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Abstract
Introduction: RVX-208 is a first-in-class, orally active, novel small molecule in development by Resverlogix Corporation (Calgary, AB, Canada). It acts through an epigenetic mechanism by inhibiting the bromodomain and extraterminal (BET) family of proteins, increasing apolipoprotein A-I (apoA-I) and targeting high-density lipoprotein (HDL) metabolism, including generating of nascent HDL and increased larger HDL particles, resulting in the stimulation of reverse cholesterol transport. RVX-208 also has a beneficial effect on inflammatory factors known to be involved in atherosclerosis and plaque stability. New therapeutic strategies are needed for patients with atherosclerosis.
Areas covered: In this review, the authors evaluate the use of RVX-208 as an agent for the treatment of atherosclerosis. The article is based on a literature search considering both animal and human studies available on PubMed as well as Media Releases from the Resverlogix Corporation.
Expert opinion: The current evidence suggests promising beneficial effects of this novel drug in the prevention and treatment of atherosclerosis and other metabolic disorders. Its unique mechanism of action is encouraging; it affects several pathways and has a modest effect on HDL levels. There is also a shift in particle size to larger HDL particles, which may have potent atheroprotective effects. Future clinical development is needed, including safety assessment.
Declaration of interest
M Banach has received lecture fees from Amgen Inc, Abbott Laboratories, Merck Sharp and Dohme and Sanofi Aventis. He is also a member of the advisory boards for Amgen Inc., Sanofi Aventis and Abbott Vascular and has worked on trials for Amgen Inc., Sanofi Aventis, Daiichi Sankyo and Resverlogix Corporation. DP Mikhailidis has held talks and been involved with conferences sponsored by Merck Sharp and Dohme, AstraZeneca and Libytec S.A. Finally, NC Wong receives both his salary from and holds stock and options in Resverlogix Corp. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.