PCSK 9 Inhibitors and Niacin Response

this is a feedback to my post the discussion board you wrote

can you please answer it based on what you wrote

Hello Yusur. Great job on your post. When I first saw the title I was intrigued and wondered how intake of niacin can compare to the use of statins. I like that you immediately mentioned that the water-soluble vitamin, niacin (a vitamin b3), has less efficacy compared to statin use in the reduction of LDL; however, there are specific scenarios in which it is the best possible treatment option. It was also interesting that niacin is less efficient at reducing LDL levels but better at increasing HDL. When reading your post and other research articles it became clear that niacin is not going to have the same efficacy as PCSK-9 inhibitors because of differences in mechanisms of action (Zhao et al 2019). PCSK-9 inhibitors are a monoclonal antibody medication that works by inhibiting PCSK-9 activity. PCSK-9 is normally responsible for the regulation of hepatocyte LDL-cholesterol receptors and binding/tagging them for degradation. The protein PCSK-9 reduces the number of LDL receptors and prevents LDL from leaving the circulatory system. Intake of PCSK-9 inhibitor medication causes the monoclonal antibodies to bind to PCSK-9 preventing binding to LDL receptors. This binding prevents LDL receptors from being marked for degradation. There are currently only two approved medications alirocumab and evolocumab. Side effects of PCSK-9 use include symptoms such as a sore throat, nausea, fever, and increased blood sugar concentration (Chaudhary et al. 2017). Niacin also had minimal risk and side effects (depending on preexisting conditions) and therefore is relatively similar in risk to PCSK-9 inhibitors (Djadjo & Bajaj, 2020). Between the two PCSK-9 has better efficacy and risk-to-reward outcome. Overall, I enjoyed reading your post I found it very clever that you focused on how vitamin supplements/intake can affect both LDL and HDL. Best of luck in the class.