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Differential Effects of Lipid-lowering Drugs in Modulating Morphology of Cholesterol Particles
Published on: November 10, 2017
Is the future of statins aligned with new novel lipid modulation therapies?
1Loyola University Chicago Stritch School of Medicine, Loyola University Medical Center, 2160 S. First Avenue, Bldg 110, Rm 6221, Maywood, IL 60153, USA. bphan@lumc.edu
Abstract:
Dyslipidemia is an established risk factor for the development of atherosclerotic cardiovascular disease. Statin therapy has been proven in a number of clinical trials to lower the risk of acute cardiovascular events and is the mainstay of cholesterol treatment. Despite current optimal treatment for dyslipidemia, many patients fail to reach adequate cholesterol treatment goals and remain at a significantly increased risk of cardiovascular events. Given this residual risk, there is a critical need for additional lipid therapies that could augment the ability of statins to lower the burden of atherogenic lipoproteins and, in some cases, raise levels of high-density lipoproteins. A number of novel lipid-altering therapies have been developed and are currently in clinical trials. In this review, we discuss these promising therapies, which include PCSK9 inhibitors, apolipoprotein B antisense oligonucleotides, microsomal transfer protein inhibitors, thyroid mimetics, and cholesteryl ester transfer protein inhibitors. Although statin therapy is the current recommended primary treatment for dyslipidemia, emerging novel agents may become adjuvant therapies in the treatment of atherosclerotic heart disease.
Insights
New lipid-altering therapies are being developed to address residual cardiovascular risk in patients with dyslipidemia who do not reach treatment goals with statins alone. These novel agents aim to improve atherogenic lipoprotein levels and potentially increase high-density lipoprotein cholesterol.
Area of Science:
- Cardiology
- Pharmacology
- Biochemistry
Background:
- Dyslipidemia is a major risk factor for atherosclerotic cardiovascular disease.
- Statin therapy is the primary treatment but leaves many patients with residual cardiovascular risk.
- There is a need for additional therapies to improve lipid profiles and reduce cardiovascular events.
Purpose of the Study:
- To review novel lipid-altering therapies currently in clinical trials.
- To discuss agents that can augment statin therapy for dyslipidemia.
- To highlight potential adjuvant treatments for atherosclerotic heart disease.
Main Methods:
- Review of current clinical trial data for novel lipid-modulating agents.
- Discussion of mechanisms of action for emerging therapies.
- Analysis of the role of these agents in managing dyslipidemia.
Main Results:
- Several novel therapies show promise in lowering atherogenic lipoproteins and managing dyslipidemia.
- Emerging agents include PCSK9 inhibitors, apolipoprotein B antisense oligonucleotides, microsomal transfer protein inhibitors, thyroid mimetics, and cholesteryl ester transfer protein inhibitors.
- These therapies offer potential to address residual risk beyond statin treatment.
Conclusions:
- Novel lipid-altering therapies are crucial for managing patients with dyslipidemia who have not achieved treatment goals.
- These agents may serve as important adjuvant therapies to statins in reducing cardiovascular risk.
- Further research and clinical trials are needed to establish the role of these emerging treatments in atherosclerotic heart disease management.
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