Abstract
Pharmacological treatment of dyslipidemia (DLP) is considered one of the most effective preventive and therapeutic procedures in the field of cardiovascular disease. After the discovery of statins and their implementation in the 1990s, the development of hypolipidemic drugs seemed to be over.
The only new molecule, ezetimibe, lacked data from a large intervention study, and the new drugs were more of a problem (CETP inhibitors, PPAR alpha / gamma agonists) and did not enter clinical practice. We need other options to control dyslipidemia for patients who are intolerant to statins or ezetimibe, for those for whom current treatment options are insufficient or have an increase in triglyceride-rich particles.
We have other orally administered active substances (lomitapide, bempedic acid, derivatives of omega-3 fatty acids). The range of parenterally administered hypolipidemic therapies is significantly expanding.
In addition to established PCSK9 inhibitors there are anti-sense therapies, oligonucleotides that block protein translation, anti-apolipoprotein B, lipoprotein (a), angiopoietin 3. The first representative of a new therapeutic principle using small interfering RNA (siRNA) sequences directed against PCSK9 has also undergone clinical trials.
All new therapies should be useful in combination with established hypolipidemics.