Current pharmacotherapies for atherosclerotic cardiovascular diseases

Area of Science:

• Cardiology
• Pharmacology
• Immunology

Background:

• Atherosclerotic cardiovascular disease (ASCVD) remains a primary global health concern, with statins alone insufficient for many patients.
• Combination therapies (e.g., statins with ezetimibe or PCSK9 inhibitors) improve lipid-lowering but do not fully resolve ASCVD morbidity and mortality.
• Emerging anti-inflammatory strategies are being investigated to address residual ASCVD risk.

Purpose of the Study:

• To review current and future pharmaceutical therapies for ASCVD.
• To explore both lipid-modifying and anti-inflammatory treatment strategies.
• To highlight the challenges and potential of novel ASCVD interventions.

Main Methods:

• Literature review of lipid-modifying agents (statins, ezetimibe, PCSK9 inhibitors).
• Review of anti-inflammatory therapies targeting pathways like interleukin-1 beta (IL-1β).
• Analysis of drug development successes and failures in ASCVD treatment.

Main Results:

• Canakinumab (targeting IL-1β) is a validated anti-inflammatory therapy for ASCVD.
• Low-dose methotrexate shows promise for ASCVD treatment due to efficacy and safety.
• Many inflammation pathway modulators have failed due to the complexity of atherosclerosis.

Conclusions:

• Pharmaceutical strategies for ASCVD are expanding to include targeted anti-inflammatory treatments.
• Addressing residual ASCVD risk requires a multi-faceted approach combining lipid modification and inflammation control.
• Further research into the complex inflammatory processes of atherosclerosis is crucial for developing effective therapies.