针对PCSK9及以后的低密度脂蛋白胆固醇的管理
Farzahna Mohamed1, Brett Mansfield1, Frederick J Raal1
1Division of Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2193, South Africa.
Journal of clinical medicine
|August 12, 2023
概括
除了他类药物之外的新疗法可以显著降低低密度脂蛋白胆固醇 (LDL-C) 和降低动脉样硬化心血管疾病 (ASCVD) 风险. 这些创新的治疗方法为无法达到LDL-C目标或不能耐受他类药物的患者提供了替代方案.
科学领域:
- 心脏病学 心脏病学
- 药理学 药理学是指药理学的学科.
- 遗传学 遗传学 是一个
背景情况:
- 升高的低密度脂蛋白胆固醇 (LDL-C) 是动脉样硬化心血管疾病 (ASCVD) 的主要驱动因素.
- 许多患者,特别是那些患有家族性高胆固醇血症 (FH) 或非常高ASCVD风险的患者,在单独使用他类药物治疗时无法达到目标的LDL-C水平.
- 新型降脂疗法 (LLT) 的使用不足归因于成本和治疗惯性.
研究的目的:
- 审查创新的方法来管理超出他单一治疗的高LDL-C.
- 探索新的LLT策略,包括组合疗法和新兴目标.
- 突出基于核酸的疗法和基因编辑的进展,以减少心血管风险.
主要方法:
- 关于新型降脂疗法的当前文献的综述.
- 讨论涉及他类药物与ezetimibe,bempedoic acid和CETP抑制剂的组合疗法.
- 探索PCSK9和ANGPTL3抑制等向疗法,以及基于核酸和基因编辑的策略.
主要成果:
- 新兴的LLT策略显示,LDL-C的显著降低.
- 这些新的方法提供了改善的心血管结果.
- 新疗法为他类药物不耐受患者和患有FH的患者提供了可行的替代方案.
结论:
- 创新的LLT策略,包括组合疗法和向药物,对于最佳的LDL-C控制至关重要.
- 这些方法解决了单独治疗他类药物的局限性,并降低了ASCVD风险.
- 基于核酸的疗法和基因编辑的进步有望提高患者的坚持性和改善心血管健康.
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