That same frustrating feeling shows up for many people: you follow the advice, take your medication, try to eat better, and still your numbers refuse to cooperate. LDL, the bad cholesterol, in particular, can be stubbornly difficult to bring down.
Now, new research suggests a potential shift that could make treatment both simpler and more effective.
Researchers at UT Southwestern Medical Center have developed an experimental daily pill called enlicitide, which delivered striking results in a large phase 3 trial.
According to findings published in the New England Journal of Medicine, the drug lowered LDL, often referred to as “bad” cholesterol, by around 60 percent. That level of reduction is comparable to some of today’s most powerful treatments, which are typically given as injections.
The trial included nearly 3,000 participants, many of whom were already taking statins but had not reached recommended cholesterol levels.
Why it matters
LDL cholesterol plays a key role in the development of cardiovascular disease. Over time, it can build up in artery walls, increasing the risk of heart attacks and strokes.
Despite existing therapies, many patients still struggle to reach safe targets. Researchers say this highlights the need for more accessible options.
What comes next
The drug works by targeting the PCSK9 pathway, a mechanism that affects how efficiently the body clears cholesterol from the bloodstream.
While similar approaches already exist, they usually require injections. An oral alternative could make a significant difference in everyday care.
Overview of Enlicitide
Clinical trials have shown that enlicitide can reduce LDL cholesterol levels significantly, with some studies reporting reductions of up to 60% in patients with hypercholesterolemia. In head-to-head trials, enlicitide demonstrated greater reductions in LDL-C compared to ezetimibe and other non-statin therapies.
Safety Profile: Enlicitide has been found to be well-tolerated, with a safety profile similar to that of placebo in clinical trials.
Overview of Ezetimibe
Efficacy: Ezetimibe is effective in lowering LDL cholesterol, particularly when used in combination with statins. It typically achieves a reduction of about 18-25% in LDL-C levels.
Safety Profile: Ezetimibe is generally well-tolerated, with a low incidence of side effects. Common side effects may include gastrointestinal symptoms, but serious adverse effects are rare
The CORALreef AddOn study
This study concluded that patients treated with enlicitide achieved an LDL-cholesterol level of less than 70 mg/dL (and a reduction of 50% or more from baseline): 81.2% versus 2.0% with bempedoic acid, 8.0% with ezetimibe, and 22.0% with ezetimibe and bempedoic acid (P < 0.001 for enlicitide vs all others).
Patient Population: Enlicitide may be particularly beneficial for patients with familial hypercholesterolemia or those who are statin intolerant.
Further studies are now underway to determine whether these cholesterol reductions will translate into fewer heart attacks and strokes over time.
Source: ©Welltica+
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