LDL胆固醇:争议和未来的治疗方向
1Harvard Medical School, Center for Cardiovascular Disease Prevention, Brigham and Women's Hospital Boston, MA, USA.
Lancet (London, England)
|August 19, 2014
概括
高的LDL胆固醇会增加心血管疾病的风险. 包括单克隆抗体在内的新型疗法正在迅速将遗传洞察力转化为临床实践,以评估安全有效的LDL胆固醇降低.
科学领域:
- 心血管医学 心血管医学
- 遗传学 是一个遗传学.
- 药理学 药理学是指药理学的学科.
背景情况:
- 升高的低密度脂蛋白 (LDL) 胆固醇是心血管事件的主要驱动因素.
- 类药物有效降低高脂血症,但关于LDL测量,查和治疗目标的争议仍然存在.
- 影响LDL受体的遗传缺陷突出了其在遗传性超脂症中发挥的关键作用.
研究的目的:
- 解决LDL胆固醇管理中持续存在的争议,包括测量,查和药物疗效.
- 评估新型疗法,特别是单克隆抗体,其显著降低LDL胆固醇的能力.
- 确定积极降低LDL胆固醇的安全性和有效性及其对动脉血症并发症的影响.
主要方法:
- 对生物,遗传和流行病学数据的审查,支持LDL胆固醇在心血管疾病中的作用.
- 对他类药物治疗和新兴的降低LDL药物的随机试验的证据分析.
- 评估正在进行的3期试验,涉及超过6万名患者,评估针对LDL受体生命周期的单克隆抗体.
主要成果:
- 类他类药物已被证明是有效的减轻人口超脂血症的负担.
- 包括单克隆抗体在内的新型疗法显示,除了他类药物治疗之外,还有可能显著降低LDL胆固醇.
- 目前正在进行大规模试验,以调查实现非常低的LDL胆固醇水平的安全性和有效性.
结论:
- 尽管有确定的好处,但关于最佳的LDL胆固醇管理策略仍然存在争议.
- 将遗传发现快速转化为单克隆抗体等新型疗法正在改变超脂血症治疗.
- 目前正在进行的研究旨在确定积极降低LDL胆固醇的安全性,有效性和长期益处,以预防心血管事件.
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