The dawn of a new era of targeted lipid-lowering therapies
Open accessAbstract
Lipid risk factors for cardiovascular disease depend in part on lifestyle, but optimum control of lipids often demands additional measures. Low-density lipoprotein (LDL) doubtless contributes causally to atherosclerosis. Recent human genetic findings have substantiated a number of novel targets for lipid-lowering therapy including apolipoprotein C-III, angiopoietin-like protein 3 and 4, apolipoprotein V, and ATP citrate lyase. These discoveries coupled with advances in biotechnology development afford new avenues for management of LDL and other aspects of lipid risk. Beyond LDL, new treatments targeting triglyceride-rich lipoproteins and lipoprotein(a) have become available and have entered clinical development. Biological and RNA-directed agents have joined traditional small-molecule approaches, which themselves have undergone considerable refinement. Innovative targeting strategies have increased efficacy of some of these novel interventions and markedly improved their tolerability. Gene-editing approaches have appeared on the horizon of lipid management. This article reviews this progress offering insight into novel biological and therapeutic discoveries, and places them into a practical patient care perspective.
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The US FDA and European Medicines Agency approved highly purified EPA, icosapent ethyl, for cardiovascular prevention in patients with dyslipidaemia.
“experts in both regulatory agencies in the USA and the European Union (EU)—from the US Food and Drug Administration (FDA) and the European Medicines Agency (EMA)—approved highly purified EPA, icosapent ethyl, for cardiovascular prevention in patients with dyslipidaemia.”
From Established and Emerging Lipid-Lowering Drugs for Primary and Secondary Cardiovascular Prevention (2023) · cites this paper as [113]
In “Shining a new light on omega-3 fatty acids: recent learnings” (page unavailable), the paper identifies icosapent ethyl as purified EPA and says it has been approved in many jurisdictions to reduce cardiovascular events in people meeting REDUCE-IT entry criteria. It does not specifically identify the FDA and EMA as the approving agencies, and its stated eligibility is narrower than patients with dyslipidaemia generally. (LLM, conf=0.87)
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- Authors
- Tokgözoğlu, L., & Libby, P.
- Affiliations
- Hacettepe University (TR)
- Brigham and Women's Hospital (US)
- Corresponding author
- Libby, Peter
- Venue
- European Heart Journal
- Publisher
- Oxford University Press (OUP)
- Published
- 2022-01-20
- Volume
- 43
- Issue
- 34
- Pages
- 3198-3208
- ISSN
- 0195-668X (ISSN-L)
- 1522-9645
- PMC
- PMC9448630
- OpenAlex
- W4205823791
- Cited by
- 171
- References
- 116
- Citations by year
- 2026: 20 · 2025: 49 · 2024: 59 · 2023: 31 · 2022: 12
- FWCI
- 6.14
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model (vor)
- Locations
- European Heart Journal (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Heart, Lung, and Blood Institute (1R01HL134892)
- American Heart Association
- Topics
- Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Lipid metabolism and disorders
- Health Sciences › Medicine › Surgery › Cholesterol and Lipid Metabolism
- Keywords
- lipid-lowering therapy, LDL cholesterol, cardiovascular risk, apolipoprotein C-III, ANGPTL3, ANGPTL4, ATP citrate lyase, triglyceride-rich lipoproteins, lipoprotein(a), PCSK9 inhibitors, genome editing, genetic risk factors, atherosclerosis
- MeSH terms
- Hypolipidemic Agents, Cardiovascular Diseases, Humans, Triglycerides, Lipoprotein(a), Dyslipidemias, Atherosclerosis
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