In order to bring you the best possible user experience, this site uses Javascript. If you are seeing this message, it is likely that the Javascript option in your browser is disabled. For optimal viewing of this site, please ensure that Javascript is enabled for your browser.

The free consultation period for this content is over.

It is now only available year-round to ESC Professional Members, Fellows of the ESC, and Young combined Members

Inflammation: LpPLA2 inhibitors and peroxisome proliferation-activated receptor alpha/gamma agonists.

Session Critical review of non-statin treatments for dyslipidaemia

Speaker Ulrich Laufs

Event : ESC Congress 2013

  • Topic : preventive cardiology
  • Sub-topic : Cardiovascular Rehabilitation
  • Session type : Clinical Seminar

The free consultation period for this content is over.

It is now only available year-round to ESC Professional Members, Fellows of the ESC, and Young combined Members

Two columns page  

Critical review of non-statin treatments for dyslipidaemia

Prevention

 

Statins have proved extremely effective for the majority of patients with dyslipidemia and those at high risk of CVD.
However, these drugs are not the complete answer; some patients do not achieve their LDL target even on a high dose, some are statin intolerant, and some have a dyslipidemia for which statin therapy is not the best strategy. New agents have been developed that have the potential to add-in to statins to produce profound LDL lowering and the possibility to raise HDL significantly.
The latter action allows us to address the ‘HDL hypothesis’ that in patients with low HDL, increasing this lipoprotein will generate additional risk reduction.
Dr Barter presented a review of the rationale and testing of CETP (cholesteryl ester transfer protein) inhibitors. Early results have been disappointing – torcetrapib was found to increase CVD risk (possibility as an off-target action) while the outcome trial with dalcetrapib was stopped for futility. Hope remains that the two remaining agents will be successful – results are anticipated for the DEFINE and ACCELERATE trials in 2017.
Novel approaches to the use of omega-3 fatty acids were reviewed by Dr Marchioli. New formulations offer more convenient dosing and a better profile of lipid regulation. A conjugated niacin-EPA compound is an interesting agent for regulation of triglycerides.
Dr Laufs offered insight into PPAR dual agonists and the problems of unwanted side effects and lack of impact on CVD. Ongoing studies focus on the potential benefits of inhibiting lipoprotein-associated-phospholipase A2, and answers to direct effect of these drugs on arterial inflammation will be known in 2014.
Dr Kastelein in assessing new LDL lowering agents picked out Anti-Sense- Oligonucleotides to ApoB and PCSK9 inhibitors as the ones to watch.
These agents are capable of inducing profound LDL reductions but are injectable and their deployment will be a challenge for prescribing physicians used to tablet-based therapy. Achieving ‘neanderthal’ LDL levels is in our grasp if we want it!

 

References


934

SessionTitle:

Critical review of non-statin treatments for dyslipidaemia

The content of this article reflects the personal opinion of the author/s and is not necessarily the official position of the European Society of Cardiology.

 

Members get more

Join now
  • 1ESC Professional Members – access all resources from general ESC events 
  • 2ESC Association Members (Ivory, Silver, Gold) – access your Association’s resources
  • 3Under 40 or in training - with a Combined Membership, access all resources
Join now

Our sponsors

ESC 365 is supported by Bayer, Boehringer Ingelheim and Lilly Alliance, Bristol-Myers Squibb and Pfizer Alliance, Novartis Pharma AG and Vifor Pharma in the form of educational grants. The sponsors were not involved in the development of this platform and had no influence on its content.

logo esc

Our mission: To reduce the burden of cardiovascular disease

Who we are