Modern trends in hypolipidemic therapy

Panakhova D.Z., Mirzabekova K.N.

Despite treatment with statins, patients with excessive levels of low-density lipoprotein cholesterol (LDL-С) and triglycerides have a relatively high risk of developing complications from cardiovascular diseases (CVDs). For the past ten years, research of various hypolipidemic medications has been in constant development. Hypolipidemic medication is applied for treatment of patients with statin intolerance or inability to reach the recommended LDL-C level. Inclisiran is a small interfering ribonucleic acid, targeted at the proprotein convertase subtilisin/kexin type 9 (PCSK9), exerts effects similar to monoclonal antibodies against PCSK9. Bempedoic acid, an ATPcitrate lyase enzyme inhibitor, is nowadays considered a promising option of statin-intolerant patients’ treatment. Pemafibrate, an agonist of the peroxisome proliferator-activated receptor alpha, had demonstrated an exceptional risk/benefit ratio during the phase 2 of the clinical trials, nevertheless, the phase 3 was terminated due to ineffectiveness shown by the late interim analysis. High doses of icosapent ethyl, the ethylic ester of eicosapentaenoic acid, has a beneficial effect on the cardiovascular system. For the time being, there still are not enough data on the use of novel medications for the primary prevention of CVDs. For faster integration into clinical practice, safety and effectiveness of these methods, as well as costefficiency, have to be demonstrated by the randomized study of cardiovascular outcomes.

Keywords: Monoclonal antibodies to proprotein convertase subtilisin/kexin 9, inclisiran, bempedoic acid, pemafibrate, eicosapentaenoic acid, docosahexaenoic acid.

For citation: Panakhova D.Z., Mirzabekova K.N. Modern hypolipidemic pharmacotherapy trends. International Heart and Vascular Disease Journal. 2025. 13(47):37-47. DOI: 10.24412/2311-1623-2025-47-46-58