Patient considerations and clinical impact of cholesteryl ester transfer protein inhibitors in the management of dyslipidemia: focus on anacetrapib
| Autor: | Marta A. Miyares, Kyle A. Davis |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2012 |
| Předmět: |
Endocrinology
Diabetes and Metabolism Atorvastatin cholesteryl ester transfer protein Review Pharmacology Risk Assessment chemistry.chemical_compound cholesteryl ester transfer protein inhibitor Anacetrapib cardiovascular disease Risk Factors Cholesterylester transfer protein medicine Humans Pharmacology (medical) CETP inhibitor Oxazolidinones Dyslipidemias Hypolipidemic Agents biology business.industry Patient Selection dyslipidemia Public Health Environmental and Occupational Health Torcetrapib Hematology General Medicine medicine.disease Lipids Cholesterol Ester Transfer Proteins Treatment Outcome chemistry Cardiovascular Diseases biology.protein lipids (amino acids peptides and proteins) anacetrapib Drug Therapy Combination Metabolic syndrome Hydroxymethylglutaryl-CoA Reductase Inhibitors Cardiology and Cardiovascular Medicine business Niacin Dyslipidemia Biomarkers medicine.drug |
| Zdroj: | Vascular Health and Risk Management |
| ISSN: | 1178-2048 1176-6344 |
| Popis: | Cardiovascular disease (CVD) is responsible for significant morbidity and mortality within the United States and worldwide. Although targeting low-density lipoprotein cholesterol (LDL-C) in the prevention of CVD has been shown to be effective, evidence exists to indicate that significant cardiovascular (CV) risk remains in patients receiving 3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitors (statins) – a risk that may be correlated with low levels of high-density lipoprotein cholesterol (HDL-C). Among the various tactics under investigation to increase HDL-C, inhibition of cholesteryl ester transfer protein (CETP) appears the most adept to raise these levels. Although torcetrapib, a CETP inhibitor, demonstrated significant beneficial changes in HDL-C and LDL-C after 12 months of therapy when coadministered with atorvastatin, patients in the torcetrapib arm experienced a rise in mortality, including increased risk of death from CV and non-CV causes as well as a significant rise in major CV events. Later studies established that the adverse effects of torcetrapib were produced from molecule-specific off-target effects and not to the mechanism of CETP inhibition. These untoward outcomes have not been detected with anacetrapib, the third of the CETP inhibitors to enter Phase III trials. Furthermore, treatment with anacetrapib revealed both a statistically significant decrease in LDL-C and increase in HDL-C over placebo. While the place in therapy of niacin and fibrates to reduce CV events is currently in question secondary to the Atherothrombosis Intervention in Metabolic Syndrome with Low HDL Cholesterol/High Triglyceride and Impact on Global Health Outcomes and the Action to Control CV Risk in Diabetes trials, the ongoing large-scale, randomized–placebo, controlled-outcomes study with anacetrapib coadministered with statin treatment will not only test the hypothesis if CETP inhibition lowers residual CV risk but will also provide insight as to which patient subgroups might benefit the most from anacetrapib despite aggressive therapy with statins. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|