Proprotein convertase subtilisin-kexin type 9 (PCSK9) inhibitor use in the management of resistant hypercholesterolemia induced by mitotane treatment for adrenocortical cancer

J Clin Lipidol. 2018 May-Jun;12(3):826-829. doi: 10.1016/j.jacl.2018.03.078. Epub 2018 Mar 13.

Abstract

We report the case of a patient with probable heterozygous familial hypercholesterolemia and mitotane-induced resistant hypercholesterolemia, despite combination therapy with rosuvastatin and ezetimibe. The patient was managed with the addition of evolocumab. Use of a proprotein convertase subtilisin-kexin type 9 inhibitor, should be considered in patients who develop mitotane-related hypercholesterolemia that cannot be managed with conventional lipid-lowering treatment.

Keywords: ACC; Adrenocortical carcinoma; Evolocumab; Hypercholesterolemia; Mitotane; PCSK9; PCSK9 inhibitors.

Publication types

  • Case Reports

MeSH terms

  • Adrenal Cortex Neoplasms / drug therapy*
  • Drug Resistance / drug effects*
  • Female
  • Humans
  • Hypercholesterolemia / chemically induced*
  • Hypercholesterolemia / drug therapy*
  • Hypercholesterolemia / enzymology
  • Middle Aged
  • Mitotane / adverse effects*
  • Mitotane / therapeutic use
  • PCSK9 Inhibitors*
  • Protease Inhibitors / pharmacology*
  • Protease Inhibitors / therapeutic use

Substances

  • PCSK9 Inhibitors
  • Protease Inhibitors
  • Mitotane