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Current Options and Future Perspectives in the Treatment of Dyslipidemia

Saverio Muscoli, Mihaela Ifrim, Massimo Russo, Francesco Candido, Angela Sanseviero, Marialucia Milite, Marco Di Luozzo, Massimo Marchei, Giuseppe Massimo Sangiorgi

JOURNAL OF CLINICAL MEDICINE(2022)

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Abstract
Low-density lipoprotein cholesterol (LDL-C) plays a crucial role in the development of atherosclerosis. Statin therapy is the standard treatment for lowering LDL-C in primary and secondary prevention. However, some patients do not reach optimal LDL-C target levels or do not tolerate statins, especially when taking high doses long-term. Combining statins with different therapeutic approaches and testing other new drugs is the future key to reducing the burden of cardiovascular disease (CVD). Recently, several new cholesterol-lowering drugs have been developed and approved; others are promising results, enriching the pharmacological armamentarium beyond statins. Triglycerides also play an important role in the development of CVD; new therapeutic approaches are also very promising for their treatment. Familial hypercholesterolemia (FH) can lead to CVD early in life. These patients respond poorly to conventional therapies. Recently, however, new and promising pharmacological strategies have become available. This narrative review provides an overview of the new drugs for the treatment of dyslipidemia, their current status, ongoing clinical or preclinical trials, and their prospects. We also discuss the new alternative therapies for the treatment of dyslipidemia and their relevance to practice.
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Key words
dyslipidemia,PCSK9 inhibitors,bempedoic acid,inclisiran,LXR agonists,PPAR beta/delta,ANGPTL3 inhibitors,mipomersen,lomitapide,volanesorsen
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