The Latest Approaches to Dyslipidemia Management. A Narrative Review

Dyslipidemia is a significant, modifiable contributor to cardiovascular disease (CVD), exhibiting significant global prevalence and imposing a particularly high burden in Europe and around the world. Although statins are widely prescribed, a considerable proportion of patients do not achieve lipid targets or experience intolerance, highlighting the need for novel therapeutic strategies. This narrative review examines emerging therapeutic approaches that extend beyond conventional lipid-lowering agents(Cannon, 2022). The paper was prepared based on a review of the literature, with primary emphasis on studies published within the past five years and focused on providing a more detailed presentation of the following therapeutic approaches. Bempedoic acid, an oral ATP-citrate lyase inhibitor, achieves effective LDL-C reduction with a favourable safety profile, particularly among statin-intolerant patients, and is associated with improved cardiovascular outcomes. Inhibition of angiopoietin-like protein 3 (ANGPTL3) offers a receptor-independent mechanism that results in substantial reductions in LDL-C and triglycerides, particularly in refractory conditions such as homozygous familial hypercholesterolemia. RNA-based therapies, including small interfering RNA (siRNA), provide highly specific and durable gene silencing, as demonstrated by inclisiran and other emerging agents targeting APOC3, ANGPTL3, and lipoprotein(a); infrequent dosing regimens may further enhance adherence. Gene therapy and genome editing technologies, including CRISPR-based methods, represent a transformative paradigm with the potential to achieve long-term or permanent correction of dyslipidemia. Collectively, these innovations expand therapeutic options, address residual cardiovascular risk, and advance lipid management toward precision and potentially curative strategies.