What are the side effects of cholesterol injections
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Side Effects of Cholesterol Injections
Cholesterol injections, particularly those involving PCSK9 inhibitors and other lipid-lowering agents, have been increasingly used to manage hypercholesterolemia. While effective in reducing LDL cholesterol levels, these treatments are associated with various side effects. This article synthesizes findings from multiple studies to provide a comprehensive overview of the side effects of cholesterol injections.
Injection-Site Reactions
Injection-site reactions are a common side effect of cholesterol injections. Studies on alirocumab, a PCSK9 inhibitor, reported higher rates of injection-site reactions compared to placebo (5.9% vs. 4.2%). Similarly, inclisiran, another PCSK9 inhibitor, was associated with mild injection-site reactions in 5% of patients. Mipomersen, an antisense oligonucleotide, also showed moderate to severe injection-site reactions in several patients, leading to discontinuation in some cases .
Myalgia and Muscle-Related Symptoms
Myalgia (muscle pain) is another reported side effect. In the alirocumab study, myalgia was observed in 5.4% of patients compared to 2.9% in the placebo group. This side effect is significant as it can affect patient compliance and quality of life.
Neurocognitive Events
Neurocognitive events such as memory impairment and confusion have been noted. Alirocumab-treated patients experienced neurocognitive events at a rate of 1.2% compared to 0.5% in the placebo group. Although the incidence is relatively low, it is a noteworthy side effect that requires monitoring.
Ophthalmologic Events
Ophthalmologic events were also reported in the alirocumab study, with a higher incidence in the treatment group (2.9%) compared to the placebo group (1.9%). These events include visual disturbances and other eye-related issues.
Elevated Liver Enzymes
Elevated liver enzymes are a concern with some cholesterol injections. Mipomersen treatment led to elevated liver enzymes in a few patients, necessitating discontinuation of the drug . This side effect indicates potential liver toxicity, which requires regular monitoring of liver function tests.
Other Adverse Events
Other adverse events include general discomfort and systemic reactions. Inclisiran was found to have no significant differences in adverse events, liver function abnormalities, or creatine kinase levels compared to placebo, although mild injection-site reactions were more frequent .
Case Reports and Individual Variability
Case reports highlight individual variability in response to cholesterol injections. For instance, a young woman with familial hypercholesterolemia experienced painful and recurring injection-site reactions to both alirocumab and evolocumab, leading to treatment discontinuation. However, she tolerated inclisiran well, with no adverse events and significant LDL-C reduction. This case underscores the importance of personalized treatment approaches.
Conclusion
Cholesterol injections, while effective in lowering LDL cholesterol levels, are associated with several side effects, including injection-site reactions, myalgia, neurocognitive events, ophthalmologic events, and elevated liver enzymes. Monitoring and managing these side effects are crucial for optimizing patient outcomes and ensuring adherence to treatment. Personalized approaches may be necessary to address individual variability in response to these therapies.
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