Antisense therapy and emerging applications for the management of dyslipidemia

J Clin Lipidol. 2011 Nov-Dec;5(6):441-9. doi: 10.1016/j.jacl.2011.08.007. Epub 2011 Sep 14.

Abstract

Background: Because a significant percentage of patients who require high-dose statin therapy for dyslipidemia experience treatment-related muscle symptoms and an inconsistent clinical response, alternative or adjunctive approaches to the management of dyslipidemia are needed. One alternative approach, antisense therapy, may offer an effective and well-tolerated option for patients not satisfactorily responsive to or intolerant to standard pharmacologic dyslipidemia therapies.

Objective: This review provides an overview of antisense technology and its potential role in the management of dyslipidemia.

Methods: Source material was obtained primarily from the published literature identified through a search of the PubMed database.

Results: Antisense technology is an evolving approach to therapy that has gone through a series of refinements to enhance molecular stability, potency, and tolerability. Mipomersen is an antisense molecule capable of producing clinically meaningful reductions in low-density lipoprotein cholesterol in patients with severe familial hypercholesterolemia. Further long-term clinical studies are required to more clearly quantify its impact on risk for cardiovascular events and establish whether it increases risk for hepatosteatosis.

Conclusion: Antisense therapy represents a potentially effective and well-tolerated emerging treatment modality for numerous diseases. In the treatment of hypercholesterolemia, the antisense therapy mipomersen may provide a possible treatment option for patients with treatment-resistant dyslipidemia.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Apolipoproteins B / blood
  • Cholesterol, LDL / blood
  • Clinical Trials as Topic
  • Drug Delivery Systems
  • Drug Stability
  • Dyslipidemias / blood
  • Dyslipidemias / therapy*
  • Humans
  • Hypolipidemic Agents / therapeutic use
  • Oligonucleotides / therapeutic use
  • Oligonucleotides, Antisense / chemistry*
  • Oligonucleotides, Antisense / therapeutic use*

Substances

  • Apolipoproteins B
  • Cholesterol, LDL
  • Hypolipidemic Agents
  • Oligonucleotides
  • Oligonucleotides, Antisense
  • mipomersen