) levels remained high. Up-titration of evolocumab from 140 mg monthly to 140 mg every two weeks resulted in a 34.7% reduction in Lp(a) levels; however, the value only decreased to 82.5 mg/dL. This case indicates a dose-dependent effect of PCSK9 inhibitor therapy on Lp(a) reduction; however, the magnitude of lowering may be insufficient in patients with extremely high baseline Lp(a) levels.
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