A large clinical study has just reported the performance of an experimental tablet, enlicitide, capable of reducing LDL cholesterol – often called 'bad' cholesterol – by up to 60%. This breakthrough suggests a new strategy to prevent heart attacks and strokes.
Currently, less than half of patients with cardiovascular diseases reach their LDL cholesterol targets. Existing treatments, such as statins, are not always sufficient, leaving a portion of the population exposed to significant risks. This observation highlights the need to develop effective and easy-to-use alternatives.
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LDL cholesterol accumulates in the walls of blood vessels, forming fatty deposits called plaques. This process, atherosclerosis, narrows the arteries and can trigger heart or brain problems. For decades, reducing this type of cholesterol has been a goal to limit these risks, but therapeutic options sometimes remain insufficient.
Basic research has provided a better understanding of this mechanism. Several years ago, scientists identified the LDL receptor on liver cells, a discovery that earned a Nobel Prize. Subsequently, the study of people with naturally low levels of LDL cholesterol revealed the role of the PCSK9 protein, which regulates cholesterol elimination.
Current treatments targeting PCSK9, such as injectable monoclonal antibodies, are very effective but underused. Their administration by injection may discourage some patients and doctors. This situation explains the interest in an oral form, easier to integrate into daily life.
Enlicitide works by binding to PCSK9 in the blood, similarly to injections, but in the form of a once-daily tablet. In the phase three clinical trial, involving nearly 3000 patients, this drug achieved an average 60% reduction in LDL cholesterol compared to a placebo. Participants, already on statins, saw their levels drop significantly, with effects maintained over one year.
These results, published in the
New England Journal of Medicine, indicate that enlicitide could become a major option for at-risk individuals. Researchers are now conducting other studies to verify whether this cholesterol reduction translates into fewer cardiovascular events, such as heart attacks or strokes.