RVX-208, a stimulator of apolipoprotein AI gene expression for the treatment of cardiovascular diseases.

RVX-208 (RVX-000222) is a first-in-class, orally active, small-molecule stimulator of apolipoprotein (APO)AI gene expression, which is being developed by Resverlogix Corp for the potential treatment of cardiovascular diseases, in particular atherosclerosis and coronary artery disease. In vitro, RVX-208 stimulated APOAI transcription and was associated with dose-dependent increases in apoAI mRNA and protein. Toxicity studies in animals and phase I/II clinical trials have indicated that RVX-208 is safe and well tolerated in multiple dosing regimens. Plasma exposure to RVX-208 was dose-dependent following single or multiple oral doses and the drug was readily absorbed. In healthy volunteers and patients with low HDL-cholesterol levels, RVX-208 increased total HDL as well as the alpha- and pre-beta HDL fractions that are important substrates in the reverse cholesterol transport pathway. The results of further phase II trials are eagerly awaited to determine whether RVX-208 can deliver plaque regression via improvements in the plasma HDL profile of patients. In addition, a phase I trial indicated that RVX-208 may have potential for the removal of beta-amyloid plaques in Alzheimer's disease and this will be further assessed in an ongoing phase I/II clinical trial.