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Management of atherosclerosis involves an integrated strategy encompassing pharmacological treatment, surgical interventions, lifestyle changes, and nutrition therapy to address the multifactorial nature of the disease.Pharmacological TherapyA cornerstone of atherosclerosis management is the use of pharmacological agents. Statins, such as atorvastatin, are pivotal in inhibiting HMG-CoA reductase, an enzyme that catalyzes an initial step in cholesterol synthesis in the liver. This reduction in...
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The empirical approach to drug therapy optimization relies on correlating pharmacological response with administered dosage. Such an approach can be costly, time-consuming, and often yields poor correlation due to variables like formulation factors and drug elimination characteristics. A more precise approach correlates response with plasma drug concentration or the amount of drug in the body, rather than dosage. This is achieved through pharmacokinetic-pharmacodynamic (PK/PD) modeling, which...
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Ongoing challenges for pharmacotherapy for dyslipidemia.

Anthony D Pisaniello1, Daniel J Scherer, Yu Kataoka

  • 1University of Adelaide, South Australian Health and Medical Research Institute , PO Box 11060, Adelaide, SA, 5001 , Australia +61 8 8128 4510 ; stephen.nicholls@sahmri.com.

Expert Opinion on Pharmacotherapy
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PubMed
Summary

Maximizing statin use in high-risk patients is crucial for cardiovascular disease prevention. Novel lipid-modifying therapies, such as PCSK9 and CETP inhibitors, show promise for additional protection but require further clinical validation.

Keywords:
atherosclerosiscardiovascular risklipid-modifying therapylipids

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Area of Science:

  • Cardiovascular Medicine
  • Pharmacology
  • Lipid Metabolism

Background:

  • Lipid-modifying therapies are vital for cardiovascular disease (CVD) prevention guidelines.
  • Current use of these agents is suboptimal, leaving a significant residual risk of clinical events.
  • There is a pressing need for more effective lipid-modifying strategies for many patients.

Purpose of the Study:

  • To review factors affecting the utilization of current lipid-modifying treatments.
  • To explore emerging therapeutic agents targeting various lipid factors.
  • To identify gaps and opportunities in lipid management for CVD prevention.

Main Methods:

  • A comprehensive literature search was conducted.
  • Focus was placed on manuscripts discussing established lipid-modifying therapies.
  • New agents in development targeting diverse lipid factors were also examined.

Main Results:

  • Statin therapy is underutilized in high-risk populations.
  • Novel therapeutic targets, including proprotein convertase subtilisin kexin-type 9 (PCSK9) and cholesteryl ester transfer protein (CETP), are under investigation.
  • Further research is needed to confirm the efficacy of these new agents.

Conclusions:

  • Intensified efforts are necessary to optimize statin utilization in patients at higher risk.
  • Emerging therapies like PCSK9 and CETP inhibitors may offer enhanced cardiovascular protection.
  • Clinical trials are essential to validate the benefits of these novel lipid-modifying approaches.