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首页> 外文OA文献 >Cholesteryl Ester Transfer Protein Inhibition as a Safe and Effective Means for Treating Dyslipidemia and Potentially Reducing Cardiovascular Risk in Patients with CHD or Risk Equivalents
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Cholesteryl Ester Transfer Protein Inhibition as a Safe and Effective Means for Treating Dyslipidemia and Potentially Reducing Cardiovascular Risk in Patients with CHD or Risk Equivalents

机译：胆固醇酯转移蛋白抑制作为治疗血脂异常和潜在降低冠心病或风险等效者心血管风险的安全有效手段

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Background: Secondary prevention of coronary events in patients with known CHD and dyslipidemia has traditionally been focused on decreasing LDL-C through the use of statins. However, significant risk remains in individuals whose LDL-C has been optimized but HDL-C remains low. A new class of medications, cholesteryl ester transfer protein inhibitors, is effective at significantly increasing HDL-C and potentially reducing cardiovascular risk in such patients. There are currently three CETP inhibitors being developed, two of which have been studied for safety and efficacy in patients with CHD or risk equivalents: anacetrapib and dalcetrapib. Following the safety concerns of torcetrapib, both study medications have demonstrated that they do not have the same off-target effects as those seen in the ILLUMINATE trial.Methods: A systematic search of the literature was performed utilizing three databases: MEDLINE, CINAHL, and Evidence-Based Medicine Reviews Multifile. Four double-blind, placebo-controlled clinical trials met the inclusion and exclusion criteria for review.Results: Anacetrapib demonstrated an impressive 138.1% greater increase in HDL-C, and 39.8% greater reduction in LDL-C as compared to placebo without any differences in tolerability or AEs. Although not a pre-determined end-point, there was a significant reduction in revascularization rates with anacetrapib as compared to placebo as well (8 vs 21). Dalcetrapib was also shown to be safe and effective, although its lipid-modifying effects were significantly less than those seen with anacetrapib. The dal-PLAQUE trial also suggested a potential benefit in reducing atherosclerotic lesions in the carotid arteries. Neither medication was shown to increase blood pressure or cardiovascular morbidity or mortality.Conclusion: Both anacetrapib and dalcetrapib have established themselves as safe and effective agents for increasing HDL-C, and to a lesser extent decreasing LDL-C. Although short-term data suggests a potential cardioprotective benefit with CETP inhibition, definitive conclusions
机译：背景：在已知冠心病和血脂异常患者中，冠心病的二级预防传统上一直集中在通过使用他汀类药物降低LDL-C上。但是，对于LDL-C已优化但HDL-C仍然较低的个体，仍然存在重大风险。一类新的药物，胆固醇酯转移蛋白抑制剂，可有效地显着增加HDL-C并可能降低此类患者的心血管风险。目前，正在开发三种CETP抑制剂，其中两种已被研究用于CHD或危险等效物的安全性和有效性：anacetrapib和dalcetrapib。遵循torcetrapib的安全性考虑，这两种研究药物均已证明它们具有与ILLUMINATE试验中所观察到的脱靶作用不同的方法。方法：利用MEDLINE，CINAHL和循证医学评论多文件。四个双盲，安慰剂对照的临床试验均符合纳入和排除标准进行审查。结果：与安慰剂相比，安赛帕比证明HDL-C升高了138.1％，LDL-C降低了39.8％，没有任何差异耐受性或不良事件。尽管不是预定的终点，但与安慰剂相比，anacetrapib的血运重建率也显着降低（8 vs 21）。 Dalcetrapib也被证明是安全有效的，尽管其脂质修饰作用明显小于anacetrapib。 dal-PLAQUE试验还显示出减少颈动脉粥样硬化病变的潜在益处。结论：anacetrapib和dalcetrapib都已确定自己是增加HDL-C并降低LDL-C的安全有效的药物。尽管短期数据显示CETP抑制具有潜在的心脏保护作用，但结论尚可

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    Montes Anthony;

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