Treating lipid disorders and diabetes with novel and established drugs

Abstract

Download the Issue @ a Glance podcast Subscribe to the EHJ Podcast ![Graphic][1] Reduction in LDL cholesterol (LDL-C)—mainly with statins—has decreased the risk of cardiovascular events over the last few decades, and has become a cornerstone of cardiovascular prevention.1–3 There are, however, several patient populations that warrant a further decrease in LDL-C, beyond what has been achieved with statins. Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors are a new class of drugs able to decrease LDL-C by 50–70% when administered either as a monotherapy or on a background with statins.4–6 PCSK9 inhibitors are also an excellent example of drug development where discovery of gene mutations and their clinical effects have rapidly progressed into successful pre-clinical and clinical studies with multiple phase I–III clinical trials completed or ongoing. A timely Clinical Review article entitled ‘ PCSK9 (proprotein convertase subtilisin/kexin type 9) inhibitors: past, present, and the future ’ by Yuichi J Shimada from the Brigham and Women's Hospital, Harvard Medical School in Boston7 summarizes the rapid evolution of this novel class of drugs from genetic discovery to the identification of the novel target, from animal and human testing, to large clinical outcomes trials, followed by a discussion on foreseeable challenges of PCSK9 inhibitors. Patients that may particularly benefit from novel drugs such as the PCSK9 inhibitors are those with familial hypercholesterolaemia,8 which is a common genetic cause of premature coronary heart disease. Worldwide, one baby is born with familial hypercholesterolaemia every minute. If diagnosed and treated early on in childhood, such individuals can enjoy a normal life expectancy. Thus, the current Clinical Review entitled ‘ Familial hypercholesterolaemia in children and adolescents: gaining decades of life by optimizing detection and treatment ’ by Albert Wiegman from the Academic Medical Center in Amsterdam, The Netherlands9 … [1]: /embed/inline-graphic-1.gif