Pirillo Angela, Catapano Alberico L, Norata Giuseppe D
Center for the Study of Atherosclerosis, E. Bassini Hospital, Cinisello Balsamo.
IRCCS MultiMedica, Sesto S. Giovanni.
Curr Opin Clin Nutr Metab Care. 2021 Mar 1;24(2):120-126. doi: 10.1097/MCO.0000000000000727.
Elevated levels of low-density lipoprotein cholesterol (LDL-C) are causal to atherosclerosis and, thus, the reduction of LDL-C represents a major objective for the prevention of cardiovascular disease. Aim of this review is to provide an overview on novel strategies to lower LDL-C.
Although inhibiting liver cholesterol biosynthesis by statins is used as the main therapeutic approach to increase hepatic LDL-receptor expression and lower plasma cholesterol levels, novel insights into lipid and lipoprotein biology have led to the development of additional lipid-lowering therapies that can be used in combination with or as an alternative to statins in patients with statin-intolerance. New approaches include bempedoic acid, proprotein convertase subtilisin/kexin type 9 inhibitors, and angiopoietin-like protein 3 inhibitors.
In the last decade, several novel therapeutic approaches have been tested and some of them have been approved as lipid-lowering agents. Some drugs are already available in clinical practice, whereas others are at late stages of development.
低密度脂蛋白胆固醇（LDL-C）水平升高是动脉粥样硬化的病因，因此降低LDL-C是预防心血管疾病的主要目标。本综述旨在概述降低LDL-C的新策略。
虽然他汀类药物抑制肝脏胆固醇生物合成被用作增加肝脏LDL受体表达和降低血浆胆固醇水平的主要治疗方法，但对脂质和脂蛋白生物学的新见解已导致开发出其他降脂疗法，这些疗法可与他汀类药物联合使用或用于不耐受他汀类药物的患者作为替代疗法。新方法包括贝派地酸、前蛋白转化酶枯草溶菌素/kexin 9型抑制剂和血管生成素样蛋白3抑制剂。
在过去十年中，已经测试了几种新型治疗方法，其中一些已被批准作为降脂药物。一些药物已在临床实践中可用，而其他药物正处于开发后期。
