MODERN APPROACHES IN THE TREATMENT OF DYSLIPIDEMIA AND FUTURE PERSPECTIVES

MODERN APPROACHES IN THE TREATMENT OF DYSLIPIDEMIA AND FUTURE PERSPECTIVES

Authors

DOI:

https://doi.org/10.52340/jecm.2023.02.10

Keywords:

dyslipidemia, treatment, modern approaches, future perspectives

Abstract

Dyslipidemia, defined as an elevated level of total low-density lipoprotein-cholesterol (LDL-C) (<90 percentile), or high-density lipoprotein-cholesterol (HDL-C), occupies one of the main places among metabolic disorders. or reduced levels of apoprotein A-1 (<10 percentile). The reduction of cholesterol and especially its atherogenic fraction DSP is focused on the identification of proteins involved in cholesterol endo and exosynthesis.

Aim of the study: to show that, despite the widely studied and widely recognized use of statins in the treatment of dyslipidemia, the "gold standard" is pharmacologically recognized.

Materials and Methods: Dyslipidemia has become a major problem in the civilized world. The paper details researches on the possibilities of managing low-density lipoproteins. Since the discovery of compactin, the dominant effectiveness of statins in the treatment of dyslipidemia has been proven. Available, innovative and will be able to reduce cholesterol and especially its atherogenic fraction DSP, focused on the identification of proteins involved in endo and exosynthesis of cholesterol.

Conclusion: approaches to the treatment of dyslipidemia have changed significantly. The use of probucol has been practically stopped. Nicotinic acid has been significantly reduced. According to the recommendations of ESC/EAK and AHA/ACC, the first-line drugs for lowering LHL-C levels are statins, and drugs that reduce cholesterol absorption from the intestines - Ezetims are also a priority. Sequestrants of bile acids - cholestyramine and others, and in the case of familial hypercholesterolemia - monoclonal antibodies. When choosing a drug for PCSK-9 (Evolokumab and others), we should take into account the potential cost-benefit of treatment, some groups, for example, statins are cheaper than new drugs. However, new drugs in certain patient populations (as opposed to those with familial hypercholesterolemia) may be more effective in lowering LHL-c levels.

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References

European Association for Cardiovascular Prevention & Rehabilitation, ReinerZ,CatapanoAL, DeBacker G,etal.ESCCommitteeforPractice Guidelines (CPG)2008–2010and2010–2012 CommitteesESC/EAS guidelines for the management of dyslipidaemias: the Task Force for the management of dyslipidaemias of the European Society of Cardiology (ESC) and the European Atherosclerosis Society (EAS). Eur Heart J. 2011;32.

Thompson GR. FH through the retrospectoscope. J Lipid Res. 2021; 62: 10003.

Yusuf S, Hawken S, Ounpuu S, INTERHEART Study Investigators, et al. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study):. Lancet. 2004;364(9438):937–52. https://doi. org/10.1016/S0140 -6736(04)17018 -9

Psaty BM, Anderson M, Kronmal RA, et al. The association between lipid levels and the risks of incident myocardial infarction, stroke, and total mortality: The Cardiovascular Health Study. J Am Geriatr Soc. 2004;52(10):1639–47. https://doi.org/10.111 1/j.15325415.2004.52455 .x.

Raal FJ, Pilcher GJ, Panz VR, et al. Reduction in mortality in subjects with homozygous familialhypercholesterolemia associated with advances in lipid-lowering therapy. Circulation. 2011;124:

Rosenson RS. Statins in atherosclerosis: lipid-lowering agents with antioxidant capabilities. Atherosclerosis.2004;173(1):1–12. https:// doi.org/10.1016/S0021 -9150(03)00239 -9.

Wadhera RK, Steen DL, Khan I, Giugliano RP, Foody JM. A review of low-density lipoprotein cholesterol, treatment strategies, and its impact on cardiovascular disease morbidity and mortal. J ClinLipidol.2016;10(3):472–89.https://doi.org/10.1016/j.jacl.2015.11.010. 1

Havel RJ, Kane JP. Structure and metabolism of plasma lipoproteins. In: Scriver CR, Beaudet AL, Sly WS, Valle D, Childs B, Kinzler K, Vogelstein B, eds. The Metabolic and Molecular Bases of Inherited Disease. New York, NY: McGraw-Hill; 2001:2705–2716.

Wetterau JR, Zilversmit DB. A triglyceride and cholesteryl ester transfer protein associated with liver microsomes. J Biol Chem. 1984;259:10863–10866.

