PCSK9 Inhibitors in a Statin-Intolerant Transgender Man With Heterozygous Familial Hypercholesterolemia: A Case Report

Journal of the Endocrine Society
Carlo PirazziStefano Romeo

Abstract

In female-to-male transgender individuals, testosterone is used to induce masculinization. Sex steroid therapy may increase circulating triglyceride and low-density lipoprotein cholesterol (LDL-C) levels and may decrease high-density lipoprotein cholesterol (HDL-C) levels, resulting in a more atherogenic lipid profile. These potentially adverse effects of androgen therapy may be exacerbated by the presence of familial hypercholesterolemia (FH). We describe the case of a transgender man with genetically diagnosed FH who was intolerant to statins and was started on a proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor to control his lipoproteins more effectively. The 35-year-old female-to-male transgender individual was referred to our center with a history of elevated LDL-C levels. Despite treatment with high doses of high-potency statins and ezetimibe, he had never achieved a sustained reduction in LDL-C; his levels of LDL-C were fluctuating between 170 and 344 mg/dL (4.4 and 8.9 mmol/L). Moreover, he developed side effects to statins in the form of myalgia and discontinued statin treatment. At the Sahlgrenska Lipid Clinic, a genetic diagnosis of heterozygous FH was established, and PCSK9 inhibitor therapy was start...Continue Reading

References

Oct 30, 2015·Circulation·Samuel S GiddingUNKNOWN American Heart Association Atherosclerosis, Hypertension, and Obesity in the Young Committee of the Council on Cardiovascula
Mar 18, 2017·The New England Journal of Medicine·Marc S SabatineUNKNOWN FOURIER Steering Committee and Investigators
Mar 18, 2017·The New England Journal of Medicine·Paul M RidkerUNKNOWN SPIRE Cardiovascular Outcome Investigators
Sep 26, 2017·The Journal of Clinical Endocrinology and Metabolism·Spyridoula MarakaM Hassan Murad
Dec 9, 2017·Nature Reviews. Disease Primers·Joep C DefescheAnthony S Wierzbicki
Jan 11, 2018·Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists·Wylie C HembreeGuy G T'Sjoen
Nov 8, 2018·The New England Journal of Medicine·Gregory G SchwartzUNKNOWN ODYSSEY OUTCOMES Committees and Investigators

❮ Previous
Next ❯

Methods Mentioned

BETA
hysterectomy
bilateral oophorectomy

Related Concepts

Related Feeds

ApoE, Lipids & Cholesterol

Serum cholesterol, triglycerides, apolipoprotein B (APOB)-containing lipoproteins (very low-density lipoprotein (VLDL), immediate-density lipoprotein (IDL), and low-density lipoprotein (LDL), lipoprotein A (LPA)) and the total cholesterol/high-density lipoprotein (HDL) cholesterol ratio are all connected in diseases. Here is the latest research.