NYMC Faculty Publications
Novel Emerging Therapies in Atherosclerosis Targeting Lipid Metabolism
DOI
10.1080/13543784.2020.1764937
Journal Title
Expert Opinion on Investigational Drugs
First Page
611
Last Page
622
Document Type
Review Article
Publication Date
6-2020
Department
Medicine
Abstract
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.
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.
Recommended Citation
Gupta, M., Blumenthal, C., Chatterjee, S., Bandyopadhyay, D., Jain, V., Lavie, C. J., Virani, S. S., Ray, K. K., Aronow, W. S., & Ghosh, R. K. (2020). Novel Emerging Therapies in Atherosclerosis Targeting Lipid Metabolism. Expert Opinion on Investigational Drugs, 29 (6), 611-622. https://doi.org/10.1080/13543784.2020.1764937