To date HMG-CoA-reductase inhibitors are the most effective drugs for reduction of LDL-cholesterol levels and for prevention of cardiovascular events. But recently 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. Thus  alirocumab and evolocumab have already been recommendd for approval.

         PCSK9 inhibitors are a new class of lipid-lowering medications that are administered as monthly or bimonthly subcutaneous injections. They are monoclonal antibodies to PCSK9, developed after the observation that naturally occurring loss-of-function polymorphisms resulting in PCSK9 underexpression led to lower low-density lipoprotein cholesterol (LDL-C) levels. These drugs cost more than $13,000 annually.

        These medicines are thought to be causing Diabetes mellitus type II but it is not true they in some people cause hyperglycemia and raise glycosylated haemoglobin only as glucose metablism is changed bu never deplets Insulin,so it can be safely used in Diabetic patients or otherwise without fear of causing diabetes in normal persons.this is also seen due to  Gene modification in these patients.