4 ms·
FDA approves new kind of cholesterol pill
- JumpCrisscross 3mo ago“Proprotein convertases (PPCs) are a family of proteins that activate other proteins. Many proteins are inactive when they are first synthesized, because they contain chains of amino acids that block their activity. Proprotein convertases remove those chains and activate the protein” [1]. [1] https://en.wikipedia.org/wiki/Proprotein_convertase https://en.wikipedia.org/wiki/Proprotein_convertase
- JoshGlazebrook 3mo agoNext up is the lp(a) lowering drugs still in trials.
- nwah1 3mo agoYes, exciting stuff. Not to mention the gene-therapy version of the same PCSK9 inhibition pathway called VERVE-102 which Eli Lilly is putting through human trials as we speak. I imagine that stacking the LP(a) antisense therapy with a PCSK9 inhibitor, and/or a statin or Nexlizet would probably lower odds of heart disease death by two to three orders of magnitude. But I guess there isn't solid mortality data to say for sure.
- derektank 3mo agoNot really a new kind of pharmaceutical, pcsk9 inhibitors have been on the market for a while now. What’s new is that it’s an oral medication rather than an injectable
- eternauta3k 3mo agoBut I vaguely remember them being expensive due to not being covered by insurance. Maybe this will change that?
- derektank 3mo agoHmmm, maybe but I wouldn’t expect a sea change myself. The reason insurance is able to get away with not covering pcsk9 inhibitors is because statins in theory provide a similar benefit for a fraction of the price, and so they can gatekeep access by requiring patients to take statins first before providing prior authorization. Now, structurally Repatha is straight up more expensive to manufacture and deliver to patients than a peptide like enlicitide, as the former is a biologic. And if a competitor decides to manufacture a biosimilar when Repatha comes off patent in 2030 that could also help cut the price of drugs in this category. But there’s really nothing cheaper than statins, so I would expect insurance agencies to continue to withhold prior authorization.
- marcosfelt 3mo agoThere's a nice writeup by Derek Lowe on the synthesis of this molecule: https://www.science.org/content/blog-post/futuristic-synthesis-indeed https://www.science.org/content/blog-post/futuristic-synthes... It's quite a beast!
- liamwire 3mo agoIt's articles such as this that truly make me sit back and marvel at our species. What an incredible accomplishment.
- hankbond 3mo agoWhat is the current state of understanding on high cholesterol as a leading or trailing indicator of poor health? I vaguely remember reading one theory that cholesterol was used by the body to mitigate arterial damage from other causes?
- shlant 3mo agothe literature is very clear about the relationship between high LDL and Atherosclerosis. Are you referring to poor health in general, separate from Cardiovascular Disease?
- _kidlike 3mo agocholesterol is one of the most crucial molecules for survival. It's used to create and maintain cell membranes, and other critical functions. The vast majority is created by the liver, and there are a lot of regulating signals for how much, which is where usually things go off. Low cholesterol production is an extremely serious condition. The "only" problem with high cholesterol is that it builds up inside artery walls, which eventually may or may not dislodge and may or may not cause a heart attack or an embolic stroke. (I'm not a doctor. I just get medication for high cholesterol and have done some research)
- cthalupa 3mo ago> Low cholesterol production is an extremely serious condition. This is correct, but not in the way you mean it. We know people can effectively produce no LDL cholesterol in their liver and have positive health impacts - these MR studies are a big part of what drove this entire class of cholesterol medications. And the monoclonal antibody versions of PCSK9 inhibitors have shown basically the same results. Virtually all human cells can produce cholesterol locally de novo, including your brain.
- _kidlike 3mo agoo_O
- eternauta3k 3mo ago
- mediumsmart 3mo agoOne could eat healthy instead of course but hey, the good life.
- shlant 3mo agoyou didn't read the article did you? Or are you actually here to claim that people with hypercholesterolemia just need to eat better? Do you have the same simplistic ideas about GLP-1's?
- moi2388 3mo agoFor all people? No. For the vast majority of people? Yes. Eat healthy and exercise more.
- pinkmuffinere 3mo agoThe dietary impact on cholesterol in the blood is surprisingly low. Looking it up, this source says diet can affect 20-30% of your blood levels [1]. I don’t have a great statistic about exercise, but I’d encourage you to question what you think you know — at the very least I’ll claim you’re mistaken about the importance of dietary impacts on cholesterol, which perhaps should give you pause about your other beliefs [1] https://my.clevelandclinic.org/health/articles/16867-cholesterol--nutrition-tlc https://my.clevelandclinic.org/health/articles/16867-cholest...
- jghn 3mo agoDietary cholesterol has little impact on blood cholesterol. However the post that started this debate mentioned mass loss. And that does have a decent correlation. Go from obese to not obese and the median person's cholesterol will drop quite a bit.
- pinkmuffinere 3mo agoIt’s possible the comments have changed, but I see nothing in the thread about mass loss. I do agree about weight though — losing weight is largely diet. > Go from obese to not obese and the median person's cholesterol will drop quite a bit. This is really interesting, I don’t think I’ve heard that before. Do you have a source you could share? Edit: this doesn’t necessarily prove you wrong, but this paper argues there’s little correlation between bmi and cholesterol [1] [1] https://link.springer.com/article/10.1007/s11695-010-0170-7 https://link.springer.com/article/10.1007/s11695-010-0170-7
- hmontazeri 3mo agoJust do fasting and lose weight. Had high cholesterol and did that lost 20 pounds and my cholesterol went back to normal without any medical intervention
- ivankra 3mo agoThis is more about lp(a) type of cholesterol which is largely driven by genetics, and barely responds to lifestyle/diet. lp(a) is not part of routine blood tests - you probably didn't measure it unless you specifically asked for it.
- Kirby64 3mo agoI’m glad that worked for you. That doesn’t work for everyone, and there’s plenty of people with completely healthy weights who eat healthy as well who just have outrageous cholesterol. Any medical interventions that fix genetic conditions seem like a win for me. Even fixing lifestyle issues medically (eg GLP-1s) seem like a win for me.
- deleted 3mo ago[deleted]
- mikestew 3mo ago8% body fat, and I can run more in a day than most people do in a week. I’m taking statins. It’s not always as simple as you seem to assume. As others have said, genetics play role, for one.
- dev_l1x_be 3mo agoAre you seriously suggesting to cut into pharma profits?
- lurker_72 3mo agoI have familial hypercholesterolemia and none of that makes any difference. In fact 2 of my siblings and both my daughters have it too. My youngest sister had a stroke at 24 because of it. Diet, statins, etc can't get us in healthy ranges and PCKS9 inhibitors is literally the only thing that moves the needle. I'm on Repatha, one of the injectable inhibitors, statins and Ezetimibe to manage it. Needless to say I am super happy about this news, especially if it is affordable. Really hopeful that Verve 102 passes trials and becomes generally available.
- brador 3mo agoOat cookies. I get them imported from Europe. High calorie but works.
- sebmellen 3mo agoWhat brand?
- Scoundreller 3mo agoI just mix rolled oats into my yoghurt. Much cheaper.
- sneak 3mo agoIt works via the same mechanism as an incredible drug called Repatha (generic name evolocumab), but Repatha is quite expensive, requires refrigeration, and must be injected subcutaneously every two weeks. The news here is that this is administered orally.
- stefantalpalaru 3mo ago[dead]
- guerby 3mo agoDocumentary: The Cholesterol Code https://m.youtube.com/watch?v=57Z8bUb1P94 https://m.youtube.com/watch?v=57Z8bUb1P94