Angiopoietin-Like Protein 3 (ANGPTL3) Inhibitors in the Management of Refractory Hypercholesterolemia.

Autor:	Kosmas CE; Division of Cardiology, Department of Medicine, Montefiore Medical Center, Bronx, NY, USA.; Cardiology Clinic, Cardiology Unlimited, PC, New York, NY, USA., Bousvarou MD; School of Medicine, University of Crete, Heraklion, Greece., Sourlas A; School of Medicine, University of Crete, Heraklion, Greece., Papakonstantinou EJ; General Directorate of Public Health and Social Welfare, Athens, Attica Region, Greece., Peña Genao E; Cardiology Clinic, Cardiology Unlimited, PC, New York, NY, USA., Echavarria Uceta R; Cardiology Clinic, Cardiology Unlimited, PC, New York, NY, USA., Guzman E; Division of Cardiology, Department of Medicine, Montefiore Medical Center, Bronx, NY, USA.; Cardiology Clinic, Cardiology Unlimited, PC, New York, NY, USA.
Jazyk:	angličtina
Zdroj:	Clinical pharmacology : advances and applications [Clin Pharmacol] 2022 Jul 16; Vol. 14, pp. 49-59. Date of Electronic Publication: 2022 Jul 16 (Print Publication: 2022).
DOI:	10.2147/CPAA.S345072
Abstrakt:	Cardiovascular disease (CVD) is the most common cause of death in a global scale and significantly depends on the elevated plasma levels of low-density lipoprotein cholesterol (LDL-C) and the subsequent formation of atherosclerotic plaques. While physicians have several LDL-C-lowering agents with diverse mechanisms of action, including statins, ezetimibe, proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors and inclisiran, angiopoietin-like protein 3 (ANGPTL3) inhibitors have recently emerged as a powerful addition in the armamentarium of lipid-lowering strategies, especially for patients with refractory hypercholesterolemia, as in the case of patients with homozygous familial hypercholesterolemia (HoFH). ANGPTL3 protein is a glycoprotein secreted by liver cells that is implicated in the metabolism of lipids along with other ANGPTL proteins. These proteins inhibit lipoprotein lipase (LPL) and endothelial lipase (EL) in tissues. Loss-of-function mutations affecting the gene encoding ANGPTL3 are linked with lower total cholesterol, LDL-C, and triglyceride (TG) levels. Evinacumab is a monoclonal antibody that targets, binds to, and pharmacologically inhibits ANGPTL3, which was recently approved by the United States Food and Drug Administration (FDA) as a complementary agent to other LDL-C lowering regimens for patients aged 12 or older with HoFH, based on clinical trial evidence that confirmed its safety and efficacy in those patients. Antisense oligonucleotides (ASOs) also represent an interesting class of agents that target and inhibit the mRNA derived from the transcription of ANGPTL3 gene. This review aims to present and discuss the current clinical and scientific data pertaining to the role of ANGPTL3 inhibitors, a novel lipid-modifying class of agents capable of reducing LDL-C levels via a mechanism independent of LDL receptors. Competing Interests: Dr Kosmas reports personal fees from Amgen, Inc. and Amarin Pharma, Inc., outside the submitted work. Dr Kosmas and Dr Guzman have served on the Dyslipidemia Speaker Bureau of Amgen, Inc. The authors report no other conflicts of interest in this work. (© 2022 Kosmas et al.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu