HDL Mimetics Infusion and Regression of Atherosclerosis: Is It Still Considered a Valid Therapeutic Option?

Curr Cardiol Rep. 2018 Jun 21;20(8):66. doi: 10.1007/s11886-018-1004-9.

Abstract

Purpose of review: This review aims to summarize and discuss the recent findings in the field of using HDL mimetics for the treatment of patients with coronary artery disease.

Recent findings: Following the largely disappointing results with the cholesteryl ester transfer protein inhibitors, focus moved to HDL functionality rather than absolute HDL cholesterol values. A number of HDL/apoA-I mimicking molecules were developed, aiming to enhance reverse cholesterol transport that has been associated with an atheroprotective effect. Three HDL mimetics have made the step from bench-testing to clinical trials in humans and are discussed here: apoA-I Milano, CSL-112, and CER-001. Unfortunately, with the exception of CSL-112 where the results of the clinical trial are not yet known, none of the agents was able to demonstrate a clinical benefit. HDL mimetics have failed to date to prove a beneficial effect in clinical practice. Reverse cholesterol transport remains a challenging therapeutic pathway to be explored.

Keywords: Atherosclerosis; CETP inhibitors; Coronary artery disease; HDL mimetics; Reverse cholesterol transport.

Publication types

  • Review

MeSH terms

  • Apolipoprotein A-I / pharmacology
  • Atherosclerosis / blood
  • Atherosclerosis / drug therapy*
  • Cholesterol, HDL / blood*
  • Cholesterol, HDL / chemistry
  • Coronary Artery Disease / complications*
  • Humans
  • Lipoproteins, HDL / pharmacology
  • Phospholipids / pharmacology
  • Randomized Controlled Trials as Topic
  • Recombinant Proteins / pharmacology

Substances

  • Apolipoprotein A-I
  • CER-001
  • CSL112
  • Cholesterol, HDL
  • Lipoproteins, HDL
  • Phospholipids
  • Recombinant Proteins
  • apolipoprotein A-I Milano