Beyond Statins: Novel Lipid-Lowering Agents for Reducing Risk of Atherosclerotic Cardiovascular Disease
Although statins have served as the cornerstone for pharmacological lowering of lipid levels in atherosclerotic cardiovascular disease (ASCVD) risk reduction, many patients are unable to achieve target doses of statin medication due to side effects or target levels of cholesterol reduction on statin...
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| Format: | Article |
| Language: | English |
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MDPI AG
2024-03-01
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| Series: | Pharmacoepidemiology |
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| Online Access: | https://www.mdpi.com/2813-0618/3/1/9 |
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| author | Teimur Kayani Bachar Ahmad Rachel S. Chang Frank Qian Melis Sahinoz Muhammad Waqar Rehan Antonio Giaimo Erica S. Spatz Jiun-Ruey Hu |
| author_facet | Teimur Kayani Bachar Ahmad Rachel S. Chang Frank Qian Melis Sahinoz Muhammad Waqar Rehan Antonio Giaimo Erica S. Spatz Jiun-Ruey Hu |
| author_sort | Teimur Kayani |
| collection | DOAJ |
| description | Although statins have served as the cornerstone for pharmacological lowering of lipid levels in atherosclerotic cardiovascular disease (ASCVD) risk reduction, many patients are unable to achieve target doses of statin medication due to side effects or target levels of cholesterol reduction on statin monotherapy. The landscape of lipid-lowering strategies has expanded in recent years, with the emergence of therapies that make use of small interfering RNA (siRNA) and antisense oligonucleotides, in addition to traditional small-molecule agents. Non-statin therapies that have shown promising results in randomized controlled trials include adenosine triphosphate-citrate lyase inhibitors, proprotein convertase subtilisin/kexin 9 (PCSK9)-inhibiting antibodies and siRNA, omega-3 polyunsaturated fatty acids, and lipoprotein(a) gene-inhibiting siRNA and ASOs, in addition to older therapies such as ezetimibe. In contrast, cholesteryl ester transfer protein (CETP) inhibitors have shown less promising results in randomized trials. The purpose of this narrative review is to summarize the evidence for these medications, with a focus on phase III randomized trials. |
| first_indexed | 2024-04-24T17:55:08Z |
| format | Article |
| id | doaj.art-78bb54e5ff354fdfa94db5de25438de0 |
| institution | Directory Open Access Journal |
| issn | 2813-0618 |
| language | English |
| last_indexed | 2024-04-24T17:55:08Z |
| publishDate | 2024-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Pharmacoepidemiology |
| spelling | doaj.art-78bb54e5ff354fdfa94db5de25438de02024-03-27T13:59:56ZengMDPI AGPharmacoepidemiology2813-06182024-03-013111716810.3390/pharma3010009Beyond Statins: Novel Lipid-Lowering Agents for Reducing Risk of Atherosclerotic Cardiovascular DiseaseTeimur Kayani0Bachar Ahmad1Rachel S. Chang2Frank Qian3Melis Sahinoz4Muhammad Waqar Rehan5Antonio Giaimo6Erica S. Spatz7Jiun-Ruey Hu8Yale School of Medicine, Yale University, New Haven, CT 06510, USAYale School of Medicine, Yale University, New Haven, CT 06510, USADepartment of Internal Medicine, University of California San Francisco, San Francisco, CA 94143, USASection of Cardiovascular Medicine, Boston Medical Center and Boston University Chobanian & Avedisian School of Medicine, Boston, MA 02118, USADepartment of Medicine, Vanderbilt University Medical Center, Nashville, TN 37232, USADepartment of Internal Medicine, Griffin Health, Derby, CT 06418, USASection of Cardiovascular Medicine, Yale School of Medicine, Yale University, New Haven, CT 06510, USASection of Cardiovascular Medicine, Yale School of Medicine, Yale University, New Haven, CT 06510, USASection of Cardiovascular Medicine, Yale School of Medicine, Yale University, New Haven, CT 06510, USAAlthough statins have served as the cornerstone for pharmacological lowering of lipid levels in atherosclerotic cardiovascular disease (ASCVD) risk reduction, many patients are unable to achieve target doses of statin medication due to side effects or target levels of cholesterol reduction on statin monotherapy. The landscape of lipid-lowering strategies has expanded in recent years, with the emergence of therapies that make use of small interfering RNA (siRNA) and antisense oligonucleotides, in addition to traditional small-molecule agents. Non-statin therapies that have shown promising results in randomized controlled trials include adenosine triphosphate-citrate lyase inhibitors, proprotein convertase subtilisin/kexin 9 (PCSK9)-inhibiting antibodies and siRNA, omega-3 polyunsaturated fatty acids, and lipoprotein(a) gene-inhibiting siRNA and ASOs, in addition to older therapies such as ezetimibe. In contrast, cholesteryl ester transfer protein (CETP) inhibitors have shown less promising results in randomized trials. The purpose of this narrative review is to summarize the evidence for these medications, with a focus on phase III randomized trials.https://www.mdpi.com/2813-0618/3/1/9cholesterolatherosclerotic cardiovascular diseasestatinlipid loweringrandomized trials |
| spellingShingle | Teimur Kayani Bachar Ahmad Rachel S. Chang Frank Qian Melis Sahinoz Muhammad Waqar Rehan Antonio Giaimo Erica S. Spatz Jiun-Ruey Hu Beyond Statins: Novel Lipid-Lowering Agents for Reducing Risk of Atherosclerotic Cardiovascular Disease Pharmacoepidemiology cholesterol atherosclerotic cardiovascular disease statin lipid lowering randomized trials |
| title | Beyond Statins: Novel Lipid-Lowering Agents for Reducing Risk of Atherosclerotic Cardiovascular Disease |
| title_full | Beyond Statins: Novel Lipid-Lowering Agents for Reducing Risk of Atherosclerotic Cardiovascular Disease |
| title_fullStr | Beyond Statins: Novel Lipid-Lowering Agents for Reducing Risk of Atherosclerotic Cardiovascular Disease |
| title_full_unstemmed | Beyond Statins: Novel Lipid-Lowering Agents for Reducing Risk of Atherosclerotic Cardiovascular Disease |
| title_short | Beyond Statins: Novel Lipid-Lowering Agents for Reducing Risk of Atherosclerotic Cardiovascular Disease |
| title_sort | beyond statins novel lipid lowering agents for reducing risk of atherosclerotic cardiovascular disease |
| topic | cholesterol atherosclerotic cardiovascular disease statin lipid lowering randomized trials |
| url | https://www.mdpi.com/2813-0618/3/1/9 |
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