Lipid-Lowering Agents: Targets Beyond PCSK9
Abstract
Several new or emerging drugs for dyslipidemia owe their existence, in part, to human genetic evidence, such as observations in families with rare genetic disorders or in Mendelian randomization studies. Much effort has been directed to agents that reduce LDL (low-density lipoprotein) cholesterol, triglyceride, and Lp[a] (lipoprotein[a]), with some sustained programs on agents to raise HDL (high-density lipoprotein) cholesterol. Lomitapide, mipomersen, AAV8.TBG.hLDLR, inclisiran, bempedoic acid, and gemcabene primarily target LDL cholesterol. Alipogene tiparvovec, pradigastat, and volanesorsen primarily target elevated triglycerides, whereas evinacumab and IONIS-ANGPTL3-L Rx target both LDL cholesterol and triglyceride. IONIS-APO(a)-L Rx targets Lp(a).
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Substantial residual cardiovascular risk remains despite lipid-lowering therapies, for which numerous promising therapeutic targets are under investigation.
“However, substantial residual risk remains, for which numerous promising therapeutic targets are under investigation.11”
From Effect of Vupanorsen on Non–High-Density Lipoprotein Cholesterol Levels in Statin-Treated Patients With Elevated Cholesterol: TRANSLATE-TIMI 70 (2022) · cites this paper as [11]
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“ASCVD risk,(204) whereas other studies showed either a marginal increase in ASCVD risk despite favorable HDL-C levels(187) or no change in ASCVD risk.(205) The contradictory genetic findings were paralleled by inconsistent RCT experience with small-molecule inhibitors of CETP.”
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Bergmark, B. A., Marston, N. A., Bramson, C. R., Curto, M., Ramos, V., Jevne, A., Kuder, J. F., Park, J.-G., Murphy, S. A., Verma, S., et al. (2022) · Circulation · doi:10.1161/circulationaha.122.059266 · Cited by 216 · see citing works
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Genetic testing in dyslipidemia: A scientific statement from the National Lipid Association
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- Authors
- Hegele, R. A., & Tsimikas, S.
- Affiliations
- Western University (CA)
- University of California San Diego (US)
- Corresponding author
- Hegele, Robert A.
- Venue
- Circulation Research
- Published
- 2019-02
- Volume
- 124
- Issue
- 3
- Pages
- 386-404
- ISSN
- 0009-7330 (ISSN-L)
- 1524-4571
- OpenAlex
- W2914063169
- Cited by
- 171
- References
- 224
- Citations by year
- 2026: 11 · 2025: 14 · 2024: 15 · 2023: 18 · 2022: 19 · 2021: 30 · 2020: 40 · 2019: 24
- FWCI
- 27.00
- Type
- journal article
- Language
- en
- Update notices
- correction (2020-10-22)
- Open access
- closed
- Locations
- Circulation Research (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Canadian Institutes of Health Research
- National Heart, Lung, and Blood Institute (R01HL106579, R01HL078610, P01HL055798, R01HL124174, P01HL088093)
- 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 drugs, dyslipidemia, LDL cholesterol, triglycerides, lipoprotein(a), HDL cholesterol, lomitapide, mipomersen, inclisiran, bempedoic acid, volanesorsen, evinacumab, genetic evidence, Mendelian randomization, rare genetic disorders
- MeSH terms
- Ezetimibe, Antibodies, Monoclonal, Anticholesteremic Agents, Hypolipidemic Agents, Benzimidazoles, Caproates, Dicarboxylic Acids, Fatty Acids, Humans, Cholesterol, HDL, Cholesterol, LDL, Oligonucleotides, Hypertriglyceridemia, Genetic Therapy, Lipoprotein(a), RNA, Small Interfering, Dyslipidemias, Diacylglycerol O-Acyltransferase
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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