Lege Artis Medicinae

[New approach in the treatment of elevated lipoprotein(a)]

KARÁDI István1

NOVEMBER 30, 2021

Lege Artis Medicinae - 2021;31(11)

DOI: https://doi.org/10.33616/lam.31.037

Review

[Lipoprotein(a) is a genetic trait, resembling the structure of low density lipoprotein (LDL). Due to its high atherogenicity it is an independent risk factor for atherosclerotic vascular diseases. External impacts (as dietary and lifestyle measurements) do not decrease its plasma level thus the primary and secondary cardiovascular prevention prefers primarily the drug therapy. How­ever, widely used lipid lowering agents do not have any impact on its plasma level. Recently, the PCSK9 inhibitor monoclonal antibodies (evolocumab and alirocumab), the small interfering mRNA inclisiran, and particularly the antisense oligonucleotide targeting the LPA mRNS, further the clinical use of pelacarsen produced significant lipoprotein(a) lowering effect. Beyond the atherosclerotic vascular diseases, lipoprotein(a) plays an important role in the pathogenesis of the calcific aortic valvular stenosis, as well. The usage of the above-men­tioned biological therapies in this condition is also promising. ]

AFFILIATIONS

  1. Semmelweis Egyetem, Belgyógyászati és Hematológiai Klinika

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