New Nonstatin Lipid-lowering Drugs

New Nonstatin Lipid-lowering Drugs


  • Inadequate response in those at high-risk or those with very high low-density lipoprotein cholesterol (LDL-C) levels. Intolerance to available therapy or at higher doses.
  • Short- and long-term side effects of therapy with the current lipid-lowering therapy (LLT).
  • Interaction of LLT with concomitant medication.
  • Inadequate response/benefit from current therapies for raising high-density lipoprotein (HDL).
  • Inadequate response from current therapies for lowering triglyceride (TG).
  • Assessing newer targets to prevent cardiovascular disease (CVD).

Newer drugs in clinical practice

  • PCSK9 inhibitors

1. Monoclonal antibodies - Evolocumab and alirocumab

2. PCSK9 inhibitors - siRNA molecule - Inclisiran

  • Bempedoic acid
  • Eicosapentaenoic acid (EPA)

Angiopoietin-like protein 3 (ANGPTL3) is a key modulator of plasma lipoprotein levels. Evinacumab is a full human monoclonal antibody and inhibits ANGPTL3.

Three new drugs targeting Lp(a) are in development; all siRNA-based therapies: Pelacarsen, Olpasiran and SLN360.

Obicetrapib is a selective cholesteryl ester transfer protein (CETP) inhibitor; a daily dose of 10 mg obicetrapib in combination with moderate-intensity statins for 12 weeks resulted in an incremental LDL-C reduction of up to 50% compared with statin monotherapy.

Dr. Devaki R Nair

Dr. Devaki R Nair is a Consultant Chemical Pathologist and Clinical Lead for Clinical biochemistry Royal Free hospital and North Middlesex University Hospital. She is Completed BSc MSc MBBS FRCP FRCPath and Director SAS Centre for Cardiovascular Biomarkers, Training Programme Director for Chemical Pathology and Metabolic Medicine; Speciality Lead for Biochemistry HSL. She is involved in conducting many clinical trials for novel lipid-lowering drugs as chief investigator and as principal investigator. She set up one of the first family support centre for FH and was awarded a BHF grant for cascade testing.

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