Neue lipidsenkende Substanzen

Gerade bei kardiovaskulären Hochrisikopatienten reicht eine Statintherapie allein häufig nicht aus, um optimale LDL-C-Werte zu erreichen. Welche Optionen derzeit bestehen – auch mit Blick auf Hypertriglyzeridämie und Lipoprotein(a)-Erhöhung – und wie die jeweilige aktuelle Studienlage zu den einzelnen Substanzen bzw. Kombinationstherapien aussieht, zeigt dieser Beitrag.

Abstract

Atherosclerotic cardiovascular disease (ASCVD) remains a leading cause of morbidity and mortality. The fact that elevated levels of low-density lipoprotein-cholesterol (LDL-C) play a causal role in the development of ASCVD is now well accepted, given the results of numerous epidemiological and genetic studies, as well as randomized controlled clinical trials. Statins have become a primary therapeutic cornerstone in ASCVD prevention since they have been shown to reduce CV events by reducing levels of LDL-C. But despite the proven efficacy and safety of statin therapy, several aspects indicate a substantial need for additional or alternative LDL-C lowering therapies. These aspects include not only a high variability in individual response to therapy, but also possible side effects, potentially reducing adherence to treatment. Most importantly, an elevated risk for cardiovascular (CV) events remains in a large proportion of high-risk patients, especially in those with persistent elevation of LDL-C levels despite a maximum tolerated dose of statin therapy. Also, large clinical trials currently investigate a potential CV benefit of drug therapies targeting elevated levels of triglycerides and lipoprotein (a), respectively.

Schlüsselwörter

Statine - Ezetimib - PCSK9-Inhibitoren - Inclisiran - Bempedoinsäure

Key words

statins - ezetimibe - PCSK9-inhibitors - inclisiran - bempedoic acid

Publication History

Article published online:
19 January 2021

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