title: Promising new therapies for the treatment of hypercholesterolemia.
abstract: BACKGROUND
  Statins are currently the most commonly used agents for treatment of hypercholesterolemia in patients with atherosclerotic cardiovascular disease. However, some patients on statins do not achieve their treatment goals or are intolerant to statins. Therefore, new therapies for treatment of hypercholesterolemia are under investigation.
  
  
  METHODS
  This article reviews the new emerging medications for the treatment of hypercholesterolemia and discusses their efficacy and safety profile based on literature searches that included human studies published on PubMed and reported clinical trials.
  
  
  CONCLUSIONS
  Inhibition of the PCSK9 protein by monoclonal antibodies results in a dramatic 40%-60% lowering of serum low-density lipoprotein cholesterol (LDL-C). This is in addition to LDL-C lowering achieved by statins. Multiple clinical studies have demonstrated the high selectivity of these antibodies for the PCSK9 pathway and their long-term safety and efficacy. Alirocumab and evolocumab have been approved by the FDA for the treatment of patients with heterozygous familial hypercholesterolemia and patients with clinical atherosclerotic cardiovascular disease) who do not achieve their LDL-C target on maximal tolerated statin treatment and dietary modification. In addition, evolocumab has been approved by the FDA for homozygous familial hypercholesterolemia. However, the long-term efficacy and safety of PCSK9 inhibitors are unknown.
authors.affiliation: a Department of Medicine, Division of Cardiology , Westchester Medical Center/ New York Medical College , Valhalla , NY , USA.
authors.forename: Marcos G
authors.initials: MG
authors.lastname: Valerio
authors.affiliation: a Department of Medicine, Division of Cardiology , Westchester Medical Center/ New York Medical College , Valhalla , NY , USA.
authors.forename: Arash
authors.initials: A
authors.lastname: Velayati
authors.affiliation: a Department of Medicine, Division of Cardiology , Westchester Medical Center/ New York Medical College , Valhalla , NY , USA.
authors.forename: Diwakar
authors.initials: D
authors.lastname: Jain
authors.affiliation: a Department of Medicine, Division of Cardiology , Westchester Medical Center/ New York Medical College , Valhalla , NY , USA.
authors.forename: Wilbert S
authors.initials: WS
authors.lastname: Aronow
mesh_terms: D054058:Acute Coronary Syndrome / Q000517:prevention & control; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D000924:Anticholesteremic Agents / Q000627:therapeutic use*; D008078:Cholesterol, LDL / Q000097:blood; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D006937:Hypercholesterolemia / Q000188:drug therapy*; D000071449:Proprotein Convertase 9; D043484:Proprotein Convertases / Q000037:antagonists & inhibitors; D012697:Serine Endopeptidases
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000924:Anticholesteremic Agents; D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; C472125:PCSK9 protein, human; D000071449:Proprotein Convertase 9; D043484:Proprotein Convertases; D012697:Serine Endopeptidases; C577155:evolocumab; C571059:alirocumab
keywords: Alirocumab; CETP; HDL-C; LDL-C; MTP; PCSK9; VLDL; anacetrapib; apo A1; apo B100; bococizumab; cholesterylester transfer protein; dalcetrapib; evacetrapib; evolocumab; high density lipoprotein; hypercholesterolemia; hyperlipidemia; lomintapide; low density lipoprotein; microsomal triglyceride transfer protein; mipomerson; monoclonal antibodies; proprotein converase subtilisin/kexin type 9; torcetrapib; very low density lipoprotein