The Future of Lipid-Lowering Therapy

Willemien van Zwol, Antoine Rimbert, Jan Albert Kuivenhoven*

*Corresponding author for this work

Research output: Contribution to journalReview articleAcademicpeer-review

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Abstract

The recent introduction of inhibitors of proprotein convertase subtilisin/kexin 9 to lower low-density lipoprotein (LDL) cholesterol on top of statins or as monotherapy is rapidly changing the landscape of treatment of atherosclerotic cardiovascular disease (ASCVD). However, existing lipid-lowering drugs have little impact on lipoprotein(a) (Lp(a)) or plasma triglycerides, two other risk factors for ASCVD. This review summarizes the evidence and the rationale to target Lp(a) and triglycerides and provides an overview of currently tested strategies to lower Lp(a), apolipoprotein C-III and angiopoietin-like protein 3. In addition, it summarizes new findings on the use of omega-3 fatty acids (OM3FA) to fight ASCVD. With the exception of OM3FA supplementation, the promise of the experimental drugs discussed here depends on the long-term safety and efficacy of monoclonal antibodies and/or antisense oligonucleotides Clinical outcome trials will ultimately prove whether these new therapeutic modalities will reduce ASCVD risk.

Original languageEnglish
Article number1085
Number of pages16
JournalJournal of Clinical Medicine
Volume8
Issue number7
DOIs
Publication statusPublished - Jul-2019

Keywords

  • atherosclerotic cardiovascular disease
  • residual risk
  • plasma lipids
  • Lp(a)
  • Angptl3
  • ApoC-III
  • Omega 3 fatty acids
  • TRIGLYCERIDE-RICH LIPOPROTEINS
  • APOLIPOPROTEIN C-III
  • FAMILIAL COMBINED HYPOLIPIDEMIA
  • HIGH-DENSITY-LIPOPROTEIN
  • CORONARY-HEART-DISEASE
  • OF-FUNCTION MUTATIONS
  • CARDIOVASCULAR-DISEASE
  • EICOSAPENTAENOIC ACID
  • LDL-C
  • OXIDIZED PHOSPHOLIPIDS

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