Abstract: Objective To investigate the research progress in lipid-lowering drugs so as to provide new insights for developing clinical lipid management strategies and promoting rational drug use. Methods Such databases as CNKI, PubMed, and Web of Science were searched for literature published between the inception of each database and December 31, 2025. Based on their mechanisms of action, lipid-lowering drugs were categorized into classic agents (statins, cholesterol absorption inhibitors, fibrates, niacin, bile acid sequestrants, and polyunsaturated fatty acids) and novel agents (proprotein convertase subtilisin kexin type 9 (PCSK9) inhibitors, angiopoietin like protein 3 (ANGPTL3) inhibitors, apolipoprotein C3 (ApoC3) inhibitors, apolipoprotein B (ApoB) synthesis inhibitors, microsomal triglyceride transfer protein (MTP) inhibitors, and ATP citrate lyase (ACLY) inhibitors. Their mechanisms of action, indications, adverse drug reactions (ADR), and information on medication monitoring were summarized. Results Classic lipid-lowering drugs, primarily working by inhibiting cholesterol synthesis or absorption, underlay lipid management. However, their risks, such as myotoxicity and hepatotoxicity, required rigorous monitoring. Novel lipid-lowering drugs mostly targeted specific pathways and characterized by potent efficacy and easy administration. Their safety profiles were generally favorable, with such common ADR as injection site reactions. Conclusion Lipid-lowering drugs have evolved from broad-spectrum regulation to precise targeting. Drug selection in clinical practice should be individualized, with emphasis on monitoring and preventing typical ADR associated with different drug classes in order to ensure precise and safe medication.

Key words: Dyslipidemias, Classical Lipid-lowering Drugs, Novel Lipid-lowering Drugs, PCSK9 Inhibitors, ANGPTL3 Inhibitors, ApoC3 Inhibitors, ApoB Synthesis Inhibitors, MTP Inhibitors, ACLY Inhibitors, Adverse Drug Reactions