Modern Approaches to Lower Lipoprotein(a) Concentrations and Consequences for Cardiovascular Diseases
Abstract
:1. Introduction
2. Proprotein Convertase Subtilisin/Kexin Type 9 Inhibitors (PCSK9i)
3. Other Drugs and Their Impact on Lp(a) Concentrations
3.1. Inclisiran
3.2. Pelacarsen
3.3. siRNA against Apo(a)
4. Lipoprotein Apheresis (LA)
5. Conclusions
Funding
Conflicts of Interest
References
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Parameter | Lp(a) nmol/L | % in Comparison with 1. LA | LDL-C mmol/L | % in Comparison with 1. LA |
---|---|---|---|---|
1st LA session | 243.5 | baseline | 2.7 | baseline |
pre session | 177 | −27.3 | 2.3 | −12.8 |
post session | 43.5 | −82.1 | 0.7 | −75 |
IMV | 121.6 | −50 | 1.9 | −29.5 |
Drugs/LA | Effect on Lp(a) Level | Published EndPoint Data | Accepted Indication for Lowering of Lp(a) | Availability at Present |
---|---|---|---|---|
Statins | No effect or slight increase | An elevated Lp(a) was a relevant atherogenic risk factor in statin studies | No | Yes |
PCSK9i | Minus 25–30% | An additional benefit exceeding that explained by the decrease of LDL-C was shown | No | Yes |
Niacin | Minus 20% | Yes (no effect seen) | No | Yes (in USA) |
Inclisiran | Minus 20–26% | No | No | Yes |
Pelacarsen | Minus up to–80% | No | Yes (in the future) | No |
siRNA | Not known | No | Yes (in the future) | No |
Mipomersen | Minus 26.4% | No | No | No |
Lomitapide | Minus 3% | No | No | In some countries |
Estrogens | Minus 10–15% | No | No | Yes |
Anacetrapib | Minus 25% | Yes (but unclear what was the effect mediated by the reduction of Lp(a)) | No | No |
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Korneva, V.A.; Kuznetsova, T.Y.; Julius, U. Modern Approaches to Lower Lipoprotein(a) Concentrations and Consequences for Cardiovascular Diseases. Biomedicines 2021, 9, 1271. https://doi.org/10.3390/biomedicines9091271
Korneva VA, Kuznetsova TY, Julius U. Modern Approaches to Lower Lipoprotein(a) Concentrations and Consequences for Cardiovascular Diseases. Biomedicines. 2021; 9(9):1271. https://doi.org/10.3390/biomedicines9091271
Chicago/Turabian StyleKorneva, Victoria A., Tatjana Yurjevna Kuznetsova, and Ulrich Julius. 2021. "Modern Approaches to Lower Lipoprotein(a) Concentrations and Consequences for Cardiovascular Diseases" Biomedicines 9, no. 9: 1271. https://doi.org/10.3390/biomedicines9091271