The hope is that a drug that modifies LDL and HDL in favorable directions will actually reduce patient risk and improve outcomes.
However, concerns over its impact on LDL and HDL (as well as anemia, neutrophil suppression, and liver enzymes elevations) lingered and questions regarding whether these laboratory measures would translate into clinical events were raised.
But he concedes that there are good HDL particles and bad HDL particles, and the bad ones might increase artery inflammation.
High-intensity exercise and healthy diets raise HDL and lower triglycerides, large studies show.
In December 2012, the FDA approved Juxtapid (lomitapide) to reduce LDL-C, total cholesterol, apolipoprotein B, and non HDL-C in patients with HoFH.
FORBES: FDA Approves Mipomersen For Homozygous Familial Hypercholesterolemia
The large doses of fructose from both sucrose (table sugar) and high fructose corn syrup may be particularly detrimental to your health as they can cause the accumulation of metabolically toxic belly fat, cholesterol abnormalities -- including high triglycerides and reduced levels of HDL (good cholesterol) -- and nonalcoholic associated fatty liver disease.
In these people, the combination of torcetrapib and Lipitor raised HDL 57% more than Lipitor alone.
As expected, mipomersen also resulted in significant reductions in app B, total cholesterol, and non-HDL cholesterol.
But the relationship between HDL and heart disease turned out to be maddeningly complex.
Pfizer's torcetrapib drug may have produced large amounts of dysfunctional HDL and just worsened the problem.
These post-menopausal women had somewhat high LDL ("bad" cholesterol), but they were otherwise healthy, with an average age of 56 (that's young) and an average HDL ("good" cholesterol) of 67 (that's high).
This causes dramatic boosts in HDL. Torcetrapib boosts levels of HDL by 70%, and Merck's drug boosts HDL by 130%.
For niacin, used to raise HDL, and for fish oil pills its 10, 000.
The idea was that Cordaptive was basically just niacin, a B vitamin that's known to raise the good cholesterol, or HDL, and cuts the bad.
Christie Ballantyne, a cardiologist at the Baylor College of Medicine, also sees risks that torcetrapib might not prove an effective way to raise HDL. And he sees another challenge.
It represented a fast approach to entering the HDL market and an example of getting researchers in different disease disciplines to work together, a triumph for Kim as he tried to revitalize Merck's research efforts.
It also lowered the so-called good cholesterol, or high-density lipoprotein (HDL), and it did not enter the cell, a characteristic Medford wanted hisdrug to have, because some of the oxidation process takes place within cellular membranes.
After consuming the tomatoes along with a high-fat and high-calorie diet, there were a number of signs suggesting a beneficial effect, including significantly lower levels of inflammation, higher levels of the antioxidant paraoxonase, higher HDL levels, and less atherosclerotic plaque.
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And unlike LDL lowering, where there is a general consensus in the field that lower is better, and it doesn't matter how you lower it, there are different HDL particles that differ in composition and size.
Pfizer, Novartis and others are working on synthetic HDL that can be injected or even swallowed.
Low-density lipoprotein (LDL) or bad cholesterol levels should be below 100, and high-density lipoprotein (HDL) should measure 35 or above.
For Fogelman, who has been working HDL drugs for years and has several more in the Bruin pipeline, the promise is huge.
Pfizer, Novartis (nyse: NVS - news - people ) and others are working on synthetic HDL that can be injected or even swallowed.
Merck and Roche are also developing other HDL-raising drugs that work by inhibiting the cholesterol-ester transfer protein, similar to a Pfizer drug that failed several years ago.
FORBES: HDL-Raising Drug Fails To Show Benefit In Government Study
That failure means that investors and researchers will zero in on the HDL analysis published in the current issue of the Journal of the American Medical Association.
But Tall has gone back and forth over the years over whether raising HDL will work.
Existing treatments such as niacin elevate HDL only 25% or so and carry annoying side effects such as flushing.
When CETP is blocked, the HDL particles become larger--and they may actually become so big that they no longer function.
The mutation carriers had less artery calcification, indicating that they had healthier hearts as well as higher HDL (good cholesterol), and lower triglycerides and LDL (bad cholesterol).
CNN: Gene mutation protects against milk shakes and other fatty fare
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