Torcetrapib: una perspectiva histórica

Aguiar-Souto, P.; González-Juanatey, J.R.

doi:10.1016/S0214-9168(10)70021-8

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Resumen

Diversos estudios experimentales han demostrado que las lipoproteínas de alta densidad (HD L) representan un grupo funcionalmente muy heterogéneo de partículas con diversos efectos antioxidantes, antiinflamatorios, que les confiere propiedades antiaterogénicas y antitrombóticas. En la actualidad, se dispone de potentes alternativas terapéuticas que permiten alcanzar cifras muy bajas de colesterol unido a lipoproteínas de baja densidad, y desde hace varios años están en continuo desarrollo y evaluación fármacos que permiten incrementos significativos de los valores de colesterol unido a HDL, con la intención de mejorar el perfil cardiovascular de los pacientes. Los inhibidores de la enzima colesteroléster transferasa constituyen una opción terapéutica válida para este fin. A continuación se revisan los resultados de los primeros y principales ensayos clínicos que evalúan la eficacia de uno de estos fármacos (torcetrapib) así como los análisis pormenorizados realizados posteriormente por sus principales autores de las posibles explicaciones de los resultados clínicos desfavorables de éstos.

Palabras clave:

Torcetrapib

HDL

Inhibidores de la enzima colesterol-éster transferasa

Abstract

Several experimental studies have shown that high-density lipoproteins are functionally a highly heterogeneous group of particles with varied antioxidant and antiinflammatory effects, conferring them with antiatherogenic and antithrombotic properties. Potent therapeutic alternatives are currently available that allow very low values of low-density lipoprotein to be achieved. For several years, drugs that allow significant increases in high-density lipoprotein cholesterol levels have been under continuous development and evaluation, with the aim of improving patients’ cardiovascular profiles. Cholesteryl ester transfer protein inhibitors are a suitable therapeutic option for this aim. We review the results of the first and main clinical trials evaluating the efficacy of one of these drugs (torcetrapib) as well as the detailed analyses subsequently performed by their main authors of the possible explanations for the unfavorable clinical results of these trials.

Keywords:

Torcetrapib

HDL

Cholesteryl ester transfer protein inhibitors

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