The new lipid-lowering drugs: focus on monoclonal antibodies

The need for new lipid-lowering drugs is based on the clear-cut evidence that a considerable proportion of patients with dyslipidemia cannot reach the target of cardiovascular protection with the use of currently available drugs (statins, ezetimibe, fibrates). Among the new classes of drugs, proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors (namely alirocumab and evolocumab) provide an effective solution for patients with familial hypercholesterolemia as well as for high-risk patients who do not achieve the target or complain statin-related adverse events. The use of PCSK9 inhibitors is associated with a huge reduction in LDL-cholesterol levels (up to 30-40 mg/dl) with 1-2 monthly administrations, and their effect is integrated with that of statins and ezetimibe. The improvement of lipid profile is in the range of that observed with other new drugs such as lopitamide and mipomersen, while the tolerability profile appears definitely better. A more effective characterization of patients with dyslipidemia is the trainer of new research in the field of lipid-lowering drugs and PCSK9 inhibitors appear the more reliable product of such a promising research.