Influence of lipid-lowering drugs on inflammation: what is yet to be done?

Atherosclerosis is a chronic inflammatory disease that is associated with risk of cardiovascular events. The best-characterised and well-standardised clin-ical indicator of inflammation is C-reactive protein. Current evidence-based drug therapies for prevention and treatment of cardiovascular diseases are mainly focused on reduction of low-density lipoprotein cholesterol. However, these drugs do not provide sufficient protection against recurrent cardio-vascular events. One of the possible mechanisms behind this recurrence might be the persistence of residual inflammation. For the most common -ly used lipid-lowering drugs, the statins, their reduction of cardiovascular events goes beyond lowering of low-density lipoprotein cholesterol. Here, we review the effects of these lipid-lowering drugs on inflammation, con -sidering statins, ezetimibe, fibrates, niacin, proprotein convertase subtilisin/ kexin type 9 inhibitors, bempedoic acid, ethyl eicosapentaenoic acid and antisense oligonucleotides. We focus in particular on C-reactive protein, and discuss how the effects of the statins might be related to reduced rates of cardiovascular events.

Automated summary

Atherosclerosis is a chronic inflammatory disease associated with cardiovascular events. The clinical indicator of inflammation, C-reactive protein, is well-characterized and standardized. Current drug therapies focus on reducing low-density lipoprotein cholesterol, but do not provide sufficient protection against recurrent cardiovascular events. Residual inflammation may contribute to this recurrence. Statins, ezetimibe, fibrates, niacin, proprotein convertase subtilisin/kexin type 9 inhibitors, bempedoic acid, ethyl eicosapentaenoic acid, and antisense oligonucleotides have been studied for their effects on inflammation and their potential role in reducing cardiovascular events, with a particular focus on C-reactive protein.