An update on “New Cholesterol Drugs”

Your body produces a waxy substance referred to as cholesterol. You can obtain this substance from food products as well. Your body requires it, but an excess of cholesterol in your blood can result in clogging of your arteries. This, in turn, enhances your risk of heart disease, heart attack, and eventually death. Heart diseases such as heart attacks and strokes are more expected in high-risk patients starved of access to revolutionary cholesterol-busting medications named as PCSK9 inhibitors. Patients with a prescription for medication but don't fill it, most likely as they can't meet the expense of the cost of medicine have a 21% higher risk of heart-associated emergencies, as per the research studies.

Certain cholesterol-lowering medications such as PCSK9 inhibitors remain costly as compared to first-line statin therapy. These recent medicines act by boosting the liver's capacity to eject too much of cholesterol from the bloodstream. There are two leading PCSK9 inhibitors named- Praluent (alirocumab) as well as Repatha (evolocumab). These two drugs can be used besides statins for high-risk heart patients who are facing difficulties in lowering their cholesterol levels. FDA gave approval for these medicines. Both are given by a self-administered injection one time or two times every month. These medicines are intended for patients with extremely high cholesterol levels, regardless of making lifestyle alterations (including diet and exercise) as well as taking the maximum recommended dose of a high-potency statin or other high cholesterol medications.

High-risk patients

Patients were considered at high risk of bad cholesterol levels if they had familial hypercholesterolemia or have had a history of heart problems associated with clogged arteries. The researchers purposely looked at the use of new cholesterol-lowering medications, and whether it had an impact on the patients' risk for heart-associated health events including coronary bypass surgery, heart attacks, angioplasty, unstable angina, cardiac arrest, as well as other heart problems or stroke resulting from congested arteries.

It was found that lack of access to these cholesterol drugs had an instantaneous impact on their risk of heart problems, heart attack, and stroke. But gaining access to these costly medications remains a challenge.

Fewer deaths

It was found that patients with a recent heart attack or unstable angina (deteriorating chest pain, frequently at rest, that needed hospitalization) who were already consuming maximal doses of statins took alirocumab for an average of almost 3 years. Their cholesterol levels started to improve.

Prohibitive pricing

But till date, the high price of these effective cholesterol medications has limited their use. And they start skipping their dosages, which leads to more risk towards dangerous health issues. These recent medications are no doubt useful to patients, but the cost is a major barrier to access to these drugs. Also, these cholesterol-lowering medications fail to be covered by insurance.

In conclusion…

It is recommended that adults below the age of 40 and above 75 years of age must be medicated if their cholesterol or their heart attack, as well as stroke risk, remains very high. This group involves younger patients with family histories of heart attack as well as older patients who have a history of diabetes for years. To decrease the levels of extremely high cholesterol, doctors must first consider supplementing or replacing a statin with cholesterol drugs such as ezetimibe (brand name Zetia) used in combination with simvastatin according to the new guidelines. In comparison to the high-risk patients who received statins only, those consuming medications such as ezetimibe noticed a decrease in their cholesterol a further 20% to 25%, on an average. Still, if the levels don’t go between 50 and 70 mg/dL or lower, he or she can consider trying this recent class of injected drugs that likely will.