TherapyTherapyТерапия2412-40362713-1823Bionika Media64655210.18565/therapy.2024.9.102-110REVIEWSОБЗОРЫResearch ArticleNew horizons in managing dyslipidemia – a risk factor for cardiovascular diseasesНовые горизонты в управлении дислипидемией как фактором риска сердечно-сосудистых заболеванийhttps://orcid.org/0000-0003-2948-4865UsanovaAnna A.УсановаАнна Александровна
Russian Federation

MD, Dr. Sci. (Medicine), professor, head of the Department of faculty therapy with a course of medical rehabilitation

д. м. н., профессор, заведующая кафедрой факультетской терапии с курсом медицинской реабилитации

anna61-u@mail.ruhttps://orcid.org/0000-0002-2839-8984NovikovaElvira K.НовиковаЭльвира Камилевна
Russian Federation

MD, assistant at the Department of faculty therapy with a course of medical rehabilitation

ассистент кафедры факультетской терапии с курсом медицинской реабилитации

Elja_F@mail.ruhttps://orcid.org/0000-0001-8274-7906SergutovaNatalya P.СергутоваНаталья Петровна
Russian Federation

MD, PhD (Medicine), associate professor of the Department of faculty therapy with a course of medical rehabilitation

к. м. н., доцент кафедры факультетской терапии с курсом медицинской реабилитации

sergutovanp@mail.ruhttps://orcid.org/0000-0002-5215-0196KuzmaFadi M.КузмаФади Мунирович
Russian Federation

MD, senior lecturer of the Department of faculty therapy with a course of medical rehabilitation

старший преподаватель кафедры факультетской терапии с курсом медицинской реабилитации

fadykuzma@mail.ruhttps://orcid.org/0000-0003-3826-3415VasilkovaAnastasia S.ВасильковаАнастасия Семеновна
Russian Federation

MD, PhD (Medicine), associate professor of the Department of hospital therapy and general medical practice named after V.G. Vogralik

к. м. н., доцент кафедры госпитальной терапии и общей врачебной практики им. В.Г. Вогралика

a_vas23@mail.ruN.P. Ogarev National Research Mordovia State UniversityФГБОУ ВО «Национальный исследовательский Мордовский государственный университет им. Н.П. Огарева»Privolzhsky Research Medical University of the Ministry of Healthcare of RussiaФГБОУ ВО «Приволжский исследовательский медицинский университет» Минздрава России281120241091021102301202523012025Copyright ©; 2024, Bionika MediaCopyright ©; 2024, ООО «Бионика Медиа»2024Bionika MediaООО «Бионика Медиа»https://journals.eco-vector.com/2412-4036/article/view/646552

Current article highlights the results of the main clinical studies in the field of dyslipidemia. Basing on them, remaining problems and unsolved issues are identified.

The aim of the review is to analyze a set of the main modern studies in the field of dyslipidemia, assess their application points, efficacy and tolerability of various lipid-lowering medicinal remedies, including innovative drugs. From considered drugs, plozasiran, olezarsen and obicetrapib led to a decrease of low-density lipoprotein (LDL) levels and an increase of high-density lipoproteins, at the same time demonstrating a favorable safety profile. Lerodalcibep significantly reduced LDL levels, achieving target level in 90% of patients. In turn, solbinsiran effectively reduced the levels of angiopoietin-like protein 3, triglycerides, low-density cholesterol and apolipoprotein B in a dose-dependent way with good tolerability. Despite the fairly wide range of lipid-lowering drugs already available on the pharmaceutical market, there remains a need to expand and continue studies on the treatment of dyslipidemias.

В статье освещены результаты основных клинических исследований в области дислипидемии и на их основании выделены сохраняющиеся проблемы и нерешенные задачи.

Цель обзора – провести анализ комплекса основных современных исследований по дислипидемии, оценить их точки приложения, эффективность и переносимость различных гиполипидемических лекарственных средств, включая инновационные препараты. Из рассматриваемых препаратов плозасиран, олезарсен и обицетрапиб приводили к снижению уровня липопротеидов низкой плотности (ЛПНП) и увеличению липопротеидов высокой плотности, продемонстрировав при этом благоприятный профиль безопасности. Леродальцибеп значительно снижал концентрацию ЛПНП с достижением их целевого уровня у 90% пациентов. В свою очередь, солбинсиран эффективно уменьшал содержание ангиопоэтин-подобного белка 3-го типа, триглицеридов, холестерина невысокой плотности и аполипопротеина B в зависимости от дозы при хорошей переносимости. Несмотря на достаточно широкий спектр уже имеющихся на фармацевтическом рынке гиполипидемических лекарственных препаратов сохраняется необходимость в расширении и продолжении исследований по лечению дислипидемий.