Wetterau JR, Combs KA, Spinner SN, Joiner BJ. Protein disulfide isomerase is a component of the microsomal triglyceride transfer protein complex. J Biol Chem. 1990;265:9800–9807.13

Burnett JR, Watts GF. MTP inhibition as a treatment for dyslipidaemias: time to deliver or empty promises? Expert Opin Ther Targets. 2007; 11:181–189.

Helene C., Toulme J.J. // Biochim. Biophys. Acta. 1990. V. 1049. № 2. P. 99–125.

Zamecnik P.C., Stephenson M.L. // Proc. Natl. Acad. Sci. USA. 1978. V. 75. № 1. P.280–284

Tafech A., Bassett T., Sparanese D. et al. // Curr. Med. Chem. 2006. V. 13. № 8. P. 863–88

Kurreck J. // Eur. J. Biochem. 2003. V. 270. № 8. P. 1628–1644

Goldstein JL, Brown MS. The LDL receptor. Arterioscler Thromb Vasc Biol. 2009;29:431-438.

Marais DA, Blom DJ, Petrides F, Gouлffic Y, Lambert G. Proprotein convertase subtilisin/kexin type 9 inhibition. Curr Opin Lipidol. 2012;23(6):511–7. https: //doi.org/1 0.1097 /MOL.

Кухарчук В.В.Бажан С.С.Пропротеин конвертаза субтилиз/кексинтипа 9 (PCSK9) –регулятор экспрессии рецепторов липопротеинов низкой плотности. Атеросклероз и дислипидемии.- №2, 2013, стр.19-26.

Nordestgaard BG,BennM,SchnohrP,Tybjaerg-Hansen A.Nonfasting triglycerides and risk ofmyocardial infarction, ischemic heart disease,anddeathinmenand women. JAMA.2007;298(3):

Catapano AL, Graham I, De Backer G, et al. 2016 ESC/EAS guidelines for the mana odyslipidaemias. EurHeart J.2016;37(39):2999–3058.https://doi.org/10.1093/eurheartj/ehw272.

Miller M. Dyslipidemia and cardiovascular risk: the importance of early preve QJM.2009;102(9):657–67.https://doi.org/10.1093/ qjmed /hcp06 5

Zeman M, Vecka M, Perlнk, et al. Niacin in the treatment of hyperlipidemias in light of new clinical trials: has niacin lost its place? MedSciMonit. 2015;21:215662.https://doi.org/10.12659/MSM.893619.

HPS2-THRIVE Collaborative Group, Landray MJ, Haynes R, et al. Effects of extended-release niacin with laropiprant in highrisk patients. N Engl J Med. 2014;371(3):203–12. https://doi.org/10.1056/ NEJMo a1300 955

AIM-HIGH Investigators, Boden WE, Probstfield JL, et al. Niacin in patients with low HDL cholesterol levels receiving intensive statin therapy. N Engl J Med. 2011;365(24):2255–67. https://doi.org/10.1056/ NEJMo a1107 579.

Lee JH, O’Keefe JH, Lavie CJ, Harris WS. Omega-3 fatty acids: cardiovascular benefits, source and sustainability. Nat Rev Cardiol. 2009;6(12):753–8.https://doi.org/10.1038/ nrcardio. 2.188.

Bowen KJ, Harris WS, Kris-Etherton PM. Omega-3 fatty acids and cardiovascular disease: are there benefits? Curr Treat Options Cardiovasc Med. 2016;18(11):69. https://doi.org/10.1007/s11936016-0487-1

Rauch B, Schiele R, SchneiderS, et al. OMEGA, a randomized, placebo-controlled trial to test the effect of highly purified omega-3 fatty acids on top of modern guideline - adjusted therapy after myocardial infarction. Circulation. 2010; 122(21):2152–9. https://doi.org/10.1161/ CIRCU LATIO NAHA.110.94856 2.

Galan P, Kesse-Guyot E, Czernichow S, Briancon S, Blacher J, Hercberg S. Effects of B vitamins and omega3 fatty acids on cardiovascular diseases: a randomized placebo-controlled trial. BMJ. 2010; 341:c6273. https://doi.org/10.1136/bmj.c6273.

ORIGIN Trial Investigators, Bosch J, Gerstein HC, et al. n-3fatty acids and cardiovascular outcomes in patients with dysglycemia. N Engl J Med. 2012; 367(4):309–18. https://doi.org/10.1056/ NEJMoa1203859.

