FDA approves new kind of cholesterol pill

It's articles such as this that truly make me sit back and marvel at our species. What an incredible accomplishment.

We've been testing for cholesterol for a long time now and have had other meds to lower it. It should be possible to see if lowering cholesterol via medication results in improved life expectancy or reducing cardiac events. I would think this study has been done a few times already. As someone who does not have much medical knowledge, I'm not even sure how to look this up or be able to assess what I see if I did.

It (Particularly ApoB/Combining LDL-C and Lp(a) is one of the single largest leading indicators of health risk we have.

If anything, the data we have is suggesting we've gotten wrong what the upper limits should be for what is considered OK.

https://www.lipidjournal.com/article/S1933-2874(25)00317-4/f...

the literature is very clear about the relationship between high LDL and Atherosclerosis. Are you referring to poor health in general, separate from Cardiovascular Disease?

cholesterol 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)

Peter Attia had a great series of blog posts on this before his fall from grace:

https://peterattiamd.com/the-straight-dope-on-cholesterol-pa...

He also had a series of podcast interviews about this with Tom Dayspring.

I believe his explanations are all mainstream, except he favors treating LDL and LP(a) more aggressively than normal doctors

You should check which part of your body has the most cholesterol.

It turns out LDL has different subfractions based on size. Normally, the liver produces large ones which shuttle fat around the bloodstream, lose their payload and shrink then the liver reabsorbs them and the cycle continues.

The problem appears to begin when these LDL molecules hang around for too long. They are damaged by external factors in the bloodstream (eg. glycation due to high blood glucose, oxidation due to fragile polyunsaturated fats) and not recognized anymore for recycling. That's when they can start forming macrophages.

tl;dr LDL by itself is an incorrect measure of cardiovascular risk. Big pharma still profits by selling everyone LDL reducing drugs.

one authentic source: https://www.youtube.com/watch?v=fVLZA0qp-wc

All the answers are smart sounding and completely avoid to address your main point. Same with most doctors I asked it to.

But I vaguely remember them being expensive due to not being covered by insurance. Maybe this will change that?

Yes, 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.

I just mix rolled oats into my yoghurt. Much cheaper.

What brand?

eat healthy as in: only once a day and only six days a week. only water for drinking and only fresh stuff to eat, no meat, no eggs, nothing cooked, nothing baked, nothing fried, nothing grilled, nothing processed, no sugar and no salt.

Being a major shift from the good life one should start it with a 7 day water fast. (do I have to say "ask your doctor before embarking"? done)

Many people have high cholesterol due to genetics. In these cases even if you ate a 100% perfect diet it would only impact 25% of your cholesterol levels - which any physician would not be satisfied with.

You wouldn't tell someone with diabetes or asthma to just live healthier and avoid their medication. There's nothing wrong with taking a pill, we're not cavemen living off the land.

you 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?

You will still die you know, no matter your diet. And no god will reward your righteous corpse for eating healthy.

I’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.

This 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.

I 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.

8% 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.

Are you seriously suggesting to cut into pharma profits?