New and emerging lipid-modifying drugs to lower LDL cholesterol

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Abstract

Cardiovascular disease (CVD) represents the leading cause of death worldwide. The role of low-density lipoprotein-cholesterol (LDL-C) in the pathophysiology of atherosclerosis and CVD has been well recognized. Statins are the standard of care for the management of hypercholesterolaemia, and their effectiveness in lowering LDL-C and reducing CVD risk in both primary and secondary prevention has been well established. However, several patients fail to attain optimal LDL-C goals or are intolerant to statins, especially at high doses. PCSK9 inhibitors, bempedoic acid, inclisiran, ANGPTL3 inhibitors, PPARβ/δ agonists and LXR agonists are novel or upcoming LDL-C-lowering agents that have shown promising beneficial results. This review aims to present and discuss the current clinical and scientific data pertaining to the new and emerging lipid-modifying LDL-C-lowering drugs.

Keywords: ANGPTL3 inhibitors, bempedoic acid, cardiovascular disease, inclisiran, LDL-C-lowering, LXR agonists, PCSK9 inhibitors, PPARβ/δ agonists.

Citation: Kosmas CE, Pantou D, Sourlas A, Papakonstantinou EJ, Echavarria Uceta R, Guzman E. New and emerging lipid-modifying drugs to lower LDL cholesterol. Drugs Context. 2021;10:2021-8-3. https://doi.org/10.7573/dic.2021-8-3

Contributions: Conceived the concepts: CEK; analysed the data: CEK; wrote the first draft of the manuscript: DP and CEK; contributed to the writing of the manuscript: AS, EJP, REU, EG; agreed with manuscript results and conclusions: CEK, DP, AS, EJP, REU, EG; jointly developed the structure and arguments for the paper: CEK; made critical revisions and approved final version: CEK; all authors reviewed and approved the final manuscript. All authors contributed equally to the preparation of this review. All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, take responsibility for the integrity of the work as a whole and have given their approval for this version to be published.

Disclosure and potential conflicts of interest: Constantine E. Kosmas and Eliscer Guzman have served as members of the Dyslipidemia Speaker Bureau of Amgen, Inc. The International Committee of Medical Journal Editors (ICMJE) Potential Conflicts of Interests form for the authors is available for download at: https://www.drugsincontext.com/wp-content/uploads/2021/10/dic.2021-8-3-COI.pdf

Acknowledgements: None.

Funding declaration: There was no funding associated with the preparation of this article.

Copyright: Copyright © 2021 Kosmas CE, Pantou D, Sourlas A, Papakonstantinou EJ, Echavarria Uceta R, Guzman E. Published by Drugs in Context under Creative Commons License Deed CC BY NC ND 4.0 which allows anyone to copy, distribute and transmit the article provided it is properly attributed in the manner specified below. No commercial use without permission.

Correct attribution: Copyright © 2021 Kosmas CE, Pantou D, Sourlas A, Papakonstantinou EJ, Echavarria Uceta R, Guzman E. https://doi.org/10.7573/dic.2021-8-3. Published by Drugs in Context under Creative Commons License Deed CC BY NC ND 4.0.

Article URL: https://www.drugsincontext.com/new-and-emerging-lipid-modifying-drugs-to-lower-ldl-cholesterol

Correspondence: Constantine E Kosmas, 168-24 Powells Cove Blvd., Beechhurst, NY, 11357, USA. Email: cekosmas1@gmail.com

Provenance: Invited; externally peer reviewed.

Submitted: 5 August 2021; Accepted: 29 September 2021; Publication date: 1 November 2021.

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