More And Powerful Drugs Are Being Developed to Fight High Cholesterol

There is even a one-time infusion that alters a gene and permanently cuts cholesterol levels in half.

Photo by Cristopher Cristia on Unsplash

Imagine having your cholesterol blood level cut in half for the rest of your life. Then imagine all it takes is a one-time drug infusion. This may become a reality within a decade.

Thirty-eight years ago, the first statin drug, Mevacor (Lovastatin), was approved by the FDA. Since then, six additional statins have been released, each with distinct and unique properties. However, as a class, they can reduce LDL-C (bad cholesterol) 30–50%. No class of drugs in modern times has been as extensively studied as statins. This included safety and efficacy.

The emergence of social media and self-claimed scientific experts post-pandemic advanced the fallacy that statins are dangerous and LDL-C levels are not as important as previously thought. These claims are false. In truth, statins are underutilized, particularly in the secondary prevention of adverse heart events, like heart attacks, strokes, and sudden death.

But as powerful as statin drugs are in reducing LDL-C, many patients still have persistently high levels or cannot tolerate this class of drugs. Thus, research has focused on newer therapies for LDL-C reduction. One such class of drugs is called PCSK9 inhibitors. The most commonly prescribed one today is Repatha (evolocumab). It can reduce LDL-C levels by as much as 60-77%.

Don’t like injections? No problem. Merck Pharmaceuticals now offers a similar drug, but it is available in pill form. It is in late-stage clinical trials and not far off from FDA approval.

Another injectable drug, Leqvio, developed by Novartis, works to lower LDL-C by utilizing mRNA technology. This is the same technology that was used for the COVID-19 vaccines.

On the horizon is a drug that can edit or alter one of your genes that controls LDL-C production. CRISPR Therapeutics is developing the drug, CTX310. It may sound like science fiction, but it will soon be science fact. Gene editing is not far off. Even Tom Brady, the future Hall of Fame quarterback, used it to clone a new dog, creating a “replica” of his old one.

And not only does this gene editing reduce LDL-C, but it also reduces the levels of another body fat, triglycerides, by as much as 55%. Triglycerides, or TG, have also been implicated as a separate risk factor for coronary artery disease, heart attacks, strokes, and pancreatitis.

A one-time infusion can dramatically lower LDL-C and TG levels. Lowering of these blood fats has been positively correlated with a similar reduction in heart attacks, strokes, and other adverse cardiac events. The drug, CTX310, is only in Phase 1 trials. The results were recently reported in the New England Journal of Medicine and at the American Heart Association's annual meeting. Before we get too excited, know that most drugs require four phases before they can win FDA approval. Thus, CTX310 is likely five to ten years away from becoming a reality.

Since so many people have undesirably high levels of LDL-C (>130), the search for new treatments will not slow down anytime soon. Hopefully, the incidence of atherosclerotic disease deaths and disability can be reduced with these therapies, too.