Novel approaches to lipid lowering: What is on the horizon?

New approaches to lipid lowering include new uses of proven treatments and development of novel agents. Several large-scale clinical trials are assess ing whether additional reduction of low-density lipoprotein cholesterol (LD L-C) levels with statin therapy results in additional benefit in coronary a rtery disease prevention. Statins with increased LDL-C-lowering potency, su ch as the new statin rosuvastatin (formerly known as ZD4522), have been dev eloped and are in advanced-phase clinical trials, New cholesterol transport inhibitors, such as ezetimibe, have been found to produce significant redu ctions in intestinal cholesterol absorption, and new bile acid transport in hibitors are in development. Inhibitors of acyl coenzyme A:cholesterol acyl transferase, which con reduce cholesterol storage in macrophages and thereb y in arterial lesions, have also been developed, with the agent avasimibe c urrently being evaluated in phase 2/3 trials, Combination approaches hold c onsiderable promise, including combined use of statins with fibrates, niaci n, and the new sterol absorption inhibitors. (C) 2001 by Excerpta Medico, I nc.