Sciahbasi Alessandro, Russo Paola, Zuccanti Michela, Chiorazzo Laura, Castelli Francesco Maria, Granatelli Antonino
Interventional Cardiology, Sandro Pertini Hospital, 00157 Rome, Italy.
Cardiology, Sant'Andrea Hospital, 00189 Rome, Italy.
J Clin Med. 2024 Dec 5;13(23):7420. doi: 10.3390/jcm13237420.
Cardio-cerebral vascular diseases due to atherosclerosis are still the leading cause of death worldwide. Low-density lipoprotein cholesterol (LDL-C) and apolipoprotein B have been identified as the primary factors responsible for the atherosclerotic process, with a causal effect. Many drugs aimed at reducing LDL-C levels are already on the market, acting in different ways in terms of mechanism of action, efficacy, and safety. Moreover, new lipid-lowering agents and new technologies in the fields of gene editing and immunotherapy are currently under investigation. A more recent biomarker associated with an increased risk of plaque generation, progression, and subsequent ASCVD is the lipoprotein (a) and, in the next few years, it will be the new target of pharmacological therapy. The aim of this review is to present the landscape of therapies already approved to reduce LDL-C levels, evaluating their efficacy, tolerability, and indications. Moreover, we take a glimpse into the future to evaluate experimental novel therapies to lower LDL-C levels that will be approved in the next few years or are under clinical evaluation.
动脉粥样硬化所致的心脑血管疾病仍是全球主要死因。低密度脂蛋白胆固醇（LDL-C）和载脂蛋白B已被确定为导致动脉粥样硬化进程的主要因素，具有因果效应。许多旨在降低LDL-C水平的药物已上市，它们在作用机制、疗效和安全性方面各有不同。此外，基因编辑和免疫治疗领域的新型降脂药物和新技术目前正在研究中。一种与斑块形成、进展及后续动脉粥样硬化性心血管疾病（ASCVD）风险增加相关的更新的生物标志物是脂蛋白（a），在未来几年，它将成为药物治疗的新靶点。本综述的目的是介绍已获批用于降低LDL-C水平的治疗方法概况，评估其疗效、耐受性和适应证。此外，我们展望未来，评估未来几年将获批或正在进行临床评估的降低LDL-C水平的新型实验性疗法。
