4.5 Review

Review of recent clinical trials and their impact on the treatment of hypercholesterolemia

Journal

PROGRESS IN CARDIOVASCULAR DISEASES
Volume 75, Issue -, Pages 90-96

Publisher

W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1016/j.pcad.2022.11.011

Keywords

Clinical trials; Bempedoic acid; Inclisiran; Pelacarsen; Evinacumab; Omega 3 fatty acids

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Cardiovascular disease is the leading cause of death in the United States, and its incidence is expected to increase in the future. Recent years have seen the development of new therapeutic approaches aimed at reducing the burden of cardiovascular disease. These advancements have improved the effectiveness and consistency of treatment and prevention methods for cardiovascular disease.
Purpose of review: Cardiovascular disease is the leading cause of death in the United States with incidence expected to increase in the coming decades. Recent years have produced a variety of new and novel therapeutics aimed at reducing the global burden of cardiovascular disease. This review highlights these recent advancements. Recent findings: In addition to more rigorous therapeutic thresholds for traditional LDL lowering agents such as statins, recent studies have developed new pathways of lipid lowering for both typical cardiovascular disease and complex, genetic lipid disorders. This includes inhibition of the cholesterol synthesis enzyme ATP citrate lyase with bempedoic acid, prevention of PCSK9 mRNA translation with inclisiran, inhibition of the lipoprotein lipase inhibitor angiopoetin like 3 protein with evinacumab and the use of anti-sense oligonucleotides to lower lipoprotein(a) levels. Icosapent ethyl, while remaining a topic of debate and controversy, demonstrates efficacy in cardiovascular risk reduction when all available data are examined. Lastly fibrate therapy continues to produce negative results in terms of cardiovascular disease reduction. Summary: Recent years have yielded breadth and depth to cardiovascular treatments. This expanded armamentarium will allow for more effective and more consistent treatment and prevention of cardiovascular disease.(c) 2022 Elsevier Inc. All rights reserved.

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