High cholesterol, also called dyslipidemia or hyperlipidemia, is a condition that includes genetic and acquired disorders with raised lipid levels within the body. Moreover, although this condition doesn’t have critical symptoms in itself, it can lead to serious illnesses if left untreated.
On the bright side, there are already multiple treatment options to choose from – ranging from dietary interventions, lifestyle changes, medications, or a combination of these three. In 2023, these options broaden even more – especially with new therapeutic approaches:
High-Intensity Statin Treatment
In a recent multi-study in China involving 689 participants with abnormal levels of cholesterol, moderate or high-intensity statin treatments were used. Here, the participants were placed into different groups with varying doses and frequencies of recaticimab (a common medication for high cholesterol).
The study also focused on comparing other medications like atorvastatin vs rosuvastatin and an additional group that added recaticimab to the other two. With this, there were multiple groups that provided evidence of different statin treatments in the same environment.
However, the study found that moderate to high-intensity doses focused on one statin medication made the most remarkable changes. On the other hand, those with add-on recaticimab treatments didn’t have any noticeable changes in their laboratory results.
Although further studies of the possible benefits and risks of high-intensity treatments are needed, this study was presented at the American Heart Association, where it received positive feedback. Likewise, a groundbreaking study has shown lower cholesterol levels by 50% in only one to three months of admission.
PSCK 9 Editing
While drugs help manage high cholesterol, they can’t completely treat those who have genetic predispositions. For this, you’d have to rely on the gene editing approach from Boston-based Verve Therapeutics.
This treatment targets your gene PCSK 9, a plasma membrane that is integral to your cholesterol levels. If you have high cholesterol, you’ll naturally have higher PCSK 9 levels.
You could think of gene editing as a permanent eraser. With a tiny change made to the gene, there is also a noticeable change in one’s ability to raise their cholesterol levels. In Verve’s initial study, three patients with higher doses had their cholesterol levels slashed by half.
Moreover, instead of maintaining daily pills or injections, you can choose a single-course treatment session like gene editing. Although this gene editing approach has yet to be approved by the U.S. Food and Drug Administration (FDA), it’s an approach that promises a new era of treating high cholesterol.
Lepidosiren: Lipoprotein Editing
Lipoprotein, a dangerous type of cholesterol, increases the risk of clogged arteries. This is due to the lipoprotein attaching itself to other types of cholesterol and causing more plaque in the bloodstream.
A drug called lepidosiren was used to shut down the process entirely. This drug targets the mRNA that tells the body to produce the lipoprotein and stops any further production of the cholesterol. Not only this, the drug shot down cholesterol levels by 94% when maintained for nearly a year.
Although the study was recently published on November 12, the drug was safe and had no significant side effects. Nonetheless, this drug could be treated as a new evolutionary approach to what was once a previously untreatable illness.
Early Use of Inhibitors
Since PCSK 9 is an essential gene for those with high cholesterol, inhibiting such along with early therapy is another approach that’s recently made headlines. This means that statin therapy and PCSK 9 inhibitors are taken at the same time.
With statin alone, cholesterol levels lower to 50% to 60%. When paired with the inhibitor, the numbers lower to 70%. This is especially helpful for those who have developed a tolerance to statin medication. Moreover, it allows for lowered cholesterol levels with less side effects.
This study’s findings were similar to a study that targeted acute coronary syndrome (ACS). ACS is a range of diseases related to reduced blood flow, and its common risk factors include diabetes, hypertension, and high cholesterol. After 6 months of statin and inhibitor treatments, there were low lipoprotein and total cholesterol levels.
Thus, although statins alone can help manage high cholesterol, pairing them with an inhibitor makes a big difference. Moreover, it’s a clinical strategy that deserves attention, especially with positive results in recent studies.
Bile Acid Sequestrants
Bile acid sequestrants are an approach already approved by the FDA, and they’re especially beneficial for statin-intolerant patients. This approach uses medication and complements it with dietary modifications and exercises. With such, the combined approach helps achieve target goals in primary and secondary prevention.
Likewise, there are also three bile acid sequestrants to choose from: cholestyramine, colestipol, and colesevelam. Cholestyramine and colestipol are used for those with primary hypercholesterolemia, a type of high cholesterol condition, whereas colesevelam is most commonly diagnosed in patients with type 2 diabetes.
Final Thoughts
Treating high cholesterol can be a lifelong process, but it’s a path constantly developing to lower cholesterol effectively and safely. Moreover, having high cholesterol will require the help of a healthcare team for a patient-specific treatment plan. It will also mean proper follow-ups and constant monitoring of your condition.
