The promise of cholesteryl ester transfer protein (CETP) inhibition in the treatment of cardiovascular disease

Curr Pharm Des. 2013;19(17):3143-9. doi: 10.2174/1381612811319170022.

Abstract

There is a strong need to reduce the risk of cardiovascular disease (CVD) beyond the use of statins that lower low-density lipoprotein cholesterol (LDL-C). The inverse relationship of high-density lipoprotein cholesterol (HDL-C) with cardiovascular disease suggests HDL-C raising therapy as a novel target. This review discusses the role of HDL-C in atherogenesis as well as the promise of cholesteryl ester transfer protein (CETP) inhibition in CVD prevention. While genetic studies show conflicting results on correlations between HDL-C and CVD, experimental studies have yielded sufficient encouraging data to proceed with the development of HDL-C raising strategies. CETP inhibition has been shown to successfully increase HDL-C levels in man. However, the first CETP inhibitor tested in phase III trials increased mortality possibly due to torcetrapib-specific vasopressor effects. More recently, dalcetrapib did not show an effect on CVD outcome while raising HDL-C by 30%, thereby refuting the HDL-C hypothesis. Anacetrapib and evacetrapib are currently tested in phase III clinical trials and have not shown adverse effects thus far. Both compounds not only increase HDL-C by 129-151%, they also decrease LDL-C (36-41%) and anacetrapib lowers Lp(a) (17%). Combined, these effects are anticipated to decrease CVD risk and the results will be revealed in 2017.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Benzodiazepines / pharmacology
  • Benzodiazepines / therapeutic use
  • Cardiovascular Diseases / drug therapy*
  • Cholesterol Ester Transfer Proteins / antagonists & inhibitors*
  • Cholesterol Ester Transfer Proteins / genetics
  • Cholesterol, HDL / blood
  • Humans
  • Oxazolidinones / pharmacology
  • Oxazolidinones / therapeutic use

Substances

  • Cholesterol Ester Transfer Proteins
  • Cholesterol, HDL
  • Oxazolidinones
  • Benzodiazepines
  • evacetrapib
  • anacetrapib