Written By: IJCP Editorial Team

Published On: 04 Mar, 2025 1:38 PM | Updated On: 04 Mar, 2025 1:43 PM

Advances in Dyslipidemia Management: Current Insights and Future Directions

Dyslipidemia, once with limited advancements, is now rapidly evolving due to new medications and updated guidelines from global health organizations. Over the past decade, the FDA has approved numerous treatments, leading to more frequent updates in management standards.

We have examined key research and widely accepted studies on dyslipidemia to provide current clinical insights. Dyslipidemia encompasses any lipid abnormalities in the blood, primarily affecting low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), total cholesterol, and triglycerides. It is a significant risk factor for cardiovascular disease, particularly due to elevated LDL-C and triglyceride levels, which increase the likelihood of atherosclerotic cardiovascular disease (ASCVD).

Recent guidelines emphasize the importance of various lipoproteins, such as non-HDL-C, ApoB, and lipoprotein(a), as critical indicators of cardiovascular risk, especially in patients with high triglyceride levels. 

Familial hypercholesterolemia (FH) is a genetic condition leading to high LDL-C levels and increased ASCVD risk. Early detection and treatment are essential, with statins being the primary therapy. If necessary, additional medications like ezetimibe or PCSK9 inhibitors may be employed, and LDL apheresis can be considered when other treatments fail.

The management of dyslipidemia typically starts with statin therapy, with additional medications recommended for patients who do not achieve target levels or cannot tolerate statins. Key treatment indications include high LDL-C levels, diabetes in specific age groups, chronic kidney disease, and high ASCVD risk.

Lifestyle changes, such as diet and exercise, are essential in managing dyslipidemia. If lifestyle modifications do not adequately lower LDL-C levels within six months, pharmacotherapy should be initiated.

Diet therapy involves a phased reduction of cholesterol intake, and aerobic exercise is encouraged to improve HDL-C levels. Drug therapy complements dietary changes and can yield quicker results. Statins are the most commonly prescribed medications, effectively lowering LDL-C and providing additional cardiovascular benefits. Ezetimibe enhances statin efficacy, and bile acid sequestrants, niacin, fibrates, omega-3 fatty acids, PCSK9 inhibitors, inclisiran, and bempedoic acid are other treatment options, each with specific mechanisms of action, benefits, and potential side effects.

Recent trials have shown promising results for newer agents like inclisiran and bempedoic acid, although their impact on long-term cardiovascular outcomes is still being evaluated. Dyslipidemia remains a prevalent metabolic disorder, and ongoing research aims to improve management strategies, ultimately enhancing patient outcomes in this area.

Source: Taher ZA, Taher AA, Radi S. An Update on Dyslipidemia Management and Medications: A Review. Cureus. 2024 Mar 16;16(3):e56255. doi: 10.7759/cureus.56255. PMID: 38623110; PMCID: PMC11017140.