Cholesterol numbers on no med, then on statin then on statin + Repatha

[Photon]

So timeline looks like this 2021 was Rosuvastatin+Eze, 2022 was the introduction of Praluent (the big dip in LDL), Repatha was switch to in January of this year (2025) as my insurance made it the preferred med and Praluent became nonpreferred/PA. My cardio says they work pretty much the same so my results should be interchangeable between praluent and repatha. I am unsure why the drop in HDL, he seemed to not be too concerned about that as my LDL had steadily declined, when I achieved 70s he was "happy" and I continued to push to drop it further (pitavastatin introduction). It appears the HDL bump could be the as described effect of Pitavastatin where HDLs are driven up by its use. Vascepa was introduced in August I believe, I was looking more for the pleiotropic effects of the icosapent described in a few papers and cardiologist was totally cool with it as my trigs are not "high".

Dam that HDL is impressive.
The PSCK9 dropped your LDL by almost 1/2.

 

[Wizbang]

Dam that HDL is impressive.
The PSCK9 dropped your LDL by almost 1/2.

Yeah I was very intolerant to rosuvastatin and my previous cardiologist didnt care, max dose due to MI with the zetia chaser. Switched to new doc he immediately DCed the statin and switched me to PCSK9i and bam I was off to the races.

 

[MarkusLA]

10mgs of Reta helped so much with my Cholesterol

Please post your before and after numbers.

 

[Avies48]

10mgs of Reta helped so much with my Cholesterol

What did ur numbers start at and where are they now with reta only?

 

[vril]

What did ur numbers start at and where are they now with reta only?

LDL was 4.1 mmol/L and went to 2.4 mmol/L when I was on 12mgs of Reta for 4 months

 

[bananafeet]

I'm not suggesting it be used as a treatment for insulin sensitivity or anything other than hyperlipidemia. Simply that those potential benefits, however modest, or even just a neutral effect (we know at the least Pita induces no insulin resistance), are advantages over other statins,

I'll share links to the relevant studies,

Can you point to any downside to Pitavastatin as a means of improving lipids compared to the others?

Ezetimebe became the go to for PED users because of it's "free" lipid improvement, since there's really almost no chance of sides. Bempedoic acid's been added to the repertoire despite the collagen suppressing effect. I think Pita fits the bill here in terms of being "low impact", while other statins are avoided for good reason.

Are there any areas in which other statins provide advantages that make them an overall better choice? Beyond the small additional reduction in LDL at the highest doses of high intensity stains, which come with accompanying hazards, I can't find a good argument, outside of needing that extra bit of LDL reduction so badly that accepting an increase in insulin resistance and the significantly higher muscle related side effect risk is a worthwhile tradeoff.

Outside of cost, for instance, I can't see any good reason to use Rosu 10mg (the most common dose of the most common statin) vs Pita 4mg .

@Ghoul never misses.

Before and after (left column is most recent) statins:



Only on 10mg Rosuvastatin and 10mg Ezetimibe per day. Ordered the Rosuvastatin before I new about pitavastatin....

No side effects.