Novel emerging therapies in atherosclerosis targeting lipid metabolism. [Review]

MedStar author(s):
Citation: Expert Opinion on Investigational Drugs. 29(6):611-622, 2020 Jun.PMID: 32363959Institution: MedStar Union Memorial HospitalForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Atherosclerosis/dt [Drug Therapy] | *Hypolipidemic Agents/pd [Pharmacology] | *Lipid Metabolism/de [Drug Effects] | Animals | Atherosclerosis/pa [Pathology] | Cardiovascular Diseases/pc [Prevention & Control] | Cholesterol, LDL/bl [Blood] | Humans | Hydroxymethylglutaryl-CoA Reductase Inhibitors/pd [Pharmacology] | Hyperlipidemias/co [Complications] | Hyperlipidemias/dt [Drug Therapy]Year: 2020ISSN:
  • 1354-3784
Name of journal: Expert opinion on investigational drugsAbstract: AREAS COVERED: Inclisiran and pemafibrate, with expected approval soon, come under the spotlight. We discuss other therapeutics such as lomitapide, mipomersen, volanesorsen, and evinacumab and newly approved non-statin-based therapies such as ezetimibe, icosapent ethyl (IPE), and bempedoic acid.EXPERT OPINION: New options now exist for the prevention of atherosclerosis in patients that are not optimized on statin therapy. Multiple guidelines endorse ezetimibe, PCSK9 inhibitors, bempedoic, and IPE as add-on therapy. Recently approved bempedoic acid/ezetimibe combination might gain popularity among clinicians. Inclisiran and pemafibrate show promise in the reduction of LDL-C and TG, respectively, and results are pending in cardiovascular outcome trials. Combination strategies could improve outcomes, but the challenge will be balancing cost and selecting the correct patient population for each treatment modality to maximize benefit with the fewest medications.INTRODUCTION: Recent years have brought significant developments in lipid and atherosclerosis research. Although statins are a cornerstone in hyperlipidemia management, new non-statin therapies have had an impact. The reduction of low-density lipoprotein cholesterol (LDL-C) further translates into the lowering of cardiovascular mortality. Additionally, lipid research has progressed beyond LDL-C reduction and this has brought triglyceride (TG) and other apoprotein-B containing lipids into focus.All authors: Aronow WS, Bandyopadhyay D, Blumenthal C, Chatterjee S, Ghosh RK, Gupta M, Jain V, Lavie CJ, Ray KK, Virani SSOriginally published: Expert Opinion on Investigational Drugs. :1-12, 2020 May 22Fiscal year: FY2020Digital Object Identifier: Date added to catalog: 2020-07-09
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Journal Article MedStar Authors Catalog Article 32363959 Available 32363959

AREAS COVERED: Inclisiran and pemafibrate, with expected approval soon, come under the spotlight. We discuss other therapeutics such as lomitapide, mipomersen, volanesorsen, and evinacumab and newly approved non-statin-based therapies such as ezetimibe, icosapent ethyl (IPE), and bempedoic acid.

EXPERT OPINION: New options now exist for the prevention of atherosclerosis in patients that are not optimized on statin therapy. Multiple guidelines endorse ezetimibe, PCSK9 inhibitors, bempedoic, and IPE as add-on therapy. Recently approved bempedoic acid/ezetimibe combination might gain popularity among clinicians. Inclisiran and pemafibrate show promise in the reduction of LDL-C and TG, respectively, and results are pending in cardiovascular outcome trials. Combination strategies could improve outcomes, but the challenge will be balancing cost and selecting the correct patient population for each treatment modality to maximize benefit with the fewest medications.

INTRODUCTION: Recent years have brought significant developments in lipid and atherosclerosis research. Although statins are a cornerstone in hyperlipidemia management, new non-statin therapies have had an impact. The reduction of low-density lipoprotein cholesterol (LDL-C) further translates into the lowering of cardiovascular mortality. Additionally, lipid research has progressed beyond LDL-C reduction and this has brought triglyceride (TG) and other apoprotein-B containing lipids into focus.

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