New Drugs for Treating Dyslipidemia: Beyond Statins
Statins have been shown to be very effective and safe in numerous randomized clinical trials, and became the implacable first-line treatment against atherogenic dyslipidemia. However, even with optimal statin treatment, 60% to 80% of residual cardiovascular risk still exists. The patients with famil...
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| Format: | Article |
| Language: | English |
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Korean Diabetes Association
2015-04-01
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| Series: | Diabetes & Metabolism Journal |
| Subjects: | |
| Online Access: | http://e-dmj.org/Synapse/Data/PDFData/2004DMJ/dmj-39-87.pdf |
| _version_ | 1819240876619071488 |
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| author | Chang Ho Ahn Sung Hee Choi |
| author_facet | Chang Ho Ahn Sung Hee Choi |
| author_sort | Chang Ho Ahn |
| collection | DOAJ |
| description | Statins have been shown to be very effective and safe in numerous randomized clinical trials, and became the implacable first-line treatment against atherogenic dyslipidemia. However, even with optimal statin treatment, 60% to 80% of residual cardiovascular risk still exists. The patients with familial hypercholesterolemia which results in extremely high level of low density lipoprotein cholesterol (LDL-C) level and the patients who are intolerant or unresponsive to statins are the other hurdles of statin treatment. Recently, new classes of lipid-lowering drugs have been developed and some of them are available for the clinical practice. The pro-protein convertase subtilisin/kexintype 9 (PCSK9) inhibitor increases the expression of low density lipoprotein (LDL) receptor in hepatocytes by enhancing LDL receptor recycling. The microsomal triglyceride transport protein (MTP) inhibitor and antisense oligonucleotide against apolipoprotein B (ApoB) reduce the ApoB containing lipoprotein by blocking the hepatic very low density lipoprotein synthesis pathway. The apolipoprotein A1 (ApoA1) mimetics pursuing the beneficial effect of high density lipoprotein cholesterol and can reverse the course of atherosclerosis. ApoA1 mimetics had many controversial clinical data and need more validation in humans. The PCSK9 inhibitor recently showed promising results of significant LDL-C lowering in familial hypercholesterolemia (FH) patients from the long-term phase III trials. The MTP inhibitor and antisesnse oligonucleotide against ApoB were approved for the treatment of homozygous FH but still needs more consolidated evidences about hepatic safety such as hepatosteatosis. We would discuss the benefits and concerns of these new lipid-lowering drugs anticipating additional benefits beyond statin treatment. |
| first_indexed | 2024-12-23T14:14:59Z |
| format | Article |
| id | doaj.art-818f8c3db0074af0a954de14790c578c |
| institution | Directory Open Access Journal |
| issn | 2233-6079 2233-6087 |
| language | English |
| last_indexed | 2024-12-23T14:14:59Z |
| publishDate | 2015-04-01 |
| publisher | Korean Diabetes Association |
| record_format | Article |
| series | Diabetes & Metabolism Journal |
| spelling | doaj.art-818f8c3db0074af0a954de14790c578c2022-12-21T17:43:56ZengKorean Diabetes AssociationDiabetes & Metabolism Journal2233-60792233-60872015-04-01392879410.4093/dmj.2015.39.2.8714740New Drugs for Treating Dyslipidemia: Beyond StatinsChang Ho AhnSung Hee ChoiStatins have been shown to be very effective and safe in numerous randomized clinical trials, and became the implacable first-line treatment against atherogenic dyslipidemia. However, even with optimal statin treatment, 60% to 80% of residual cardiovascular risk still exists. The patients with familial hypercholesterolemia which results in extremely high level of low density lipoprotein cholesterol (LDL-C) level and the patients who are intolerant or unresponsive to statins are the other hurdles of statin treatment. Recently, new classes of lipid-lowering drugs have been developed and some of them are available for the clinical practice. The pro-protein convertase subtilisin/kexintype 9 (PCSK9) inhibitor increases the expression of low density lipoprotein (LDL) receptor in hepatocytes by enhancing LDL receptor recycling. The microsomal triglyceride transport protein (MTP) inhibitor and antisense oligonucleotide against apolipoprotein B (ApoB) reduce the ApoB containing lipoprotein by blocking the hepatic very low density lipoprotein synthesis pathway. The apolipoprotein A1 (ApoA1) mimetics pursuing the beneficial effect of high density lipoprotein cholesterol and can reverse the course of atherosclerosis. ApoA1 mimetics had many controversial clinical data and need more validation in humans. The PCSK9 inhibitor recently showed promising results of significant LDL-C lowering in familial hypercholesterolemia (FH) patients from the long-term phase III trials. The MTP inhibitor and antisesnse oligonucleotide against ApoB were approved for the treatment of homozygous FH but still needs more consolidated evidences about hepatic safety such as hepatosteatosis. We would discuss the benefits and concerns of these new lipid-lowering drugs anticipating additional benefits beyond statin treatment.http://e-dmj.org/Synapse/Data/PDFData/2004DMJ/dmj-39-87.pdfDyslipidemiaMTP inhibitorPCSK9 inhibitor |
| spellingShingle | Chang Ho Ahn Sung Hee Choi New Drugs for Treating Dyslipidemia: Beyond Statins Diabetes & Metabolism Journal Dyslipidemia MTP inhibitor PCSK9 inhibitor |
| title | New Drugs for Treating Dyslipidemia: Beyond Statins |
| title_full | New Drugs for Treating Dyslipidemia: Beyond Statins |
| title_fullStr | New Drugs for Treating Dyslipidemia: Beyond Statins |
| title_full_unstemmed | New Drugs for Treating Dyslipidemia: Beyond Statins |
| title_short | New Drugs for Treating Dyslipidemia: Beyond Statins |
| title_sort | new drugs for treating dyslipidemia beyond statins |
| topic | Dyslipidemia MTP inhibitor PCSK9 inhibitor |
| url | http://e-dmj.org/Synapse/Data/PDFData/2004DMJ/dmj-39-87.pdf |
| work_keys_str_mv | AT changhoahn newdrugsfortreatingdyslipidemiabeyondstatins AT sungheechoi newdrugsfortreatingdyslipidemiabeyondstatins |