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Advanced Prostate Cancer

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New cholesterol lowering drug

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With all the interest in the affect of cholesterol on PCa, I thought this paper might be of Cardiol Rev. 2019 Jan/Feb;27(1):49-56. doi: 10.1097/CRD.0000000000000218.

Bempedoic Acid (ETC-1002): ATP Citrate Lyase Inhibitor: Review of a First-in-Class Medication with Potential Benefit in Statin-Refractory Cases.

Zagelbaum NK1, Yandrapalli S1, Nabors C1, Frishman WH1,2.

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Abstract

Bempedoic acid (BA; ETC-1002) is a new agent that reduces cholesterol synthesis through inhibition of adenosine triphosphate citrate lyase, an enzyme upstream from 3-hydroxy-3-methylglutaryl-coenzyme A. In animal models, BA also influences fatty acid synthesis, but in humans, its role is limited primarily to lowering low-density lipoprotein cholesterol (LDL-C). In early clinical trials, BA was well tolerated and without major side effects. Alone or in various combinations with atorvastatin and/or ezetimibe, LDL-C lowering ranged from 17% to 64%. In addition, BA lowers levels of non-high-density lipoprotein cholesterol, C-reactive protein, and apolipoprotein B. Statins are first-line agents for primary and secondary prevention of cardiovascular disease. However, muscle-related side effects and other problems such as elevated liver enzymes may limit their use. In addition, LDL-C lowering beyond that provided by statin therapy alone may be needed. BA may be useful in either of these scenarios, as it is relatively free of muscle-related side effects and appears to enhance LDL-C lowering beyond that achieved with statin monotherapy. Phase 3 trials and one outcomes study are currently under way to better define this agent's potential clinical role.

PMID: 29939848 DOI: 10.1097/CRD.0000000000000218

[Indexed for MEDLINE]

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Interesting. Seems like my cholesterol level isn't a problem, my blood sugar is. I'm having to give up on sugary snacks. I stopped the sugary soda years ago. I thought I was OK since I wasn't putting on weight. I don't take any diabetes related meds. I haven't crossed the threshold to diabetes yet and I'd like to keep it that way. I am 69 and mildly overweight at 6'4" and 200 lbs. Used my (diabetic) wife's monitor and had a blood sugar level of 116 this morning. I think carbs are my problem but I also imbibe a few ounces of prune juice at breakfast and dinner for regularity.

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