Aung T, Halsey J, Kromhout D, Omega-3 Treatment Trialists’ Collaboration, et al. Associations of omega-3 fatty acid supplement use with cardiovascular disease risks: meta-analysis of 10 trials involving 77917 individuals. JAMA Cardiol. 2018; 3(3):225–34. https://doi. org/10.1001/jamacardio.2017.5205

Bhatt DL, Steg PG, Miller M, REDUCE-IT Investigators, et al. Cardiovascular risk reduction with icosapent ethyl for hypertriglyceridemia. N Engl J Med. 2018. https://doi.org/10.1056/NEJMo a1812 79

Anderson TJ, et al. 2016 Canadian Cardiovascular Society Guidelines for the management of dyslipidemia for the prevention of cardiovascular disease in the adult. Can J Cardiol. 2016; 32(11):1263–82. https://doi.org/10.1016/j. cjca.2016.07.510

ACC/AHA Guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults /N. J. Stone, J. Robinson, A. H. Lichtenstein J. Amer. Coll. Cardiol. 2014. 63(25):2889-34

Opie L. H., Gersh B. J. Drugs for the heart. – Elsevier, 2013. – 592 p

Диагностика и коррекция нарушений липидного обмена с целью профилактики и лечения атеросклероза. Российского общества кардиосоматической реабилитации и вторичной профилактики (V пересмотр). – М., 2012

Reiner Z., Catapano A. L., De Baker G.ESC/EAS Guidelines for the management of dyslipidaemias. The Task Force for the management of dyslipidaemias of the European Society of Cardiology (ESC) and the European Atherosc. Society Eur. Heart J. 2011;32:1769-1818.

Santosa S, Varady KA, AbuMweis S, Jones PJH. Physiological and therapeutic factors affecting cholesterol metabolism: does a reciprocal relationship between cholesterol absorption and synthesis really exist? Life Sci. 2007;80(6):505–14. https://doi.org/10.1016/j.lfs.2006.10.006

Pandor A, Ara RM, Tumur I, et al. Ezetimibe monotherapy for cholesterol lowering in 2,722 people: systematic review and meta-analysis of randomized controlled trials. J Intern Med. 2009;265(5):568–80. https://doi.org/10.1111/j.13652796.2008.02062.x

Morrone D, Weintraub WS, Toth PP, et al. Lipid-altering efficacy of ezetimibe plus statin and statin monotherapy and identification of factors associated with treatment response: a pooled analysis of over 21,000 subjects from 27 clinical trials. Atherosclerosis. 2012;223(2):251–61. https://doi.org/10.1016/j.atherosclerosis.2012.02.016

Lloyd-Jones DM, Morris PB, Ballantyne CM, et al. 2017 focused update of the 2016 ACC expert consensus decision pathway on the role of non-statin therapies for LDL-cholesterol lowering in the management of atherosclerotic cardiovascular disease risk: a report of the American College of Cardiology Task Force on Expert Consensus Decision Pathways. J Am Coll Cardiol. 2017;70(14):1785–822. https://doi.org/10.1016/j.jacc.2017.07.745.

Wetterau JR, Gregg RE, Harrity TW, et al. An MTP inhibitor that normalizes atherogenic lipoprotein levels in WHHL rabbits. Science. 1998;282:751–754.

Burnett JR, Watts GF. MTP inhibition as a treatment for dyslipidaemias: time to deliver or empty promises Expert Opin Ther Targets. 2007; 11:181–189.

Akdim F, Stroes E, Kastelein JJ. Antisense apolipoprotein B therapy: where do we stand? CurrOpin Lipidol 2007;18:397-400.

Yu R, Zhang H, Geary R. Pharmacokinetics and pharmacodynamics of an antisense oligonucleotide targeting FasmRNA in mice. J Pharmacol Exp Ther 2001;296:388-395.

Mullick A, Fu W, Graham M. Antisense oligonucleotide reduction of apoB ameliorated artherosclerosis in LDL receptor-deficient mice. J Lipid Res 2011;52:885-896.

Goldberg A. Novel therapies and new targets of treatment for familial hypercholesterolemia. J Clin Lipidol 2010;4:350-356

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Published

2023-05-23

How to Cite

TABUKASHVILI, R., KAPETIVADZE, V., KAPETIVADZE, I., SILAGADZE, T., KUPARADZE, M., MAGLAPERIDZE, Z., & LAZASHVILI, T. (2023). MODERN APPROACHES IN THE TREATMENT OF DYSLIPIDEMIA AND FUTURE PERSPECTIVES. Experimental and Clinical Medicine Georgia, (2). https://doi.org/10.52340/jecm.2023.02.10

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