Editorial
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Cardiol. Nov 26, 2019; 11(11): 256-265
Published online Nov 26, 2019. doi: 10.4330/wjc.v11.i11.256
Novel lipid-modifying therapies addressing unmet needs in cardiovascular disease
Constantine E Kosmas, Andreas Sourlas, Delia Silverio, Peter D Montan, Eliscer Guzman
Constantine E Kosmas, Eliscer Guzman, Department of Medicine, Division of Cardiology, Montefiore Medical Center, Bronx, NY 10467, United States
Andreas Sourlas, School of Medicine, University of Crete, Heraklion 71003, Greece
Delia Silverio, Peter D Montan, Cardiology Clinic, Cardiology Unlimited, PC, New York, NY 10033, United States
Author contributions: Kosmas CE conceived the concepts and analyzed the data. Sourlas A and Kosmas CE wrote the first draft of the manuscript. Silverio D, Montan PD and Eliscer Guzman E contributed to the writing of the manuscript. All of the authors agreed with manuscript results and conclusions. Kosmas CE jointly developed the structure and arguments for the paper and made critical revisions and approved final version. All authors reviewed and approved the final manuscript.
Conflict-of-interest statement: Kosmas CE and Guzman E are members of the Dyslipidemia Speaker Bureau of Amgen, Inc. The other authors declare no potential conflict of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Constantine E Kosmas, FACC, FACP, MD, PhD, Attending Doctor, Department of Medicine, Division of Cardiology, Montefiore Medical Center, Bronx, 111 E 210th St, Bronx, NY 10467, United States. cekosmas1@gmail.com
Telephone: +1-646-7347969
Received: March 29, 2019
Peer-review started: April 3, 2019
First decision: August 2, 2019
Revised: August 22, 2019
Accepted: October 6, 2019
Article in press: October 6, 2019
Published online: November 26, 2019
Processing time: 238 Days and 6.5 Hours
Abstract

Cardiovascular disease (CVD) remains a major cause of morbidity and mortality worldwide. Currently, it is well established that dyslipidemia is one of the major risk factors leading to the development of atherosclerosis and CVD. Statins remain the standard-of-care in the treatment of hypercholesterolemia and their use has significantly reduced cardiovascular morbidity and mortality. In addition, recent advances in lipid-modifying therapies, such as the development of proprotein convertase subtilisin/kexin type 9 inhibitors, have further improved cardiovascular outcomes in patients with hypercholesterolemia. However, despite significant progress in the treatment of dyslipidemia, there is still considerable residual risk of recurring cardiovascular events. Furthermore, in some cases, an effective therapy for the identified primary cause of a specific dyslipidemia has not been found up to date. Thus, a number of novel pharmacological interventions are under early human trials, targeting different molecular pathways of lipid formation, regulation and metabolism. This editorial aims to discuss the current clinical and scientific data on new promising lipid-modifying therapies addressing unmet needs in CVD, which may prove beneficial in the near future.

Keywords: Lipid-modifying therapies; Cardiovascular disease; Dyslipidemia

Core tip: Despite significant progress in the treatment of dyslipidemia, there is still considerable residual risk of recurring cardiovascular events. Ongoing research has led to the discovery of several different molecules involved in lipid homeostasis, which can serve as possible targets for new lipid-modifying therapies. Novel medications that have provided promising results in early human trials include inclisiran, bempedoic acid, seladelpar, CSL-112, apabetalone, volanesorsen, APO(a)-RX, and APO(a)-LRX. Furthermore, several other lipid-lowering agents are being evaluated in ongoing trials. Thus, there is optimism that use of these lipid-lowering medications may in the future lead to a reduction of the residual cardiovascular risk.