COMMENTARY

Is PCSK9 the Next Wonder Drug?

Henry R. Black, MD; Howard S. Weintraub, MD

Disclosures

September 27, 2013

In This Article

And Then There's HDL

Dr. Weintraub: Anticipating your next question, and if it's not, I'm sorry: What do we do about high-density lipoprotein (HDL)? You were part of the NYU symposium last year in May, when Dan Rader got up and told us that it's all in HDL functionality. And he explained some of the AIM HIGH problems in an article a week or two ago in the Journal of the American College of Cardiology that niacin does not improve the function of HDL.[3] It raises how much of it you have, but it doesn't work any better. Regrettably, but at least thankfully, we go ahead with this premise, supported by epidemiologic studies on [using niacin for increasing] HDL cholesterol. Then, as we look a little further in trying to treat it, to make it better, we find that this doesn't seem to work. Then we are trying to figure out why, and it turns out that you want the functionality of HDL to be there as a garbage truck, but sometimes these HDLs are not trained as garbage trucks.

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