HDL as the next target in lipid management
Prof. John Betteridge (London) and prof. Chris Packard (Glasgow) talk about HDL as the next target in terms of a global approach to lipid and lipoprotein management.
The epidemiology is strong that low HDL is a very important risk factor. There are no outcome trials yet for a pure HDL raising agent. CETP, cholesteryl ester transfer protein, is a very attractive target in terms of increasing HDL. CETP is responsible for moving cholesterol from HDL into other particles like LDL and VLDL. If its activity is blocked, the cholesterol is retained in HDL and HDL cholesterol rises. It is a good target for raising HDL. Outcome trials have to prove that the increase in HDL with CETP inhibition is going to translate into beneficial effects on the process of atherosclerosis clinically. Dalcetrapib is currently being investigated. It raises HDL about 30-percent and it lowers CETP about 30 to 50-percent. Large outcome trials are currently ongoing; results are expected in the next couple of years.
Topics discussed in this PACE talk:
- Is HDL the next target after LDL?
- Do we already have outcome trials on raising HDL?
- What is the effect of CETP on HDL metabolism?
- Will increasing HDL by CETP inhibition have positive effects on atherosclerosis?
- How does dalcetrapib work?
- Was the failure of torcetrapib due to the molecule, not to inhibiting CETP?
- When will safety & efficacy of dalcetrapib be clear?