From the Research
For patients with elevated LDL cholesterol, the most effective treatment approach is to use established therapies such as statins, ezetimibe, and PCSK9 inhibitors, in combination with lifestyle modifications, as these have been proven to reduce LDL cholesterol levels and decrease the risk of major adverse cardiovascular events. C15, a synthetic peptide, has been studied for its potential to reduce LDL cholesterol levels, but it is not currently available as an approved medication for managing high cholesterol in clinical practice. According to a study published in 2023 1, PCSK9 inhibitors, ezetimibe, and bempedoic acid are evidence-based therapies for statin-intolerant patients, and they have been shown to effectively reduce LDL cholesterol levels and regress atherosclerosis. Another study published in 2021 2 found that the percentage LDL cholesterol reduction with statins, ezetimibe, and PCSK9 inhibition is not attenuated in patients starting with lower baseline LDL cholesterol levels, and is even greater for PCSK9 inhibition.
Key Considerations
- Established treatments for elevated LDL cholesterol include statins, ezetimibe, and PCSK9 inhibitors
- Lifestyle modifications, such as a heart-healthy diet, regular exercise, weight management, and smoking cessation, are also essential for managing elevated LDL cholesterol levels
- C15 is not currently available as an approved medication for managing high cholesterol in clinical practice
- PCSK9 inhibitors, ezetimibe, and bempedoic acid are effective alternatives for statin-intolerant patients
Recommendations
- Patients with elevated LDL cholesterol should work with their healthcare providers to develop an evidence-based treatment plan using currently approved therapies
- Lifestyle modifications should be emphasized as a critical component of first-line treatment for elevated blood pressure or cholesterol, as recommended by the American Heart Association 3
- PCSK9 inhibitors, ezetimibe, and bempedoic acid should be considered for statin-intolerant patients, as they have been shown to effectively reduce LDL cholesterol levels and regress atherosclerosis 1, 4