Personalized medicine in lipid-modifying therapy.
Christopher Wai Kei LamChen-Hsiu LinPaul ChanChristopher Wai Kei LamPublished in: Personalized medicine (2021)
The choice of lipid-modifying treatment is largely based on the absolute level of cardiovascular risk and baseline lipid profile. Statins are the first-line treatment for most patients requiring reduction of low-density-lipoprotein cholesterol (LDL-C) and ezetimibe and proprotein convertase subtilisin/kexin type 9 inhibitors can be added to reach LDL-C targets. Statins have some adverse effects that are somewhat predictable based on phenotypic and genetic factors. Fibrates or omega-3 fatty acids can be added if triglyceride levels remain elevated. The RNA-targeted therapeutics in development offer the possibility of selective liver targeting for specific lipoproteins such as lipoprotein(a) and long-term reduction of LDL-C with infrequent administration of a small-interfering RNA may help to overcome the problem of adherence to therapy.
Keyphrases
- low density lipoprotein
- fatty acid
- end stage renal disease
- cardiovascular disease
- ejection fraction
- chronic kidney disease
- newly diagnosed
- cancer therapy
- prognostic factors
- genome wide
- stem cells
- gene expression
- dna methylation
- patient reported outcomes
- copy number
- nucleic acid
- insulin resistance
- mesenchymal stem cells
- cell therapy