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血脂异常治疗的当前选择与未来展望

Current Options and Future Perspectives in the Treatment of Dyslipidemia.

作者信息

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

机构信息

Division of Cardiology, "Tor Vergata" University Hospital, v.le Oxford 81, 00133 Rome, Italy.

Department of Biomedicine and Prevention, "Tor Vergata" University, 00133 Rome, Italy.

出版信息

J Clin Med. 2022 Aug 12;11(16):4716. doi: 10.3390/jcm11164716.

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.

摘要

低密度脂蛋白胆固醇(LDL-C)在动脉粥样硬化的发展过程中起着关键作用。他汀类药物治疗是在一级和二级预防中降低LDL-C的标准治疗方法。然而,一些患者无法达到最佳的LDL-C目标水平,或者不耐受他汀类药物,尤其是长期服用高剂量药物时。将他汀类药物与不同的治疗方法相结合,并测试其他新药,是减轻心血管疾病(CVD)负担的未来关键。最近,几种新型降胆固醇药物已研发并获批;其他药物也取得了有前景的结果,丰富了除他汀类药物之外的药物库。甘油三酯在CVD的发展中也起着重要作用;新的治疗方法对其治疗也非常有前景。家族性高胆固醇血症(FH)可在生命早期导致CVD。这些患者对传统疗法反应不佳。然而,最近出现了新的且有前景的药物治疗策略。这篇叙述性综述概述了用于治疗血脂异常的新药、它们的现状、正在进行的临床或临床前试验以及它们的前景。我们还讨论了血脂异常的新替代疗法及其与临床实践的相关性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b17a/9410330/ca8bacd50d78/jcm-11-04716-g001.jpg

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