dyslipidemiaplozasiranolezarsenobicetrapiblerodalcibepsolbinsiranдислипидемияплозасиранолезарсенобицетрапиблеродальцибепсолбинсираStark B., Benziger C.P., Roth G.A. et al. Modifiable risk factors and attributable ischemic heart disease mortality for US STATES, 1990–2021. J Am Coll Cardiol. 2024; 83(13): 1191. https://doi.org/10.1016/S0735-1097(24)03181-4.Mensah G.A., Fuster V., Murray C.J.L. et al. Global burden of cardiovascular diseases and risks, 1990–2022. J Am Coll Cardiol. 2023; 82(25): 2350–473. https://doi.org/10.1016/j.jacc.2023.11.007. PMID: 38092509.Ruiz-García A., Arranz-Martinez E., López-Uriarte B. et al. Prevalence of hypertriglyceridemia in adults and related cardiometabolic factors. SIMETAP-HTG study. Clin Investig Arterioscler. 2020; 32(6): 242–55. https://doi.org/10.1016/j.arteri.2020.04.001. PMID: 32534728.Drexel H., Tamargo J., Kaski J.C. et al. Triglycerides revisited: Is hypertriglyceridaemia a necessary therapeutic target in cardiovascular disease? Eur Heart J Cardiovasc Pharmacother. 2023; 9(6): 570–82. https://doi.org/10.1093/ehjcvp/pvad044. PMID: 37328424.Nordestgaard B.G., Varbo A. Triglycerides and cardiovascular disease. Lancet. 2014; 384(9943): 626–35. https://doi.org/10.1016/S0140-6736(14)61177-6. PMID: 25131982.Marston N.A., Giugliano R.P., Im K. et al. Association between triglyceride lowering and reduction of cardiovascular risk across multiple lipid-lowering therapeutic classes: A systematic review and meta-regression analysis of randomized controlled trials. Circulation. 2019; 140(16): 1308–17. https://doi.org/10.1161/circulationaha.119.041998. PMID: 31530008. PMCID: PMC6791781.Solnica B., Sygitowicz G., Sitkiewicz D. et al. 2020 Guidelines of the Polish Society of Laboratory Diagnostics (PSLD) and the Polish Lipid Association (PoLA) on laboratory diagnostics of lipid metabolism disorders. Arch Med Sci. 2020; 16(2): 237–52. https://doi.org/10.5114/aoms.2020.93253. PMID: 32190133. PMCID: PMC7069434.Gaudet D. et al. Plozasiran (ARO-APOC3) for severe hypertriglyceridemia: The SHASTA-2 randomized clinical trial. JAMA cardiology. 2024; 9(7): 620–30. https://doi.org/10.1001/jamacardio.2024.0959. PMID: 38583092. PMCID: PMC11000138.Bergmark B.A. et al. Olezarsen for hypertriglyceridemia in patients at high cardiovascular risk. N Eng J Med. 2024; 390(19): 1770–80. https://doi.org/10.1056/NEJMoa2402309. PMID: 38587249.Bavry A.A. Efficacy and safety of Lerodalcibep in patients at very high and high risk for cardiovascular disease – LIBerate-HR. URL: https://www.acc.org/Latest-in-Cardiology/Clinical-Trials/2024/04/05/04/34/liberate-hr (date of access – 18.10.2024).Koren M.J., Rodriguez F., East C. et al. An “inclisiran first” strategy vs usual care in patients with atherosclerotic cardiovascular disease. J Am Coll Cardiol. 2024; 83(20): 1939–52. https://doi.org/10.1016/j.jacc.2024.03.382. PMID: 38593947.Banach M., Lopez-Sendon J.L., Averna M. et al. Treatment adherence and effect of concurrent statin intensity on the efficacy and safety of alirocumab in a real-life setting: Results from ODYSSEY APPRISE. Arch Med Sci. 2022; 18(2): 285–92. https://doi.org/10.5114/aoms/143476. PMID: 35316922. PMCID: PMC8924821.Katzmann J.L., Sorio-Vilela F., Dornstauder E. et al. Non-statin lipid-lowering therapy over time in very-high-risk patients: Effectiveness of fixed-dose statin/ezetimibe compared to separate pill combination on LDL-C. Clin Res Cardiol. 2022: 111(3): 243–52. https://doi.org/10.1007/s00392-020-01740-8. PMID: 32949286. PMCID: PMC8873069.Lewek J., Niedziela J., Desperak P. et al. Intensive statin therapy versus upfront combination therapy of statin and ezetimibe in patients with acute coronary syndrome: A propensity score matching analysis based on the PL-ACS data. J Am Heart Assoc. 2023; 12(18): e030414. https://doi.org/10.1161/JAHA.123.030414. PMID: 37671618. PMCID: PMC10547305.Hsiehet A., Davidson M.H., Ditmarsch M. et al. Synergistic effect of obicetrapib and ezetimibe on circulating LDL particles. J Am Coll Cardiol. 2024; 83(13): 1952. https://doi.org/10.1016/s0735-1097(24)03942-1.Zimerman A., Giugliano R.P., Kunzler A. et al. Cardiovascular benefit of evolocumab in 27,564 patients with and without autoimmune or inflammatory diseases: An analysis of the FOURIER trial. J Am Coll Cardiol. 