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Published on: September 20, 2019
2019 clinical trials in lipid lowering
David I Feldman1, Justin M Pacor2, Roger S Blumenthal3
1Ciccarone Center for the Prevention of Cardiovascular Disease, Department of Medicine, The Johns Hopkins Hospital, Baltimore, Maryland.
Purpose Of Review:
Lipid-lowering therapies play a major role in reducing atherosclerotic cardiovascular disease (ASCVD). This article reviews the most recent lipid-lowering therapy trials, many of which provide a unique opportunity to further reduce low-density lipoprotein cholesterol (LDL-C) levels and ASCVD risk on top of statin therapy, and in doing so further decrease the number of future major adverse cardiovascular events.
Recent Findings:
Although statin therapy has been the mainstay of treatment for lowering LDL-C levels for many years, many individuals require additional or alternative options for further reducing their risk. Trials on previously studied therapies, such as PCSK9 inhibitors, and new therapies, including inclisiran, bempedoic acid and icosapent ethyl demonstrate significant potential for further lowering of LDL-C levels and risk for events on top of maximally tolerated statin therapy with favourable side effect profiles.
Summary:
As therapies for ASCVD prevention continue to emerge, clinicians will need to identify the appropriate treatment for individuals based on their estimated risk and risk-enhancing factors. When statin therapy is either not sufficient or patients do not tolerate adequate statin therapy, relying on newer therapies, such as PCSK9-inhibitors, inclisiran, bempedoic acid and icosapent ethyl, will be critical to maximize risk factor profiles to reduce adverse outcomes.
Insights
Newer lipid-lowering therapies offer significant potential to further reduce atherosclerotic cardiovascular disease (ASCVD) risk beyond statin therapy. These advanced treatments, including PCSK9 inhibitors and inclisiran, provide options for patients needing additional risk reduction.
Area of Science:
- Cardiology
- Pharmacology
- Preventive Medicine
Background:
- Lipid-lowering therapies are crucial for managing atherosclerotic cardiovascular disease (ASCVD).
- Statin therapy is the primary treatment for lowering low-density lipoprotein cholesterol (LDL-C).
- Many patients require additional or alternative therapies to achieve optimal LDL-C reduction and ASCVD risk management.
Purpose of the Study:
- To review recent clinical trials on novel lipid-lowering therapies.
- To evaluate the efficacy of these therapies in further reducing LDL-C and ASCVD risk.
- To highlight the role of emerging treatments in ASCVD prevention.
Main Methods:
- Review of recent clinical trials on lipid-lowering agents.
- Analysis of data on LDL-C reduction and cardiovascular event rates.
- Assessment of safety and tolerability profiles of new therapies.
Main Results:
- PCSK9 inhibitors, inclisiran, bempedoic acid, and icosapent ethyl demonstrate significant LDL-C lowering.
- These therapies offer additional risk reduction on top of maximally tolerated statin therapy.
- Favorable side effect profiles were noted for several new agents.
Conclusions:
- Emerging lipid-lowering therapies provide valuable options for ASCVD risk reduction.
- Clinicians must tailor treatment based on individual patient risk and tolerance.
- These newer agents are critical for maximizing risk factor modification in ASCVD prevention.
