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

© 2022 Kosmas et al..

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.

Medienart:

E-Artikel

Erscheinungsjahr:

2022

Erschienen:

2022

Enthalten in:

Zur Gesamtaufnahme - volume:14

Enthalten in:

Clinical pharmacology : advances and applications - 14(2022) vom: 13., Seite 49-59

Sprache:

Englisch

Beteiligte Personen:

Kosmas, Constantine E [VerfasserIn]
Bousvarou, Maria D [VerfasserIn]
Sourlas, Andreas [VerfasserIn]
Papakonstantinou, Evangelia J [VerfasserIn]
Peña Genao, Edilberto [VerfasserIn]
Echavarria Uceta, Rogers [VerfasserIn]
Guzman, Eliscer [VerfasserIn]

Links:

Volltext

Themen:

ANGPTL3 inhibitors
Cardiovascular disease
Evinacumab
Familial hypercholesterolemia
Journal Article
LDL receptors
LDL-cholesterol
Refractory hypercholesterolemia
Review

Anmerkungen:

Date Revised 26.07.2022

published: Electronic-eCollection

Citation Status PubMed-not-MEDLINE

doi:

10.2147/CPAA.S345072

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM343932652