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Initiation

Regression

Progression

Figure 16 Current treatment strategies and new approaches for atherosclerosis.

increases in HDLc observed with torcetrapib and JTT-705 are higher than those observed clinically following statin, fibrate, or niacin treatment. It will however be important to determine whether these agents perform similarly across a broader, more diverse patient population without disrupting normal lipoprotein balance and function. At the same time, there is still a clear need to demonstrate their direct benefit on reducing morbidity and mortality in phase III trials with larger CHD patient populations.

While the inflammatory aspects underlying atherosclerosis initiation and progression are now better appreciated, the first potential new therapies based upon these hypotheses are undergoing key phase III testing. Oral FLAP inhibitors and VCAM-1 expression inhibitors have the potential to alter the treatment landscape for CHD patients dramatically. Beyond these, a number of new exploratory anti-inflammatory targets are also being pursued. It remains to be seen whether any of these new approaches for treating CHD patients succeed in the clinic and come to fruition as viable treatment options for the majority of patients who are still unable to avoid major coronary events with statin monotherapy.

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