Addressing Advances and Roadblocks in Lipid Management, With Joseph Saseen, MD

Dyslipidemia is an increasingly prevalent cardiovascular risk factor worldwide, and current therapies are rapidly evolving to keep up with the spread of increased hypertriglyceridemia, hypercholesterolemia, and low HDL-C.1

On National Lipid Day 2026, the editorial team at HCPLive spoke with Joseph Saseen, MD, professor and associate dean for clinical affairs at the University of Colorado Skaggs School of Pharmacy and Pharmaceutical Science and former president of the National Lipid Association, to discuss recent advancements in the field and how far we have yet to go.

“The medicines, at least the foundational medicines, are very affordable, if not free under some insurance plans,” Saseen told HCPLive. “Basic treatment is not costly. It does require a commitment by the provider and by the patient to not only adhere with the prescribed regimen, but more importantly, to buy into the regimen through shared decision-making, through conversations that discuss cardiovascular risk, to motivate the patient to understand the risks associated with elevated LDL-C and getting that commitment to treat.”

In March of 2026, a joint committee of the American College of Cardiology (ACC) and American Heart Association (AHA) released updated clinical guidelines on the management of dyslipidemia. Key practice-changing shifts included a return to specific, targeted LDL-C goals after the 2018 version introduced percent LDL-C reductions as a method of monitoring progress.1,2

Additionally, the current guidelines emphasize the need to focus on lipoprotein(a), or Lp(a), encouraging clinicians to measure all adult patients’ Lp(a) at least once when addressing risk of atherosclerotic cardiovascular disease (ASCVD). This is a Class of Recommendation (COR) 1 suggestion and has widely been considered a substantial step forward for dyslipidemia treatment.1,2

While statins and fenofibrate are still frontline therapies for dyslipidemia, recent advancements in CETP inhibitors such as obicetrapib have offered new frontiers for lipid management. After a history of failure in clinical trials due to long drug half-life or negative side effects, with 3 individual compounds failing in phase 3 trials, current research has shown significant promise.3

A 2025 study among patients with ASCVD or heterozygous familial hypercholesterolemia enrolled 2530 patients, who were then randomly assigned to obicetrapib (n = 1686) or placebo (n = 844). The primary endpoint was percent change in LDL-C level by day 84 – by this timepoint, the least-squares mean percent change in the obicetrapib arm was -29.9% (95% CI, -32.1 to -27.8) and 2.7% (95% CI, -0.4 to 5.8) in the placebo group. Investigators ultimately concluded that obicetrapib was noninferior to placebo based on these data.4

However, Saseen states that he expects LDL-C to remain the central target of lipid-lowering therapies moving forward. He cites other targets like Lp(a) as secondary, given the prominent role LDL-C plays in most forms of dyslipidemia.

“I think the future holds something with the basics,” Saseen said. “Over the next 5 to 10 years, we’re going to have more and more drugs that treat LDL-C. They will become more and more streamlined, with more available options. I think the future and the innovation is probably smarter and better ways to use LDL-lowering therapies with some new additions.”

Editors’ Note: Saseen reports disclosures with Amgen.

References

1. Blumenthal RS, Morris PB, Gaudino M, et al. 2026 ACC/AHA/AACVPR/ABC/ACPM/ADA/AGS/APHA/ASPC/NLA/PCNA guideline on the management of Dyslipidemia: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2026;153(17). doi:10.1161/cir.0000000000001423

2. Livingston R. Updated ACC/AHA Dyslipidemia Guidelines Incorporate LDL-C Goals, Lp(a) Focus With Deepak Bhatt, MD, MPH. HCPLive. March 25, 2026. Accessed May 8, 2026. https://www.hcplive.com/view/updated-acc-aha-dyslipidemia-guidelines-incorporate-ldl-c-goals-lp-a-focus-with-deepak-bhatt-md-mph

3. Chang B, Laffin LJ, Sarraju A, Nissen SE. Obicetrapib-the Rebirth of CETP Inhibitors? Curr Atheroscler Rep. 2024 Oct;26(10):603-608. doi:10.1007/s11883-024-01231-5.

4. Nicholls SJ, Nelson AJ, Ditmarsch M, et al. Safety and efficacy of Obicetrapib in patients at high cardiovascular risk. New England Journal of Medicine. 2025;393(1):51-61. doi:10.1056/nejmoa2415820