Background: Lomitapide (Juxtapid® in US and Lojuxta® in Europe) is the first developed
inhibitor of the Microsomal Triglyceride Transfer Protein (MTP) approved as a novel drug for the management
of Homozygous Familial Hypercholesterolemia (HoFH). It acts by binding directly and selectively
to MTP thus decreasing the assembly and secretion of the apo-B containing lipoproteins both in
the liver and in the intestine.
Aims: The present review aims at summarizing the recent knowledge on lomitapide in the management
Results: The efficacy and safety of lomitapide have been evaluated in several trials and it has been
shown a reduction of the plasma levels of Low-Density Lipoprotein Cholesterol (LDL-C) by an average
of more than 50%. Although the most common side effects are gastrointestinal and liver events, lomitapide
presents generally with a good tolerability and satisfactory patients compliance. Recently, in Europe,
to evaluate the long-term safety and efficacy of lomitapide, the LOWER registry (ClinicalTrials.gov
Identifier: NCT02135705) has been established in order to acquire informations on HoFH lomitapidetreated
patients from “real life” clinical practice.
Furthermore, the observation that lomitapide decreases triglyceride levels may be considered for patients
affected by severe forms of hypertriglyceridemia who undergo recurrent episodes of pancreatitis and are
poor responders to conventional treatment.
Conclusion: Lomitapide represents an innovative and efficacious drug for the treatment of HoFH. Longterm
safety data, treatment of pediatric and pregnant HoFH patients and management of severe hypertriglyceridemia
still require further investigations.