Supplementation with Octacosanol Affects the Level of PCSK9 and Restore Its Physiologic Relation with LDL-C in Patients on Chronic Statin Therapy

Abstract

Dietary supplementation with sugar cane derivates may modulate low-density lipoproteincholesterol (LDL-C) and proprotein convertase subtilisin/kexin type 9 (PCSK9) levels. The purposeof this study was to determine if dietary supplement (DS), containing Octacosanol (20 mg) andvitamin K2 (45μg), could restore the disrupted physiologic relation between LDL-C and serumPCSK9. Double-blind, randomized, placebo-controlled, single-center study including 87 patients onchronic atorvastatin therapy was conducted. Eighty-seven patients were randomized to receive DS(n= 42) or placebo (n= 45), and followed for 13 weeks. Serum PCSK9 levels, lipid parameters andtheir relationship were the main efficacy endpoints. The absolute levels of PCSK9 and LDL-C werenot significantly different from baseline to 13 weeks. However, physiologic correlation between %change of PCSK9 and % change of LDL-C levels was normalized only in the group of patients treatedwith DS (r= 0.409,p= 0.012). This study shows that DS can restore statin disrupted physiologicpositive correlation between PCSK9 and LDL-C. Elevated PCSK9 level is an independent risk factorso controlling its rise by statins may be important in prevention of cardiovascular events.