Friday - Oct 30, 2020

New Medications that Can Help Lower Bad Cholesterol


man taking Statins

A new drug is discovered which is believed to help lower bad cholesterol level aside from statins. The study was recently published by the Journal of the American Medical Association. Statins is the currently prescribed medications by clinicians to help reduce bad cholesterol or LDL level that increases the possibility of heart diseases.

The injectable drug is called Evolocumab which is currently being tested before it will be allowed in the market. The efficacy of the drug is promising according to the findings of the researchers. But more studies are being requested to check the efficacy and safety of the drug.

A global trial was conducted wherein the injectable drug is taken alongside with statins.  The findings showed that the patients had 63 to 75 percent reduction of bad cholesterol levels, aside from the expected reduction that is caused by taking the traditional Statin medications. Statins is a well-known drug that helps lower cholesterol level by blocking the substance that makes cholesterol.

Statins helps reabsorb cholesterol that has built plaques around the artery walls thus, preventing further blockage of the blood vessels and reduce the risk of heart attacks.  Statins have other potential benefits making it one of the trusted drugs by most physicians in lowering bad cholesterol levels.

According to the lead author of the newly discovered medication, Dr. Jennifer Robinson, an epidemiology and cardiology professor at the University Of Iowa College Of Public Health, evolocumab further enhances the body’s natural process of reducing bad cholesterol levels in the bloodstream. The drug helps in reducing the LDL levels very well particularly with people who are having genetic cholesterol problems and also those people who cannot take large doses of statins.

The researcher said that the drug is a human monoclonal antibody which means that it enhances the natural mechanism of the body to reduce LDL levels in the bloodstream. Robinson noted that liver cells contains receptors which target LDL cholesterol and then works by removing it in the circulation.

At the same time, the liver also produces PCSK9, a regulatory protein that works by binding and breaking down these receptors. The evolocumab is designed as an antibody wherein it intercepts PCSK9 which prevents the protein from breaking the LDL receptors.  This in turn, allows the liver cell receptors for LDL cholesterol to stay longer in the bloodstream, hence it helps improves it efficiency to remove the bad cholesterol.

On the phase 3 of the clinical trial, Amgen, the drug’s manufacturer conducted a study in 17 countries with 198 sites for 12 weeks.  Approximately 2000 people taking statins in moderate to high doses were assigned randomly to take evolocumab and exetimibe with brand name Zetia, another drug that lowers bad cholesterol, and another assigned group for the placebo.

The findings showed that evolocumab which is regularly taken every two weeks reduces LDL levels by 66 to 75 percent compared with the inactive placebo.  Those who took the drug regularly every month have about 63 to 75 percent reduction.  As compared with ezetimibe, who had only around 24 percent reduction rate.

The findings also showed that evolocumab is well-tolerated compared with ezetimibe or statins.  Researchers believed that since it is a specific antibody it does not have any drug interactions or side effect. Robinson also added that evolocumab is helpful in people who are having genetic disorder that predisposes them to have a high cholesterol levels since birth. 

Based from the report of the National Institutes of Health of the United States around 1 out of 500 people have this kind of disorder. The genetic disorder is called familial hypercholesterolemia which is a condition wherein high levels of LDL or bad cholesterol is present at birth.  This may increase the risk of heart attack even for younger patients.

The drug is also useful for people who cannot take high doses of statins.  This is particularly true for people having diabetes and or heart disease who cannot tolerate large amount of statins.

Despite the promising efficacy of the drug, the American Heart Association stressed out that the impact for the risk of getting stroke or heart attack has not yet been studied. Other clinicians also want to know the efficacy of the drug in treating cardiovascular problems. They noted that statin is widely prescribed simply because it does not cause stroke and heart attack. 

Some clinician also said that their doubt about ezetimibe is that it presents mixed results wherein the drug is effective in lowering cholesterol but it does not show clear evidence if it can prevent the risk of heart attack.

Robinson said that further studies will be conducted to determine the safety and possible treatment outcome of the drug.  She also noted that if the drug will be approved by the Food and Drug Administration of the United States, it will definitely be an expensive medication.   Just like other antibody drugs that are used to treat other diseases like Arthritis, it may cost patients around thousands of dollar per year.

Dr. Robinson noted that the drug is more beneficial for people having genetic cholesterol problems and those individuals who have problems in taking large doses of statins. Evolocumab is not designed for everybody. But one thing is for sure, the multiple researches conducted showed clear evidence that the drug can dramatically lower bad cholesterol.  As soon as the drug proved that it does not have any risk for stroke and heart attack, it can be approved by FDA and may hit the market soon.