A new experimental medicine may one day change the way doctors treat high cholesterol and protect people from heart disease.
The drug, called enlicitide, comes as a once-daily pill and has shown impressive results in a large clinical trial.
The findings were published in The New England Journal of Medicine and have raised hopes that patients could soon have a simpler and more convenient option for lowering cholesterol.
Heart disease remains one of the biggest health problems in the world. Every year, millions of people die from heart attacks, strokes, and other diseases linked to poor blood flow.
One of the main causes of these conditions is high levels of low-density lipoprotein, or LDL cholesterol. LDL is often called ‘bad’ cholesterol because it can build up inside blood vessels. Over many years, fatty deposits called plaques can form in artery walls. This process is known as atherosclerosis.
As plaques grow larger, the arteries become narrower and blood cannot flow as easily. If a plaque suddenly breaks apart, it can completely block blood flow. When this happens in the heart, it can cause a heart attack.
If it happens in the brain, it can cause a stroke. For this reason, doctors have spent decades trying to find better ways to lower LDL cholesterol and reduce the risk of these serious events.
For many years, statins have been the most common treatment for high cholesterol. These medicines lower the amount of cholesterol made by the liver and have saved many lives. However, statins do not work well enough for everyone.
Some patients cannot tolerate high doses because of side effects, while others still have cholesterol levels that remain above recommended targets even after treatment. These people continue to face a higher risk of heart disease.
The development of enlicitide is based on discoveries that have taken scientists many years to understand. In the 1980s, researchers discovered special receptors in the liver that remove LDL cholesterol from the blood. This important finding later earned a Nobel Prize because it changed scientists’ understanding of cholesterol control.
Years later, scientists discovered another protein called PCSK9. This protein reduces the number of cholesterol-removing receptors in the liver, making it harder for the body to clear LDL cholesterol from the bloodstream.
This discovery led to the development of medicines called PCSK9 inhibitors. These drugs are very effective and can reduce LDL cholesterol by around 60 percent. However, they are usually given by injection every few weeks. Some people do not like injections, and some doctors are reluctant to prescribe them because they are less convenient than tablets.
Enlicitide targets the same PCSK9 pathway but offers an important advantage. Instead of an injection, it is taken as a daily pill. Researchers hope this convenience could encourage more people to stay on treatment and reach healthier cholesterol levels.
The phase three clinical trial involved almost 3,000 participants. The people in the study either already had atherosclerosis or had a high chance of developing it. Most of them were already taking statins, yet their cholesterol levels remained higher than recommended. On average, their LDL cholesterol levels were about 96 milligrams per deciliter.
After 24 weeks of treatment, people who took enlicitide experienced a reduction of about 60 percent in LDL cholesterol compared with those who received a placebo. The medicine also improved other markers related to heart disease, including apolipoprotein B and lipoprotein(a). These improvements continued for up to one year during the study.
The study’s lead researcher, Dr. Ann Marie Navar, said that fewer than half of people with established heart disease achieve their cholesterol goals using current treatments. She suggested that an effective pill like enlicitide could help many more patients lower their risk of heart attacks and strokes.
Even though the results are encouraging, important questions still remain. Scientists already know that lowering LDL cholesterol usually reduces heart disease risk.
However, researchers still need to prove that enlicitide will actually prevent heart attacks and strokes in real-world patients over many years. A larger study is already underway to answer these questions.
Researchers also need to continue studying the drug’s long-term safety and cost. New medicines sometimes reveal unexpected side effects after being used by larger numbers of people. The price of the medication will also influence how widely it can be used if it eventually receives approval.
Overall, enlicitide represents an exciting step forward in the treatment of high cholesterol. It combines the strong cholesterol-lowering effects seen with injectable PCSK9 medicines with the convenience of a simple daily tablet.
If future studies confirm its benefits and safety, this new pill could become an important tool for preventing heart disease and helping more people achieve healthy cholesterol levels.
If you care about heart disease, please read studies that herbal supplements could harm your heart rhythm, and how eating eggs can help reduce heart disease risk.
For more health information, please see recent studies that apple juice could benefit your heart health, and results showing yogurt may help lower the death risks in heart disease.
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