Title : Lipid-lowering therapies: Where are we now and where are we heading?
Abstract:
Background. Coronary artery disease is one of the leading causes of death worldwide and the incidence is on the rise in the past decade. One of the main causes is the obesity epidemic and the increase of metabolic syndrome. Hypertension, diabetes, smoking and hyperlipidaemia are the risk factors that are modifiable and have shown, through various trials, that if controlled reduce cardiac events.
Methods. We search over the medical publications (Web of Science, PubMed, Google Scholar) information about actual therapies.
Results. Statins have been one of the pillars in lipid-lowering therapy for many years with demonstrated benefits in reducing morbidity and mortality related to atherosclerotic disease. Due to their known side effects, new agents such as the PCSK9 inhibitors were developed which have reported to greatly reduce LDL-cholesterol and have proven to reduce cardiovascular events.
The most recent approved treatment for hypercholesterolemia is the bempedoic acid which inhibits adenosine triphosphate citrate lyase (ACL) an enzyme with a role in cholesterol synthesis in the liver. Phase 3 studies have shown significant reductions in all lipid levels and further studies demonstrating reduction of cardiovascular events will finish this year.
The CO-VID19 pandemic registered a high mortality in patients with cardiovascular risk, obesity, diabetes and hypercholesterolemia. The scientific community globally focused on developing a vaccine through different methods, the SARS-COV2 mRNA vaccine helped pave the way in developing RNA interfering agents. An agent was developed to inhibit translation of the PCSK9 protein and its formation with promising results.
Conclusions. Finally, new evidence in the field of gene editing with alternating lipoprotein structures and controlling their serum concentrations are being tested in primates. All other actual therapies are part of the actual treatment strategies.
Keywords: Lipid-lowering therapies, statins, PCSK9, bempedoic acid, mRNA
Audience Take Away
- The audience will learn the actual and the future therapies in lipidology.
- A clarification of actual guidelines will be presented.
- This research will use to clarify new direction in lipidology.
- We will provide a practical solution, a clear integrated algorithm of 3-4 professional societies in lipidology to act for a prescription.
