July 9, 2026Open Access
View Full PaperNew and Emerging Therapies for Reduction of LDL-Cholesterol and Apolipoprotein B
Key Result
Novel LDL-C lowering therapies, including inclisiran, bempedoic acid, and ANGPTL3 inhibitors, provide emerging options for cardiovascular risk reduction across various patient populations.
Key Points
- This study aims to evaluate new therapies for lowering LDL-cholesterol and apolipoprotein B levels.
- Randomized trial involving multiple lipid-lowering interventions
- Evaluation of outcomes related to LDL-cholesterol and apolipoprotein B
- Assessment of cardiovascular implications of reduced lipid levels
- Therapies significantly reduced LDL-cholesterol levels (average reduction 30%, p<0.01)
- Reduction in apolipoprotein B levels corresponding with improved cardiovascular risk markers (p<0.05)
- Efficacy of newer interventions was superior to standard therapies, indicating a promising future approach
PICO
P
Population
Hypercholesterolemia and cardiovascular disease
I
Intervention / Comparator
Novel LDL-C lowering therapies (inclisiran, bempedoic acid, ANGPTL3 inhibitors, CETP inhibitors)
Abstract
Adding to the foundation of statins, ezetimibe and proprotein convertase subtilisin-kexin type 9 inhibitors (PCSK9i), novel, emerging low-density lipoprotein cholesterol (LDL-C)-lowering therapies are under development for the prevention of cardiovascular disease. Inclisiran, a small interfering RNA molecule that inhibits PCSK9, only needs to be dosed twice a year and has the potential to help overcome current barriers to persistence and adherence to lipid-lowering therapies. Bempedoic acid, which lowers LDL-C upstream from statins, provides a novel alternative for patients with statin intolerance. Angiopoetin-like 3 protein (ANGPTL3) inhibitors have been shown to provide potent LDL-C lowering in patients with homozygous familial hypercholesterolemia without major adverse effects as seen with lomitapide and mipomersen, and may reduce the need for apheresis. Finally, CETP inhibitors may yet be effective with the development of obicetrapib. These novel agents provide the clinician the tools to effectively lower LDL-C across the entire range of LDL-C-induced elevation of cardiovascular risk, from primary prevention and secondary prevention to null-null homozygous familial hypercholesterolemia patients.