To date HMG-CoA-reductase inhibitors are the most effective drugs for reduction 
of LDL-cholesterol levels and for prevention of cardiovascular events. 
Inhibition of the enzyme PCSK9 (proprotein convertase subtilisin/kexin type 9), 
which is involved in depletion of the LDL-receptor, is a new pharmacologic 
approach. Inhibition of PCSK9 by monoclonal antibodies provokes an additional 
reduction of LDL-cholesterol levels by 50-60 % in addition to statins. Previous 
phase III studies indicate good compatibility. Ongoing long-term studies will 
answer questions of safety and influence on cardiovascular events. Although 
those results are not available yet, alirocumab and evolocumab have already been 
recommendd for approval.