Therapeutic management of hyperlipoproteinemia (a)

Article Details

Authors
Constantine E Kosmas MD, PhD, Andreas Sourlas, Gordon Mallarkey PhD, Delia Silverio MD, Domingo Y Ynoa MD, Peter D Montan MD, Eliscer Guzman MD, Mario J Garcia MD

Article Type
Review

DOI
10.7573/dic.212609

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Abstract

Cardiovascular disease (CVD) has consistently been the leading cause of death worldwide. Several clinical and epidemiological studies have demonstrated that an elevated plasma concentration of lipoprotein (a) [Lp(a)] is a causative and independent major risk factor for the development of CVD, as well as calcific aortic valve stenosis. Thus, the therapeutic management of hyperlipoproteinemia (a) has received much attention, as significant reductions in Lp(a) levels may, potentially, favorably affect cardiovascular risk. Aspirin, niacin, estrogens, and statins, which act on different molecular pathways, may be prescribed to patients with mild or modest elevations of Lp(a) levels. Other therapeutic interventions, such as proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors, Lp(a) apheresis, and the novel antisense oligonucleotides APO(a)-Rx and APO(a)-LRx, which are being evaluated in ongoing clinical trials, have provided some promising results and can potentially be used in severe cases of hyperlipoproteinemia (a). This review aims to present and discuss the current clinical and scientific data pertaining to the therapeutic options for the management of hyperlipoproteinemia (a).

Keywords: cardiovascular disease, cardiovascular risk, hyperlipoproteinemia (a), lipoprotein (a), therapeutic management.

Citation: Kosmas CE, Sourlas A, Mallarkey G, Silverio D, Ynoa DY, Montan PD, Guzman E, Garcia MJ. Therapeutic management of hyperlipoproteinemia (a). Drugs in Context 2019; 8: 212609. DOI: 10.7573/dic.212609

Contributions: CEK conceived the concepts and analyzed the data; AS and CEK wrote the first draft of the manuscript; GM, DS, DYY, PDM, EG, and MJG contributed to the writing of the manuscript; CEK, AS, GM, DS, DYY, PDM, EG, and MJG agreed with manuscript results and conclusions; CEK jointly developed the structure and arguments for the paper; CEK made critical revisions and approved the final version; all authors reviewed and approved the final manuscript. 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 are members of the Dyslipidemia Speaker Bureau of Amgen, Inc. None of the other authors have any conflicts of interest. 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/2019/07/dic.212609-COI.pdf

Acknowledgments: None.

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

Copyright: Copyright © 2019 Kosmas CE, Sourlas A, Mallarkey G, Silverio D, Ynoa DY, Montan PD, Guzman E, Garcia MJ. https://doi.org/10.7573/dic.212609. 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 © 2019 Kosmas CE, Sourlas A, Mallarkey G, Silverio D, Ynoa DY, Montan PD, Guzman E, Garcia MJ. Published by
Drugs in Context under Creative Commons License Deed CC BY NC ND 4.0.

Article URL: https://www.drugsincontext.com/therapeutic-management-of-hyperlipoproteinemia-(a)/

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

Provenance: invited; externally peer reviewed.

Submitted: 10 July 2019; Peer review comments to author: 16 July 2019; Revised manuscript received: 22 July 2019; Accepted: 24 July 2019; Publication date: 4 September 2019.

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