Traditional and novel non-statin lipid-lowering drugs

Simple item page
dc.contributor.authorJain, Peeyushen_US
dc.date.accessioned2025-05-09T07:17:52Z
dc.date.available2025-05-09T07:17:52Z
dc.date.issued2024-03
dc.description.abstractNon-statin drugs find utility in the management of dyslipidaemia in mixed dyslipidaemia, patients with statin intolerance, and when guidelines directed low-density lipoprotein cholesterol (LDL-C) target cannot be achieved despite maximally tolerated statin. The most definite indication of fenofibrate monotherapy is fasting serum triglyceride >500 mg/dl to reduce the risk of acute pancreatitis It offers a modest reduction in cardiovascular events. The statin-ezetimibe combination is commonly used for lipid lowering particularly after ACS. Fish oils reduce serum triglycerides by about 25 %. EPA (and not DHA) seems to have cardioprotective effects. Despite cardiovascular outcome benefits, bile-exchange resins have limited use due to poor tolerance. Bempedoic acid added to maximally tolerated statin therapy is approved to lower LDL-C in adults with primary hypercholes- terolemia or mixed dyslipidaemias, HeFH, in patients with ASCVD who require additional lowering of LDL-C, and in patients who are statin-intolerant. Inclisiran is a long-acting double-stranded small interfering RNA (siRNA) that inhibits the transcription of PCSK-9 leading to a decrease in PCSK9 generation in hepatocytes and an in- crease in LDL receptor expression in the liver cell membrane leading to about 50 % reduction in serum LDL-C levels. Lomitapide lowers plasma levels of all ApoB-containing lipoproteins, including VLDL, LDL, and chylo- microns by inhibiting the enzyme microsomal triglyceride transfer protein (MTP) and approved for the treatment of adult patients with homozygous familial hypercholesterolemia (HoFH). Close monitoring for hepatotoxicity is required. Mipomersen is a single-stranded synthetic antisense oligonucleotide (ASO) that affects the production and secretion of apoB-containing lipoproteins with demonstrated efficacy in both homozygous and heterozygous FH patients. It is approved for restricted use due to risk of hepatotoxicity. Pelacarsen is an antisense oligonu- cleotide that reduces the production of apo(a) in the liver.en_US
dc.identifier.affiliationsDepartment of Preventive Cardiology, Fortis-Escorts Heart Institute, Okhla Road, New Delhi, 110 025, Indiaen_US
dc.identifier.citationJain Peeyush . Traditional and novel non-statin lipid-lowering drugs. Indian Heart Journal. 2024 Mar; 76(1): 38-43en_US
dc.identifier.issn0019-4832
dc.identifier.placeIndiaen_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/242764
dc.languageenen_US
dc.publisherElsevieren_US
dc.relation.issuenumber1en_US
dc.relation.volume76en_US
dc.source.urihttps://doi.org/10.1016/j.ihj.2023.11.003en_US
dc.subjectFibratesen_US
dc.subjectEzetimibeen_US
dc.subjectFish oilsen_US
dc.subjectBile acid sequestrantsen_US
dc.subjectBempedoic aciden_US
dc.subjectInclisiranen_US
dc.subjectLomatipideen_US
dc.subjectMipomersenen_US
dc.subjectPelacarsenen_US
dc.titleTraditional and novel non-statin lipid-lowering drugsen_US
dc.typeJournal Articleen_US
Files
Original bundle
Now showing 1 - 1 of 1
No Thumbnail Available
Name:
ihj2024v76s1p38.pdf
Size:
350.02 KB
Format:
Adobe Portable Document Format
Download
Collections
Indian Heart Journal