Current pharmacotherapies for atherosclerotic cardiovascular diseases

Abstract

Despite the introduction of statins for lowering LDL-C level, atherosclerotic cardiovascular disease (ASCVD) remains a leading cause of death and morbidity worldwide. Combination therapies with statin and other lipid-lowering drugs, including ezetimibe and proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors, have unlocked additive benefits for treatment of ASCVD, but morbidity and mortality due to ASCVD remain high. New anti-inflammatory therapies have emerged for treatment and prevention of ASCVD to address these problems. Canakinumab neutralization of interleukin-1 beta (IL-1 beta) is the only verified therapy, and low-dose methotrexate holds promise due to its efficacy and safety for treatment of ASCVD. However, many agonistic and antagonistic candidates within inflammation pathways have failed to develop into useful drugs for ASCVD because of the complexity of the inflammatory process in atherosclerosis. In this review, we outline current and future pharmaceutical therapies for ASCVD in terms of lipid-modifying strategies and anti-inflammation treatments.