New players in the treatment of hypercholesterolaemia: focus on bempedoic acid and inclisiran

Author:

Ruscica Massimiliano1,Sirtori Cesare Riccardo123,Ferri Nicola4,Corsini Alberto14

Affiliation:

1. Department of Pharmacological and Biomolecular Sciences, Università degli Studi di Milano, Milan, Italy

2. Centro Dislipidemie, ASST Grande Ospedale Metropolitano Niguarda Ca’ Granda, Milano, Italy

3. Department of Pharmaceutical and Pharmacological Sciences, Università degli Studi di Padova, Padova, Italy

4. IRCCS MultiMedica, Sesto S. Giovanni, Milan, Italy

Abstract

Abstract Dyslipidaemias and in particular elevated plasma low-density lipoprotein cholesterol (LDL-C) levels are major risk factors for atherosclerotic cardiovascular disease (ASCVD). Indeed, the more LDL-C is reduced the larger will be the ASCVD risk reduction. Although statins represent the first-line intervention to reduce the atherosclerotic burden driven by raised levels of LDL-C, adherence is not optimal and most patients do not follow guidelines and recommended doses. Thus, to achieve optimal LDL-C goals, especially in very high-risk patients, there is a need for new and safe agents, more tolerable than statins with low risk of myalgia. Thus, the present review will address the most recent clinical trials with bempedoic acid and inclisiran. Bempedoic acid is an oral drug acting at a biochemical step preceding hydroxymethylglutaryl-CoA reductase and not associated with muscular side effects. Inclisiran, the first-in-class small interfering RNA-based approach, has the ability to effectively reduce LDL-C by inhibiting the hepatic synthesis of proprotein convertase subtilisin/kexin type 9, with the advantage of requiring subcutaneous of a single dose on Day 1, Day 90, and every 6 months thereafter.

Publisher

Oxford University Press (OUP)

Subject

Cardiology and Cardiovascular Medicine

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