Alirocumab in a high cardiovascular risk patient on hemodialysis with liver abnormalities.

We present a male diabetic type 2 patient on hemodialysis (HD) with high cardiovascular (CVD) risk and hyperlipidemia. The patient was under cholesterol-lowering therapy with statin and ezetimibe but he was obligated to discontinue due to chronic hepatitis C virus infection. Statins and ezetimibe may exert a potential hepatotoxic effect and for this reason, we attempted to find an alternative treatment to prevent CVD. Given that a potential hepatotoxic effect has not been reported for Abs SPCK9, we administered alirocumab 150 mg every 2 weeks for a total of 8 weeks. Low-density lipoprotein levels have decreased and no side effects have been observed. In conclusion, alirocumab is a safe and efficient alternative therapy approach for HD patients with high CVD risk and liver abnormalities. We suggest that SPCK 9 inhibitors should be considered as a first line treatment for lowering cholesterol in this specific patient group.