INTRODUCTION: Statins are currently the most commonly used agents for treatment 
of hypercholesterolemia in patients with atherosclerotic cardiovascular disease. 
However, some patients on statins do not achieve their treatment goals or are 
intolerant to statins. Therefore, new therapies for treatment of 
hypercholesterolemia are under investigation.
AREAS COVERED: This article reviews the new emerging medications for the 
treatment of hypercholesterolemia and discusses their efficacy and safety 
profile based on literature searches that included human studies published on 
PubMed and reported clinical trials.
EXPERT OPINION: Inhibition of the PCSK9 protein by monoclonal antibodies results 
in a dramatic 40%-60% lowering of serum low-density lipoprotein cholesterol 
(LDL-C). This is in addition to LDL-C lowering achieved by statins. Multiple 
clinical studies have demonstrated the high selectivity of these antibodies for 
the PCSK9 pathway and their long-term safety and efficacy. Alirocumab and 
evolocumab have been approved by the FDA for the treatment of patients with 
heterozygous familial hypercholesterolemia and patients with clinical 
atherosclerotic cardiovascular disease) who do not achieve their LDL-C target on 
maximal tolerated statin treatment and dietary modification. In addition, 
evolocumab has been approved by the FDA for homozygous familial 
hypercholesterolemia. However, the long-term efficacy and safety of PCSK9 
inhibitors are unknown.