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Updated: Dec 19, 2025
Differential Effects of Lipid-lowering Drugs in Modulating Morphology of Cholesterol Particles
Published on: November 10, 2017
Lipid lowering therapy in cardiovascular disease: From myth to molecular reality
Philipp Mourikis1, Saif Zako1, Lisa Dannenberg1
1Division of Cardiology, Pulmonology, and Vascular Medicine, Heinrich Heine University Medical Center Dusseldorf, Dusseldorf, Germany.
Insights
Novel lipid-lowering therapies are emerging to combat cardiovascular disease by reducing LDL cholesterol, triglycerides, and lipoprotein (a). These advancements offer new strategies beyond statins for better patient outcomes.
Area of Science:
- Cardiovascular Medicine
- Pharmacology
- Lipid Metabolism
Background:
- Lipid-lowering therapy is crucial for managing atherosclerosis and cardiovascular disease.
- Current guidelines recommend statins, ezetimibe, and PCSK9 inhibitors, which improve lipid profiles and reduce cardiovascular events.
- The
Purpose of the Study:
- To review current and future therapeutic strategies for lipid management.
- To highlight emerging drug classes targeting LDL cholesterol, triglycerides, and lipoprotein (a).
Main Methods:
- Review of current literature on lipid-lowering therapies.
- Discussion of novel drug classes and their mechanisms of action.
Main Results:
- Bempedoic acid and inclisiran show promise for targeting LDL cholesterol.
- Icosapent ethyl demonstrates cardiovascular risk reduction via triglyceride lowering.
- Evinacumab, ANGPTL3 antisense-oligonucleotides, ApoC-III antisense-oligonucleotides, and Lp(a) antisense-oligonucleotides show potential for triglyceride and Lp(a) reduction.
Conclusions:
- New therapeutic options are expanding lipid management beyond traditional therapies.
- Targeting LDL, triglycerides, and lipoprotein (a) with novel agents offers improved cardiovascular risk reduction.
Abstract:
Lipid-lowering therapy is one major cornerstone of medical treatment of cardiovascular disease in order to modulate atherosclerosis. Statins, ezetimibe and novel PCSK9-inhibitors are already recommended in current guidelines and were shown to improve lipid profiles and have positive effects on the rate of ischemic events and cardiovascular mortality. Recent studies suggest that the concept of "The lower the better" might be valid at least regarding low density lipoproteins. In addition, lowering lipoprotein (a) still displays a major challenge in lipid therapy. Furthermore, also lowering triglycerides seems to improve cardiovascular outcome. Regarding triglycerides, icosapent ethyl, a polyunsaturated fatty acid recently attracted attention showing cardiovascular risk reduction due to triglyceride lowering. Therefore, new therapeutic strategies and drug classes are eagerly awaited. Targeting LDL, bempedoic acid and the siRNA inclisiran provide promising results. Moreover, regarding TG a monoclonal antibody called evinacumab and an antisense-oligonucleotide against ANGPTL3 showed effective TG-lowering. At least, using antisense-oligonucleotides against ApoC-III and Lp(a) resulted in promising outcomes. In this review, current and future options for lipid management are presented depending on different drug classes.
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