Dyslipidaemia: what's around the corner?

Area of Science:

• Cardiovascular Medicine
• Pharmacology
• Biochemistry

Background:

• Hyperlipidemia is a primary risk factor for atherosclerosis and cardiovascular disease (CVD).
• Current guidelines emphasize statin therapy without strict lipid targets, yet residual CVD risk persists.
• Novel therapeutic strategies are essential for patients unresponsive or intolerant to statins.

Purpose of the Study:

• To review emerging therapies for lipid management beyond current standards of care.
• To explore novel agents targeting low-density lipoprotein (LDL)-cholesterol, high-density lipoprotein (HDL)-cholesterol, and triglycerides.
• To discuss specialized treatments for rare genetic lipid disorders.

Main Methods:

• Review of ongoing research and clinical trials for novel lipid-lowering drugs.
• Analysis of mechanisms of action for investigational therapies.
• Examination of therapeutic potential for specific patient populations, including those with orphan lipid disorders.

Main Results:

• Proprotein convertase subtilisin/kexin-9 (PCSK-9) inhibitors show promise for further LDL-cholesterol reduction.
• Cholesterol ester transfer protein inhibitors (CETPIs) are being investigated for HDL-cholesterol elevation.
• Novel peroxisome proliferator-activated receptor (PPAR)-agonists and omega-3 fatty acid preparations aim to reduce triglycerides.
• Lomitapide and alipogene tiparvovec are specialized therapies for homozygous familial hypercholesterolemia and familial chylomicronaemia, respectively.

Conclusions:

• Novel lipid-lowering agents offer significant potential for managing residual cardiovascular risk.
• These therapies are expected to benefit patients with the highest cardiovascular risk profiles.
• Advancements in treating rare lipid disorders are expanding therapeutic options for specialized populations.