New Cholesterol Drug Could Eliminate Heart Disease

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What is cholesterol?  A Cholesterol molecule by RedAndr via Wikimedia Commons

What is cholesterol? This is a visual representation of a cholesterol molecule. Image by RedAndr

Researchers have developed a new type of cholesterol medication, a PCSK9 inhibitors, that lowers bad LDL cholesterol to previously unachievable levels.

This new drug is a monoclonal antibody that controls the gene in the body responsible for limiting how much cholesterol the liver can filter out of the blood stream.

The new drug turns this gene off, allowing the liver to filter more cholesterol out of the body, lowering blood cholesterol levels dramatically and thereby theoretically reducing heart disease risk.

Heart disease is responsible for one third of all deaths in individuals over the age of 35 in the United States.

What is Heart Disease?

Heart disease, or coronary heart disease, is the result when the blood vessels leading to the heart become damaged or blocked.  Blockage in these vesssels means blood carrying oxygen and nutrition cannot reach the heart – this causes a ‘heart attack.’  This blockage is most often made of cholesterol.

What Are Safe Cholesterol Levels?

Cholesterol is a yellow waxy substance that hardens arteries, building up on the walls and clogging them.  A simple blood test taken when fasting can determine cholesterol levels in the blood. According to the Mayo Clinic, your total cholesterol should be under 200, and low density lipoprotein (LDL), also known as ‘bad cholesterol,’ should be under 100. If you’re at high risk for heart disease, your LDL should be under 70. High density lipoprotein (HDL), also known as ‘good cholesterol’ should be over 40 for men and 50 for women, and triglyceride levels should be under 150.

Why do Cholesterol Numbers Matter?

In the U.S., heart disease is the number one killer of both men and women, causing 1 million heart attacks and 600,000 deaths annually.  Heart disease costs the United States $108.9 billion dollars annually. According to the CDC, for every percentage you drop LDL levels, the risk for heart disease drops by the same percentage.

New Cholesterol Drug: What Is It?

Three major U.S. drug companies are all working to develop a PCSK9 inhibiting cholesterol drug.  Currently in late stage human trials, the drugs seem to be safe and working as intended to lower LDL cholesterol in test subjects.  The next step is FDA approval.

Scientists accidentally discovered the PCSK9 gene ten years ago after testing a family in Paris with extremely high levels of LDL cholesterol, and a family history of extreme heart disease and early death.  This family was found to have a mutation of the PCSK9 gene.

Further study proved that others with extremely low levels of LDL in their blood had under-active or inactive PCSK9 genes.

Caucasian individuals with one mutated gene show a 46% reduction in heart disease even though the mutation is much less powerful than that found in African-American counterparts.

Scientist have learned that individuals with one mutated gene have lower LDL levels their entire life.  They are almost immune to heart disease, even with risk factors such as diabetes, smoking and high blood pressure.  Only two people in the world have been found with two mutated genes, one from each parent.

Heart Attack Prevention: Injection

Could monthly injections reduce your heart attack risk? Image by Bill Branson (Photographer), courtesy of the National Cancer Institute

Monoclonal antibody medications such as this new treatment are rendered ineffective by stomach acid.

The current form of the cholesterol drug is given by injection, just under the skin, every two to four weeks.  This type of medication is expensive, hard to store, and requires more manufacturing than oral medications.  It is made in living cells, and is referred to as a “biologic.”

 

In an interview with Decoded Science, Mary S. Schwartz, a consultant pharmacist in South Florida, said “This is exciting, a new arena.  All drugs are going the way of biologics, this is the new field in medicine.  Being able to control genes in the human body could lead to cures for and the ability to control all kinds of genetic diseases.”

Schwartz does, however, question long-term risks and how this new drug will be presented to the general public.  “Is this going to be a fix-all  for everyone, or just for people who cannot control their cholesterol any other way?  What will we see in 20 years?

 

 

Resources:

Centers for Disease Control and Prevention. Heart Disease Facts.  Accessed August 9, 2013.

Kolata, Gina.  Rare Mutation Ignites Race for Cholesterol Drug.  (2013). New York Times. Accessed August 9, 2013.

Mayo Clinic Staff.  High Cholesterol.  Cholesterol Levels: What numbers should you aim for?  Accessed August 9, 2013.

National Heart, Lung, and Blood Institute, US Department of Health and Human Services. Lower Heart Disease Risk: What is Heart Disease? Accessed August 9, 2013.

National Heart, Lung and Blood Institute.  What You Need to Know About High Blood Cholesterol. Accessed August 9, 2013.

Wilson, Peter and Douglas, Pamela.  Epidemiology of Coronary Heart Disease.  Up-to-Date.  Accessed August 9, 2013.

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