Biotechnology includes the process of using or manipulating living organisms or genes to produce new drugs. Biotechnology is being used to create new methods to lower high cholesterol.
Low-density lipoprotein (LDL) is the bad type of cholesterol. When you have too much LDL cholesterol in your bloodstream, it can build up into “cholesterol plaques” that block your arteries. This process is known as atherosclerosis. High LDL cholesterol is associated with increased risk of cardiovascular disease, heart attack, and stroke.
Many people are able to lower their LDL cholesterol through healthy diet and regular exercise. For those who can’t lower LDL levels with lifestyle change alone, statin therapy is usually the next step. Doctors consider statins to be safe and effective treatments for most people, as long as they are closely monitored for side effects.
Some people can’t tolerate the side effects of statins even after switching to another one or decreasing the daily dose.
When you think of cholesterol, you probably think about the cholesterol in your diet. Diet is only one of the ways you get cholesterol into your bloodstream. Your body also has a built-in cholesterol factory of its own. You have a gene called the proprotein convertase subtilisin/kexin type 9 (PCSK9). It controls the number of LDL receptors on the surface of cells. The receptors are mostly found in the liver. They remove excess cholesterol so you don’t end up with too much in your bloodstream.
Certain genetic mutations can affect this process and lead to high cholesterol (hypercholesterolemia). That’s why high cholesterol sometimes runs in families.
Researchers are now using this type of genetic information to design new drugs that may significantly lower cholesterol levels.
Evolocumab is now FDA approved to lower your cholesterol. It works by blocking the protein that interferes with the liver’s ability to remove LDL cholesterol from the blood.
Participants who took the drug in recent clinical trials were about half as likely to have a heart attack or stroke, or die, versus those who had standard care. Evolocumab has been shown to lower LDL cholesterol by 61 percent.
Alirocumab is another FDA-approved drug to lower your cholesterol. Both of these biologics appear to be effective in lowering LDL cholesterol.
Statins, which are already in widespread use, are also effective in lowering LDL cholesterol. While statins come in tablet form and are generally affordable, biologics must be injected every two to four weeks and are more expensive.
All drugs have the potential to cause side effects, including:
- joint pain
- injection site reactions
- limb pain
- elevated aminotransferase (liver enzyme) or creatine kinase levels
- neurocognitive issues, such as delirium, cognitive and attention disorders and disturbances, disturbances in thinking and perception
Adverse events were reported in 81 percent of people receiving the drug in the alirocumab trial. These included:
- injection site reactions
- neurocognitive issues, such as amnesia, memory impairment, confusional state
- ophthalmologic (visual) events
- general allergic reaction
- neurologic events, such as peripheral neuropathy
More data is needed to assess the safety and effectiveness of these drugs over the long term, especially in people who have diabetes or other underlying medical conditions.
Talk to your doctor about treatment options if you have high cholesterol. You may be able to lower your LDL cholesterol and raise your HDL cholesterol by making a few lifestyle changes. If you can’t, it may require a combination approach with medications. Discuss the pros and cons of statins with your doctor.
More research is needed. Longer-term studies will help determine if these drugs will be safe and effective over extended periods of time.
Biologics are a promising avenue of treatment for people who can’t control their cholesterol using other treatment methods. There’s little doubt you’ll see more news about biologics for treatment of cholesterol in the years to come.