Table 4.

Indications for Treatment with PCSK9 Inhibitors

Disease States	Patients with ASCVD, HoFH, HeFH.
Prerequisite for treatment	Decision to start PCSK9 inhibitor would depend on achieving specific target LDL-C levels in various conditions that increase ASCVD risk or in presence of ASCVD. PCSK9 inhibitors are started in addition to maximum tolerated statin with or without ezetimibe. PCSK9 inhibitors are started in statin-intolerant patients for achieving specific target LDL-C levels in various conditions that increase ASCVD risk or in presence of ASCVD.
Lipid levels in ACVD for treatment	Stable with risk factors and in progressive LDL-C ≥70 mg/dL or non-HDL-C ≥100 mg/dL.
Lipid levels in HeFH for treatment	Age 40 years to 79 years and controlled ASCVD risk factors, with baseline LDL-C ≥190 mg/dL, and LDL-C ≥100 mg/dL or non-HDL-C ≥130 mg/dL with statin ± ezetimibe. Age 40 to 79 years and uncontrolled ASVCD risk factors, baseline LDL-C ≥190 mg/dL, and LDL-C ≥70 mg/dL or non-HDL-C ≥100 mg/dL with statin ± ezetimibe. Age 18 to 39 years with uncontrolled ASVCD risk factors, baseline LDL-C ≥190 mg/dL, and LDL-C ≥100 mg/dL or non-HDL-C ≥130 mg/dL with statin ± ezetimibe.
Lipid levels in HoFH for treatment	LDL-C ≥70 mg/dL or non-HDL-C ≥100 mg/dL with statin ± ezetimibe.

PCSK9, proprotein convertase subtilisin/kexin type 9; LDL-C, low-density lipoprotein cholesterol; HDL-C, high-density lipoprotein cholesterol; HoFH, homozygous familial hypercholesterolemia; HeFH, heterozygous familial hypercholesterolemia; ASCVD, Atherosclerotic cardiovascular disease.