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Future Lipid-Altering Therapeutic Options Targeting Residual Cardiovascular Risk

  • Michel Farnier
Lipid Abnormalities and Cardiovascular Prevention (G De Backer, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Lipid Abnormalities and Cardiovascular Prevention

Abstract

Low-density lipoproteins (LDL) play a causal role in the development of atherosclerosis, and reduction of LDL cholesterol with a statin is a cornerstone in prevention of cardiovascular disease. However, it remains an unmet need to reduce the residual risk on maximally tolerated statin alone or in combination with other drugs such as ezetimibe. Among the new LDL-lowering therapies, PCSK9 inhibitors appear the most promising class. Genetic studies suggest that triglyceride-rich lipoproteins are associated with cardiovascular risk and several promising triglyceride-lowering therapies are at various stages of development. At the opposite end, high-density lipoprotein (HDL) cholesterol seems to not be causally associated with cardiovascular risk, and thus far, trials designed to reduce cardiovascular risk by mainly raising HDL cholesterol levels have been disappointing. Nevertheless, new drugs targeting HDL are still in development. This review describes the new drugs reducing LDL, apolipoprotein(a), and triglyceride-rich lipoproteins, and the strategies to modulate HDL metabolism.

Keywords

LDL cholesterol Triglyceride-rich lipoproteins HDL metabolism PCSK9 inhibitors Cardiovascular risk Antisense oligonucleotide 

Notes

Compliance with Ethical Standards

Conflict of Interest

Dr. Farnier reports having received grants, consulting fees, and/or honoraria, and delivering lectures for Abbott/Mylan, Amgen, AstraZeneca, Eli Lilly, Genzyme, Kowa, Merck and Co, Pfizer, Roche, Sanofi/Regeneron, and Servier.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  1. 1.Lipid Clinic, Point MedicalDijonFrance

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