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New drugs to lower cholesterol on the horizon

As potent as statins are to lower high cholesterol and reduce heart attacks, they don’t work effectively in about 30 to 50 percent of patients, according to Dr. Robert Giugliano, a cardiologist at Brigham and Women’s Hospital.

Some patients can’t tolerate them because of side effects, while others find that, while on the maximum dose of the most potent statin, their cholesterol levels drop, but not enough to lower their heart risk.

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Amgen, Pfizer, and Sanofi/Regeneron have all developed injectable compounds — in a class of drugs called monoclonal antibodies — that bind to a protein which normally prevents liver cells from removing excess amounts of LDL particles circulating in the bloodstream. Results from these early trials that were presented at the American Heart Association last week suggest that the injections can be used with statins to lower LDL cholesterol to recommended levels and can also lower levels in those who can’t take statins.

What’s needed now, said Giugliano, who led one of the Amgen trials, are much larger studies involving thousands of patients who are given these injections for at least five years. “These new monoclonal antibodies present a huge opportunity for many new patients to reach their cholesterol goals,” Giugliano added, “but first we have to see if there are any real safety problems.”

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