Statins are the first-line therapy in LDL-Cholesterol (LDL-C) reduction and its clinical use has contributed to significant prevention and treatment of atherosclerotic vascular disease. Yet, a significant proportion of patients remain at high risk. Recently, a number of new therapies have been developed to further lower LDL-C. These agents may provide clinical benefit on top of statin therapy in patients with high residual risk, severe hypercholesterolemia or as an alternative for patients who are intolerant to statins. We review four novel approaches based on the inhibition of proprotein convertase subtilisin/kexin type 9 (PCSK9), apolipoprotein-B100 (apoB), Cholesteryl ester transport protein (CETP) and microsomal triglyceride transfer protein (MTP). ApoB and MTP inhibitors (Mipomersen and Lomitapide) are indicated only for homozygous familial hypercholesterolemia patients. The results of ongoing trials with CETP and PCSK9 inhibitors may warrant a wider employment in different categories of patients at high risk for cardiovascular disease.

Noto, D., Cefalù, A., Averna, M. (2014). Beyond Statins: New Lipid Lowering Strategies to Reduce Cardiovascular Risk. CURRENT ATHEROSCLEROSIS REPORTS, 16(6), 414-423 [10.1007/s11883-014-0414-4].

Beyond Statins: New Lipid Lowering Strategies to Reduce Cardiovascular Risk

NOTO, Davide;CEFALU', Angelo Baldassare;AVERNA, Maurizio
2014-01-01

Abstract

Statins are the first-line therapy in LDL-Cholesterol (LDL-C) reduction and its clinical use has contributed to significant prevention and treatment of atherosclerotic vascular disease. Yet, a significant proportion of patients remain at high risk. Recently, a number of new therapies have been developed to further lower LDL-C. These agents may provide clinical benefit on top of statin therapy in patients with high residual risk, severe hypercholesterolemia or as an alternative for patients who are intolerant to statins. We review four novel approaches based on the inhibition of proprotein convertase subtilisin/kexin type 9 (PCSK9), apolipoprotein-B100 (apoB), Cholesteryl ester transport protein (CETP) and microsomal triglyceride transfer protein (MTP). ApoB and MTP inhibitors (Mipomersen and Lomitapide) are indicated only for homozygous familial hypercholesterolemia patients. The results of ongoing trials with CETP and PCSK9 inhibitors may warrant a wider employment in different categories of patients at high risk for cardiovascular disease.
2014
Settore MED/09 - Medicina Interna
Noto, D., Cefalù, A., Averna, M. (2014). Beyond Statins: New Lipid Lowering Strategies to Reduce Cardiovascular Risk. CURRENT ATHEROSCLEROSIS REPORTS, 16(6), 414-423 [10.1007/s11883-014-0414-4].
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10447/93704
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