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Differential Effects of Lipid-lowering Drugs in Modulating Morphology of Cholesterol Particles
Published on: November 10, 2017
Novel approaches to lipid lowering: what is on the horizon?
1Emory University School of Medicine, Atlanta, Georgia, USA.
Abstract:
New approaches to lipid lowering include new uses of proven treatments and development of novel agents. Several large-scale clinical trials are assessing whether additional reduction of low-density lipoprotein cholesterol (LDL-C) levels with statin therapy results in additional benefit in coronary artery disease prevention. Statins with increased LDL-C-lowering potency, such as the new statin rosuvastatin (formerly known as ZD4522), have been developed and are in advanced-phase clinical trials. New cholesterol transport inhibitors, such as ezetimibe, have been found to produce significant reductions in intestinal cholesterol absorption, and new bile acid transport inhibitors are in development. Inhibitors of acyl coenzyme A:cholesterol acyltransferase, which can reduce cholesterol storage in macrophages and thereby in arterial lesions, have also been developed, with the agent avasimibe currently being evaluated in phase 2/3 trials. Combination approaches hold considerable promise, including combined use of statins with fibrates, niacin, and the new sterol absorption inhibitors.
Insights
New lipid-lowering strategies are emerging, including novel agents and enhanced uses of existing treatments. Research is exploring additional reductions in low-density lipoprotein cholesterol (LDL-C) for improved cardiovascular disease prevention.
Area of Science:
- Cardiovascular Medicine
- Pharmacology
- Lipid Metabolism
Background:
- Lipid lowering is crucial for cardiovascular disease prevention.
- Existing treatments are being re-evaluated for enhanced efficacy.
- Novel therapeutic targets for lipid management are under investigation.
Purpose of the Study:
- To review emerging strategies for lipid lowering.
- To discuss the role of additional low-density lipoprotein cholesterol (LDL-C) reduction in cardiovascular prevention.
- To highlight novel agents and combination therapies.
Main Methods:
- Review of ongoing large-scale clinical trials.
- Evaluation of new lipid-lowering drug classes.
- Assessment of combination therapy approaches.
Main Results:
- New statins with higher potency, like rosuvastatin, are in development.
- Cholesterol absorption inhibitors (e.g., ezetimibe) show significant efficacy.
- Acyl-CoA:cholesterol acyltransferase inhibitors (e.g., avasimibe) are being evaluated for reducing arterial lesion cholesterol.
Conclusions:
- Novel agents and combination therapies offer promising new avenues for lipid management.
- Further research is needed to confirm the benefits of intensive LDL-C reduction.
- Personalized lipid-lowering strategies may improve cardiovascular outcomes.
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Lipid Digestion
Lipid-Lowering Drugs: Statins and Miscellaneous Agents
Bioavailability Enhancement: Drug Permeability Enhancement
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