2024; 83(13): 1682. https://doi.org/10.1016/S0735-1097(24)03672-6.Said S.A., O’Donoghue M.L., Ran X. et al. Long-term evolocumab in elderly patients with established atherosclerotic cardiovascular disease: Analysis from FOURIER and FOURIER-OLE. J Am Coll Cardiol. 2024; 83(13): 2078. https://doi.org/10.1016/S0735-1097(24)04068-3.Ballantyne C.M., Nambi V. HDL Therapeutics – time for a curtain call or time to reconceptualize? N Eng J Med. 2024; 390(17): 1622–1623. https://doi.org/10.1056/NEJMe2403036. PMID: 38587250.Gibson C.M., Duffy D., Korjian S. et al. Apolipoprotein A1 infusions and cardiovascular outcomes after acute myocardial infarction. N Eng J Med. 2024; 390(17): 1560–71. https://doi.org/10.1056/NEJMoa2400969. PMID: 38587254.Park S.-J., Ahn J.-M., Do-Yoon K. et al. Preventive percutaneous coronary intervention versus optimal medical therapy alone for the treatment of vulnerable atherosclerotic coronary plaques (PREVENT): A multicentre, open-label, randomised controlled trial. Lancet. 2024; 403(10438): 1753–65. https://doi.org/10.1016/S0140-6736(24)00413-6. PMID: 38604213.Kurozumi A., Shishido K., Yamashita T. et al. Sodium-glucose cotransporter-2 inhibitors stabilize coronary plaques in acute coronary syndrome with diabetes mellitus. Am J Cardiol. 2024; 214: 47–54. https://doi.org/10.1016/j.amjcard.2023.12.056. PMID: 38215815.Singh S., Tantry U., Bliden K. et al. Meta-analysis of rosuvastatin vs atorvastatin in patients with cardiovascular disease. J Am Coll Cardiol. 2024; 83(13): 1225. https://doi.org/10.1016/S0735-1097(24)03215-7.Wei C.R., Lakhdhir F., Rawat A. et al. Comparison of the efficacy of atorvastatin with rosuvastatin in preventing cardiovascular events among patients with cardiovascular disease: A meta-analysis. Cureus. 2023; 15(12): e50421. https://doi.org/10.7759/cureus.50421. PMID: 38222118. PMCID: PMC10784709.Di Palo K.E., Chen D., Miller M. et al. Real-world evaluation of lipid-lowering pharmacotherapy in very high-risk persons at discharge and 1 year following acute ST-elevation myocardial infarction. J Am Coll Cardiol. 2024; 83(13): 1207. https://doi.org/10.1016/S0735-1097(24)03197-8.Yadalam A.K., Razavi A.C., Jain V. et al. Lipoprotein (a) as a predictor of incident cardiovascular events in coronary artery disease stratified by low-density lipoprotein level. J Am Coll Cardiol. 2024; 83(13): 1200. https://doi.org/10.1016/S0735-1097(24)03190-5.Szarek M., Bhatt D.L., Brinton E.A. et al. Icosapent ethyl reduces mace in patients with elevated triglycerides and high or low lipoprotein (a) concentrations: A REDUCE-IT subanalysis. J Am Coll Cardiol. 2024; 83(13): 1159. https://doi.org/10.1016/S0735-1097(24)03149-8.Sherratt S.C.R., Libby P., Bhatt D.L., Mason R.P. Eicosapentaenoic acid inhibits lipoprotein (a) oxidation due to scavenging mechanisms in vitro. J Am Coll Cardiol. 2024; 83(13): 1167. https://doi.org/10.1016/S0735-1097(24)03157-7.Borghi C., Bragagni A. Clinical results and mechanism of action of icosapent ethyl. Eur Heart J Suppl. 2023; 25(Suppl B): B37–V40. https://doi.org/10.1093/eurheartjsupp/suad088. PMID: 37091641. PMCID: PMC10120946.Sheppard J.P., Palatnic L., Lakshmanan S. et al. Effects of purified eicosapentaenoic acid versus mixed eicosapentaenoic/docosahexaenoic acid on cardiovascular mortality: Meta-analysis of randomized clinical endpoint trials. J Am Coll Cardiol. 2024; 83(13): 1272. https://doi.org/10.1016/S0735-1097(24)03262-5.Patil T., Gregory M., Surface L. et al. Evaluating the real-world effectiveness of icosapent ethyl vs omega-3 polysaturated fatty acid on major cardiovascular adverse events in a retrospective nationwide veterans health administration observational cohort. J Am Coll Cardiol. 2024; 83(13): 1323. https://doi.org/10.1016/S0735-1097(24)03313-8.Ray K.K., Ruotolo G., Michael L. et al. Solbinsiran, a galnac-conjugated sirna targeting angptl3, reduces atherogenic lipoproteins in individuals with mixed dyslipidaemia in a durable and dosedependent manner. J Am Coll Cardiol. 2024; 83(13): 1673. https://doi.org/10.1016/S0735-1097(24)03663-5.Sosnowska B., Adach W., Surma S. et al. Evinacumab, an ANGPTL3 inhibitor, in the treatment of dyslipidemia. J Clin Med. 2022; 12(1): 168. https://doi.org/10.3390/jcm12010168. PMID: 36614969. PMCID: PMC9821629.