a Key Laboratory of Structure-Based Drug Design & Discovery , Shenyang Pharmaceutical University , Shenyang , China.
Expert Opin Ther Pat. 2018 Apr;28(4):331-340. doi: 10.1080/13543776.2018.1439476. Epub 2018 Feb 15.
Epidemiological studies have identified that high levels of low-density lipoprotein-cholesterol (LDL-C) and low levels of high-density lipoprotein-cholesterol (HDL-C) are two independent causes of cardiovascular disease (CVD). Statins, niacin and fibrate are used for the treatment of CVD. However, some defects are shown in the treatment process. Thus, there is a demand for better treatment strategies that confer preferable efficacy with fewer side effects. Cholesteryl ester transfer protein (CETP) promotes the movement of CEs from HDL to LDL and VLDL in exchange for triglycerides (TGs).
In this review, we reviewed the development and therapeutic applications of CETP inhibitors. A comprehensive review of the patents and pharmaceutical applications between 2009 and 2017 has been highlighted.
Recently, CETP inhibitors have attracted considerable interest in atherosclerosis-related disease. There are four drugs (torcetrapib, anacetrapib, evacetrapib and dalcetrapib) that have been clinically evaluated in phase III clinical trials and showed promising results in raising HDL-C levels, but there were suboptimal performances in reducing the risk of cardiovascular events with all the compounds. The correlation between plasma HDL-C levels and CVD incidence needs further verification. The timeline is still long for CETP inhibitors to emerge from the treatment of CVD.
流行病学研究表明,高水平的低密度脂蛋白胆固醇(LDL-C)和低水平的高密度脂蛋白胆固醇(HDL-C)是心血管疾病(CVD)的两个独立原因。他汀类药物、烟酸和贝特类药物用于 CVD 的治疗。然而,在治疗过程中显示出一些缺陷。因此,需要更好的治疗策略,以较少的副作用获得更好的疗效。胆固醇酯转移蛋白(CETP)促进胆固醇酯(CEs)从 HDL 转移到 LDL 和 VLDL 以换取甘油三酯(TGs)。
在这篇综述中,我们回顾了 CETP 抑制剂的开发和治疗应用。重点综述了 2009 年至 2017 年期间的专利和药物应用。
最近,CETP 抑制剂在动脉粥样硬化相关疾病方面引起了相当大的兴趣。有四种药物(torcetrapib、anacetrapib、evacetrapib 和 dalcetrapib)已在 III 期临床试验中进行了临床评估,在提高 HDL-C 水平方面显示出有希望的结果,但所有化合物降低心血管事件风险的效果都不理想。血浆 HDL-C 水平与 CVD 发病率之间的相关性需要进一步验证。CETP 抑制剂从 CVD 治疗中出现的时间还很长。