Advances in pharmacotherapy of dyslipidemia

Abstract

Abstract: Dyslipidaemia is a group of disorders of lipoprotein metabolism with consequences of endothelial dysfunction, atherosclerosis and increase in thrombogenecity of blood. Management of dyslipidaemia include diet and lifestyle modifications followed by pharmacotherapy. There are multiple drugs used for the management of dyslipidaemia with statins as most widely used therapeutic class. There are other class of drugs like resins, fibrates, drugs like niacin, ezetimibe being the established drugs in treatment of dyslipidaemia. With identification of mutations in specific genes of the lipoprotein receptors and on observation of adverse effects due to the established treatment modalities available, there is a need for new therapeutic targets to find an alternative treatment. Thus, new agents are approved for the treatment like the microsomal triglyceride transfer protein inhibitors, proprotein convertase substillin/klexin type 9 inhibitors, omega 3 fatty acid ethyl esters, antisense inhibition of Apo B-100 synthesis. Although the available drugs have well defined actions and effects, yet still in some patients either they could not fulfil the desired lipid lowering goals or the patients are intolerant/ non respondent to treatment or there is an imbalance between the risk-benefit profile. Thus, new drugs are being developed, described as pipeline drugs. Some of these are the cholesteryl ester transfer protein inhibitor, ATP citrate lyase inhibitor, antisense oligonucleotide inhibitor of lipoprotein A and Apo C–III, angiopeptin-like-3 inhibitors, AMP kinase activators, cylodextrins, thyroid receptor beta agonists, peroxisome proliferator-activated receptor agonists, acetyl CoA carboxylase inhibitor, diacylglycerol transferase inhibitor, acetyl coenzyme A cholesterol acetyl transferase-1 inhibitors, gene therapy and active immunisations.