Κατεύθυνση Κλινικές Μελέτες: Σχεδιασμός και ΕκτέλεσηLibrary of the School of Health Sciences
Κίμων Σταματελόπουλος, Επίκουρος Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Μαρία Γαβριατοπούλου, Επίκουρη Καθηγήτρια, Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Ευστάθιος Καστρίτης, Αν. Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Η κλινική αξία των νεότερων υπολιπιδαιμικών φαρμάκων
Clinical value of new hypolipidemic drugs
There are several established lipid-modifying agents, including statins, fibrates, niacin, and ezetimibe, that have been shown in randomized clinical outcome trials to reduce the risk of having an atherosclerotic cardiovascular event. However, in many
people, the risk of having an event remains unacceptably high despite treatment with these established agents.
This has stimulated the search for new therapies designed to reduce residual cardiovascular risk. New approaches that target atherogenic lipoproteins include:
1) inhibition of proprotein convertase subtilisin/kexin type 9 to increase removal of atherogenic lipoproteins from plasma
2) inhibition of microsomal triglyceride transfer protein to block the formation of atherogenic lipoproteins
3) inhibition of the synthesis of apolipoprotein (apo) B, the main protein component of atherogenic lipoproteins
4) inhibition of cholesteryl ester transfer protein, which not only reduces the concentration of atherogenic lipoproteins but also increases the level and function of the potentially antiatherogenic HDL fraction.
5) inhibition of adenosine triphosphate citrate lyase to inhibit the synthesis of cholesterol
6) inhibition of apoC-III to reduce triglyceride-rich lipoproteins and to enhance high-density lipoprotein (HDL) functionality
7) inhibition of the synthesis of lipoprotein(a), a factor known to cause atherosclerosis
Other new therapies that specifically target HDLs include infusions of reconstituted HDLs, HDL delipidation, and infusions of apoA-I mimetic peptides that mimic some of the functions of HDLs. This review describes the scientific basis and rationale for developing these new therapies
and provides a brief summary of established therapies.
The main objective of this study is to present the treatment options not only for Dyslipidemias but also cardiovascular risk and atherosclerosis through a review of the literature and clinical trials of newer hypolipidemic drugs performed in phase I and mainly in phase IΙ and III, but also in phase IV. The categorization is based on the active substance of the lipidemic drugs, the effect on the lipids, the atherosclerosis and the cardiovascular risk but also the side effects that have been reported.
Main subject category:
Hypolipidemic drugs, Dyslipidemias
Number of references:
Η κλινική αξία των νεότερων υπολιπιδαιμικών φαρμάκων.pdf
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