New Drug Showing Promise In Tough Cholesterol Cases
Gus Genetti’s cardiologist is rarely pleased with him, the 78-year-old hospitality magnate said.
“But he’s pleased with my cholesterol,” he quickly added. “He said it’s come down considerably.”
About 2½ years ago, Genetti, whose family owns Genetti Manor in Dickson City and the Genetti Hotel and Conference Center in Wilkes-Barre, started on a new drug to get his cholesterol under control, and it’s had amazing results.
The drug, known commercially as Repatha and Praluent, helps patients who struggle to meet their goals with statins, a first-line defense for high cholesterol, and other treatment.
Patients who have high cholesterol thanks to heredity often are prescribed the drugs immediately, said Dr. Richard Blum, Genetti’s lipidologist.
The drugs inhibit a protein called PCSK9, which prevents how the body breaks down the bad LDL cholesterol.
The United Health Foundation’s America’s Health Rankings report shows more than 35 percent of adult Pennsylvanians report being diagnosed with high cholesterol.
Most patients can reach their cholesterol goals with some combination of statins and other therapy alone.
“The real problem comes with patients who just don’t tolerate statins,” Blum said.
The new drug is expensive, about $14,000 a year before insurance for the twice-monthly self injected medicine.
Blum said insurance companies typically will cover the drug for patients who can’t reach their cholesterol goals with the highest tolerated dose of other drugs or if they can prove they inherited high cholesterol, which is a fairly simple process.
Researchers first discovered PCSK9 in 2003, quickly designed a drug to quiet it and got through a rigorous Food and Drug Administration approval process, which typically takes more than a decade.
“That’s really remarkable. We’ve only even known about this stuff for 15 years and it only took 13 years to get from brand new information to marketable,” Blum said. “It didn’t take long, really, to find this particular protein, and then develop, in the case of PCSK9 inhibitors that currently exist, monoclonal antibodies against the protein — so they basically rendered this protein inactive.”
An ideal cholesterol level is 100, Blum said, but given Genetti’s complex heart condition, his doctor wanted him to get it lower.
Despite having good cholesterol levels, he still developed symptoms, requiring stents and cardiac catheterization, Blum said.
There’s no minimum for LDL cholesterol, and since starting on the new drug, Genetti’s gotten his below 20.
“I do have heart disease. It’s there. It’s not going away,” Genetti said, adding that under the new inhibitors, he has hope for longer, fuller life. “I’m in fairly good health, I’m 78, almost 79. Hopefully I’m going to make it a few more years.”
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How high is too high?
High cholesterol is different for each patient, but a healthy person should shoot for a level of 100. Someone with health complications may need to get it lower.
Some complicating factors for high cholesterol include:
High blood pressure