TY - JOUR
T1 - Efficacy and safety of add on therapies in patients with hypercholesterolemia undergoing statin therapy
AU - Tomlinson, Brian
AU - Chan, Paul
AU - Zhang, Yuzhen
AU - Lam, Christopher Wai Kei
N1 - Publisher Copyright:
© 2020 Informa UK Limited, trading as Taylor & Francis Group.
Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2020
Y1 - 2020
N2 - Introduction: Statins are the first-line treatment to reduce cardiovascular (CV) events, mainly by reducing low-density-lipoprotein cholesterol (LDL-C), but many patients need additional treatments to reach the current lipid goals. Areas covered: Herein, the authors review the published literature on the efficacy and safety of the therapies that are most often added to statins to achieve lipid targets. Expert opinion: Ezetimibe is usually the first additional treatment to achieve LDL-C targets. It reduces LDL-C by about a further 20% and has an excellent safety and tolerability profile. The monoclonal antibody proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors, evolocumab, and alirocumab, can reduce LDL-C by ≥50% when added to statins and they also have a well-established safety and tolerability record. The recently approved bempedoic acid is well tolerated and appears to be free of skeletal muscle-related problems, but the CV outcome study with this drug has not been completed. Inclisiran, a small-interfering RNA targeting PCSK9 is at an advanced stage of development and the available data indicate a satisfactory safety profile and LDL-C lowering efficacy similar to the PCSK9 monoclonal antibodies with the advantage of less frequent administration.
AB - Introduction: Statins are the first-line treatment to reduce cardiovascular (CV) events, mainly by reducing low-density-lipoprotein cholesterol (LDL-C), but many patients need additional treatments to reach the current lipid goals. Areas covered: Herein, the authors review the published literature on the efficacy and safety of the therapies that are most often added to statins to achieve lipid targets. Expert opinion: Ezetimibe is usually the first additional treatment to achieve LDL-C targets. It reduces LDL-C by about a further 20% and has an excellent safety and tolerability profile. The monoclonal antibody proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors, evolocumab, and alirocumab, can reduce LDL-C by ≥50% when added to statins and they also have a well-established safety and tolerability record. The recently approved bempedoic acid is well tolerated and appears to be free of skeletal muscle-related problems, but the CV outcome study with this drug has not been completed. Inclisiran, a small-interfering RNA targeting PCSK9 is at an advanced stage of development and the available data indicate a satisfactory safety profile and LDL-C lowering efficacy similar to the PCSK9 monoclonal antibodies with the advantage of less frequent administration.
KW - Alirocumab
KW - bempedoic acid
KW - evolocumab
KW - ezetimibe
KW - icosapent ethyl
KW - inclisiran
KW - proprotein convertase subtilisin/kexin type 9 inhibitors
KW - statins
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U2 - 10.1080/14656566.2020.1801638
DO - 10.1080/14656566.2020.1801638
M3 - Review article
AN - SCOPUS:85089184055
SN - 1465-6566
VL - 21
SP - 2137
EP - 2151
JO - Expert Opinion on Pharmacotherapy
JF - Expert Opinion on Pharmacotherapy
IS - 17
ER -