Modern prospects of targeted hypolipidemic therapy

Abstract

ABSTRACT. This article analyzes new approaches to reducing atherogenic lipoproteins using lipid-lowering drugs with innovative mechanisms of action. It examines the role of different groups of lipid-lowering drugs in the overall range of modern methods for correcting lipid metabolism disorders. The significance of statins as a foundational therapy in primary and secondary prevention of cardiovascular diseases with atherosclerotic origins is emphasized. The article presents research findings on a new target in lipid-lowering therapy, namely the proprotein convertase of subtilisin/kexin type 9 (PCSK9), and the use of a new class of drugs known as PCSK9 inhibitors, whose which have proven to be a powerful tool in reducing low-density lipoproteins. Moreover, advancements in this field have led to the development of molecules capable of genetically blocking the genes responsible for PCSK9 proprotein convertase synthesis, offering an exceptional effectiveness with dosing intervals of once every six months. The article also explores potential new drugs such as bempedoic acid, which lowers low-density lipoprotein levels, and cholesterol ester transporter protein inhibitors, which raise high-density lipoproteins levels. Additionally, it delves into more extensively studied drug groups like оmega-3 polyunsaturated fatty acids and fibrates. Consequently, lipid-lowering therapy provides an additional risk reduction for cardiovascular complications. The article highlights efforts to personalize cholesterol-lowering therapy, including improved risk stratification tools, the utilization of a genetic risk scale, and the integration of studies on lipid-lowering drugs with innovative mechanisms of action. Statins remain the first-line drugs for lipid level reduction; however, the emergence of alternative methods of treatment, provided their positive effect on the cardiovascular prognosis, enables an individualized approach based on the specific lipid profile of each patient. Implementing such a strategy requires training for both healthcare professionals and patients, as well as specialized programs.