Multiple studies have shown a strong correlation between low-density lipoprotein cholesterol (LDL-C) concentration and development as well as progression of atherosclerosis and cardiovascular disorders. Thus, the decrease of the LDL-C burden through lifestyle modification and/or pharmacological interventions unanimously demonstrated a decrease in cardiovascular events and mortality. To date, statins are considered the cornerstone of lipid-lowering therapy. The Cholesterol Treatment Trialists’ (CTT) Collaboration has shown consistency of treatment benefits across a wide patient population. However, new data are now revealing that a considerate patient population failed to achieve lipid goals solely on statins and a significant percentage cannot tolerate treatment. Therefore, extensive work has recently been done in generating novel LDL-C-lowering agents that would act through mechanisms different from statins. Among others, monoclonal antibodies to protein convertase subtilisin/kexin type 9 (PCSK9) and ezetimibe seem particularly promising. Both PCSK9 monoclonal antibodies and ezetimibe have shown to be well tolerated and very effective at lowering LDL-C.
Part of the book: Dyslipidemia