Update on patented cholesterol absorption inhibitors.
BACKGROUND
Atherosclerosis is one of the most life-threatening diseases primarily associated with hypercholesterolemia and is characterized by increased serum cholesterol level. Cholesterol originates from both its de novo synthesis within the hepatic cells and its absorption into the intestine in the form of dietary or bile cholesterol. Interventions influencing both of these processes are promising therapeutic options to lower the cholesterol level. Hydroxymethyl glutaryl-CoA reductase inhibitors, commonly known as statins, effectively block the rate determining step in the biosynthesis of cholesterol. Ezetimibe is the first new class of drugs used to treat hypercholesterolemia by inhibition of cholesterol absorption through Niemann Pick C1 Like 1 membrane of enterocytes. Therefore, combination therapy of ezetimibe and statins offers an efficacious new approach for the prevention and treatment of hypercholesterolemia.


OBJECTIVE
The present review focuses on updates on ezetimibe and patented profile of novel cholesterol absorption inhibitors followed by critical analysis of different targets such as cholesterol esterase inhibitors, bile acid transport inhibitors or phospholipase-A(2) inhibitors, etc.which play an important role in the lipid absorption.


CONCLUSIONS
The discovery of ezetimibe has opened a new door for the management of hyper-cholesterolemia in combination with statins. There are newer analogues that are under clinical trials, among which darapladib, FM-VP4 and A-002 are promising compounds.
Chhabria
M T
MT
L. M. College of Pharmacy, Department of Pharmaceutical Chemistry, Navrangpura, Ahmedabad - 380 009, Gujarat, India. mahesh.chhabria@rediffmail.com
Mahajan
B M
BM
D000042:Absorption; D000818:Animals; D000924:Anticholesteremic Agents / Q000494:pharmacology*; D001384:Azetidines / Q000494:pharmacology; D001647:Bile Acids and Salts / Q000378:metabolism; D001692:Biological Transport / Q000187:drug effects; D001798:Blood Proteins / Q000494:pharmacology; D002784:Cholesterol / Q000378:metabolism*; D000069438:Ezetimibe; D006571:Heterocyclic Compounds / Q000494:pharmacology; D006801:Humans; D006937:Hypercholesterolemia / Q000188:drug therapy*; D010330:Patents as Topic; D002787:Sterol Esterase / Q000037:antagonists & inhibitors; D002785:Sterol O-Acyltransferase / Q000037:antagonists & inhibitors
D000924:Anticholesteremic Agents; D001384:Azetidines; D001647:Bile Acids and Salts; D001798:Blood Proteins; D006571:Heterocyclic Compounds; C400481:PLIalpha; D002784:Cholesterol; D002785:Sterol O-Acyltransferase; D002787:Sterol Esterase; D000069438:Ezetimibe