New treatment to reduce high cholesterol
..as determined by the Cleveland Clinic committee of subject matter experts
Last week, the Cleveland Clinic ranked the top 10 medical innovations for 2022. A recently released drug treatment for high cholesterol made their list.
Importance in real terms:
Heart disease remains the #1 cause of death in America, and high levels of LDL can be a significant contributor to heart disease. LDL cholesterol, often referred to as ‘bad cholesterol,’ can build up on blood vessel walls and that buildup is referred to as ‘plaque.’ With more and more plaque buildup, blood vessels naturally narrow and reduce blood flow to and from your heart to the rest of your body. And as you guessed, when not enough blood flows to your heart, chest pain and/or heart attacks follow. High LDL can also lead to a stroke, which is currently the fifth leading cause of death in America.
While high cholesterol can be detected with a blood test, it is undetectable otherwise since there are no symptoms.
Some interesting high cholesterol facts, courtesy of the CDC:
Almost 100 million U.S. adults (over 20 years old) have total cholesterol levels higher than 200 mg/dL, and 28 million of them have levels higher than 240 mg/dL. For a frame of reference, normal LDL cholesterol levels are different for different types of people but typically should be under 100 mg/dL.
Broken down by gender and race/ethnicity, the group with the highest prevalence of high cholesterol were non-Hispanic White women. Almost 1 out of 7 individuals in that group, ages 20 years or older) have a total cholesterol of 240 mg/dL or higher.
The 9 states with the highest prevalence of reported high cholesterol (31.8% or higher) are all in the South.
More than 45% of U.S. adults who could benefit from cholesterol medicine are NOT currently taking it. (This statistic does not take into account if those individuals have health insurance or if the cholesterol medicine would be covered by their insurance.)
7% of young Americans, ages 6 to 19, have high total cholesterol.
What are current treatments to lower LDL?
The first route is personal accountability - start living healthy. Some tips include:
Cut down or eliminate tobacco use.
Eat more fruits, vegetables and whole grains and significantly reduce saturated fat and trans fats in your regular diet.
Move your body, aiming for ~30 minutes of exercise per day
Find healthy ways to deal with anger and stress.
Control blood sugar and monitor blood pressure.
For those who require medication, statin medications is the most popular category of cholesterol drugs. Statins reduce the amount of cholesterol produced by the liver, and there are several statins available in America.
New drug treatment
The FDA recently approved inclisiran to treat high LDL, while patients remain on a maximally tolerated dose of statin therapy. According to the Cleveland Clinic, “inclisiran is an injectable small interfering RNA that targets the PCSK9 protein. In contrast to statins, it requires infrequent dosing (twice per year) and provides effective and sustained LDL-C reduction in conjunction along with statins. Its prolonged effect may help alleviate medication non-compliance, one of the leading causes of failure to lower cholesterol levels.” Inclisiran has also been approved by the UK’s National Health Service and European regulators. FDA trials have proven inclisiran (brand name Leqvio) to have a very high effectiveness rate:
Study 1 enrolled 1,561 adults with ASCVD. At day 510, the Leqvio group had an average LDL-C decrease of 51% whereas the placebo group had an average LDL-C increase of 1%.
Study 2 enrolled 1,414 adults with ASCVD. At day 510, the Leqvio group had an average LDL-C decrease of 46% whereas the placebo group had an average LDL-C increase of 4%.
Study 3 enrolled 482 adults with HeFH. At day 510, the Leqvio group had an average LDL-C decrease of 40% whereas the placebo group had an average LDL-C increase of 8%.
*HeFH is a life-threatening condition in which patients have a mutation in a small group of genes that controls the way the body clears cholesterol. As a result, patients have extremely high levels of LDL-C. ASCVD involves the buildup of cholesterol plaque in arteries. Approximately 18.3 million American adults (8%) have ASCVD.
..if you want to learn more: