【論文摘要】Today's Trials Tomorrow's Treatments

10.6907/SCJ.201909/SP_1(2).0196

Kausik Ray

海峽循環醫學雜誌

1卷2S期（2019 / 09 / 01）

235 - 235

英文

Convergence of genetics, epidemiology and trails demonstrate that LDL-C is a causal and cumulative risk factor for cardiovascular disease. The benefits of LDL-C lowering standardised per unit change in LDL-C show that the benefit per unit change is independent of the mechanism via which this is achieved. Statins are first line treatment but many patients cannot tolerate appropriate doses or require add on therapy. Several treatments are now available including eztemibe and PCSK9 monoclonal antibodies. Beyond these small molecule inhibitors such as bempedoic acid especially as fixed dosed combinations with ezetimibe offer options for patients who are statin intolerant to achieve substantial LDL-C lowering. New approaches with infrequent dosing intervals targeting PCSK9 offer an infrequent dosing schedule and may overcome poor adherence. Beyond LDL-C triglycerides (TG) and Lp(a) have emerged as therapeutic targets. Patients with TG benefit from high dose EPA and other small molecule and RNA based approaches are being investigated. In contrast there are no small molecules that lower Lp(a) and trials the usig RNA based approaches are underway.