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Sudden Fall in the Lipid-Lowering Effect of Evolocumab: The Butler Is Not Always Guilty

A 78-year-old man came to our attention after undergoing coronary computed tomography angiography documenting multivessel coronary artery disease. He was started on treatment with the proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor evolocumab 140 mg subcutaneously every 2 weeks. Trea...

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Detalles Bibliográficos
Autores principales: Fogacci, Federica, Borghi, Claudio, Di Micoli, Antonio, Cicero, Arrigo F. G.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8468156/
http://dx.doi.org/10.3390/medicina57090857
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author Fogacci, Federica
Borghi, Claudio
Di Micoli, Antonio
Cicero, Arrigo F. G.
author_facet Fogacci, Federica
Borghi, Claudio
Di Micoli, Antonio
Cicero, Arrigo F. G.
author_sort Fogacci, Federica
collection PubMed
description A 78-year-old man came to our attention after undergoing coronary computed tomography angiography documenting multivessel coronary artery disease. He was started on treatment with the proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor evolocumab 140 mg subcutaneously every 2 weeks. Treatment-emergent changes in lipids and lipoproteins were long-lasting, and the medication was well tolerated by the patient in the long-term. Unexpectedly, after 2 years of continuous treatment with evolocumab, serum lipids increased, apparently without any reasonable explanation. During the follow-up visit, the patient was found to have habitually injected evolocumab into his right thumb instead of into the appropriate injection sites (i.e., abdomen, thighs or upper arms) after turning the injector upside down.
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spelling pubmed-84681562021-09-27 Sudden Fall in the Lipid-Lowering Effect of Evolocumab: The Butler Is Not Always Guilty Fogacci, Federica Borghi, Claudio Di Micoli, Antonio Cicero, Arrigo F. G. Medicina (Kaunas) Case Report A 78-year-old man came to our attention after undergoing coronary computed tomography angiography documenting multivessel coronary artery disease. He was started on treatment with the proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor evolocumab 140 mg subcutaneously every 2 weeks. Treatment-emergent changes in lipids and lipoproteins were long-lasting, and the medication was well tolerated by the patient in the long-term. Unexpectedly, after 2 years of continuous treatment with evolocumab, serum lipids increased, apparently without any reasonable explanation. During the follow-up visit, the patient was found to have habitually injected evolocumab into his right thumb instead of into the appropriate injection sites (i.e., abdomen, thighs or upper arms) after turning the injector upside down. MDPI 2021-08-24 /pmc/articles/PMC8468156/ http://dx.doi.org/10.3390/medicina57090857 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Fogacci, Federica
Borghi, Claudio
Di Micoli, Antonio
Cicero, Arrigo F. G.
Sudden Fall in the Lipid-Lowering Effect of Evolocumab: The Butler Is Not Always Guilty
title Sudden Fall in the Lipid-Lowering Effect of Evolocumab: The Butler Is Not Always Guilty
title_full Sudden Fall in the Lipid-Lowering Effect of Evolocumab: The Butler Is Not Always Guilty
title_fullStr Sudden Fall in the Lipid-Lowering Effect of Evolocumab: The Butler Is Not Always Guilty
title_full_unstemmed Sudden Fall in the Lipid-Lowering Effect of Evolocumab: The Butler Is Not Always Guilty
title_short Sudden Fall in the Lipid-Lowering Effect of Evolocumab: The Butler Is Not Always Guilty
title_sort sudden fall in the lipid-lowering effect of evolocumab: the butler is not always guilty
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8468156/
http://dx.doi.org/10.3390/medicina57090857
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