When diet and exercise aren’t enough to treat high cholesterol, there are many promising medications that can help, according to research recently presented at the American College of Cardiology’s 64th Annual Scientific Session in San Diego.
The first study, which was also published in the New England Journal of Medicine, assessed a new drug called evolocumab, which lowers bad cholesterol. Known as the OSLER-1 trial, this study included nearly 4,500 patients treated for high cholesterol at 190 medical centers in the U.S. and abroad. Two-thirds of subjects were randomly assigned to the new injectable drug, evolocumab, plus standard therapy, while the remaining third of participants took the standard cholesterol therapy alone. After following patients for an average of 11 months, researchers found that evolocumab reduced bad cholesterol levels by 61% and cut risk of heart events in half compared to those receiving standard care.
Evolocumab has yet to be approved by the U.S. Food and Drug Administration (FDA), but researchers are encouraged by study findings. Not only may the new injectable drug safely and effectively reduce cholesterol levels, evolocumab could drastically reduce risk of life-threatening heart events, such as heart attack and stroke. If approved, evolocumab may be a potential option for patients with high cholesterol that can’t tolerate cholesterol-lowering statins, which have been shown to cause side effects in many patients. With larger studies being completed by 2017, researchers hope to better assess the safety and efficacy of evolocumab before it is reviewed by the FDA for widespread use.
In the meantime, there are many already approved drugs that can go a long way in reducing cholesterol levels. A second study, also published in the New England Journal of Medicine, tested the use of cholesterol-lowering statins plus a non-statin drug called ezetimibe. Ezetimibe and statins are both drugs used to lower cholesterol, but since they work in different ways, researchers wondered if using both together could help further reduce cholesterol and cardiovascular risk.
A total of 18,144 patients with high cholesterol participated in the study, roughly half of whom were randomly assigned to take ezetimibe plus a common statin, while the other half took the statin only. After following participants for six years, researchers found that patients taking the combined treatment had 9% fewer heart events than those taking statins alone. There were no significant differences in side effects or complications in either group.
Based on study findings, researchers believe statins plus ezetimibe may be more effective than statins alone. Findings also suggest that “lower is better” when it comes to bad cholesterol, as achieving low levels of bad cholesterol in this study helped significantly lower risk for heart attack, stroke, and even death.