PCSK9 and chronic obstructive pulmonary disease: Two large phase III trials and subsequent open-label extensions found no excess risk of respiratory disease in individuals treated with PCSK9 inhibition for up to 9 years.9,10 However, the association of PCSK9-GS with exacerbations of COPD indicates that PCSK9 inhibition potentially confers higher risk only in individuals with existing respiratory disease, perhaps triggered by URTI.