Year: 2024
Type: article
Abstract: As the medications with different types of action increase in their power for low density lipoprotein cholesterol (LDL-C) lowering there it great interest in their mechanisms of action that can lead to new pharmacological interventions.Ezetimibe is an inhibitor of dietary and bile cholesterol absorption and binds to the "Niemann-Pick C1-Like 1 (NPC1L1)" protein, located in the brush border cells of the intestinal epithelium, blocking cholesterol absorption, which confers a 15% to 20% reduction in plasma cholesterol.Having established the efficacy and safety of very low LDL-C values with proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors plus statins in the short and medium term, the long-term benefits were determined by the open-label extension of the FOURIER study (FOURIER-OLE).The FOURIER-OLE study also demonstrated that the earlier the reduction in LDL-C, the greater the reduction in cardiovascular risk, consistent with the legacy effect observed in trials with statins and PCSK9 inhibitors.Inclisiran is a novel small interfering RNA-based therapy administered as a twice-yearly subcutaneous injection.By binding to the messenger RNA (mRNA) precursor of PCSK9, inclisiran inhibits expression of the PCSK9 gene, resulting in increased recycling and expression of LDL receptors and decreased levels of LDL-C.Like PCSK9 inhibitors, inclisiran was associated with a comparable extent of LDL-C reduction in several phase II/III trials.In conclusion, prevention is the mainstay of atherosclerosis treatment, whether it is prevention of the onset of the atherogenic process or prevention of the progression of atherosclerotic lesions.Facilitating measures that can prevent these processes must be increasingly implemented.
Author: Tania Leme da Rocha Martinez
Institution: Beneficência Portuguesa de São Paulo
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4410215143