New Drugs and Technologies

The field of high-density lipoprotein (HDL) therapeutics is broadly aimed at combating the significant residual cardiovascular risk remaining after effective low-density lipoprotein (LDL) cholesterol reduction.1 After the recent failure of 3 orally active HDL-raising agents in prospec-tive intervention trials, including 2 in the cholesteryl ester transfer protein (CETP) inhibitor class2,3 and niacin,4,5 the goals of HDL therapy are currently undergoing reassess-ment. Key opinion leaders are advocating a shift in the target of HDL therapy from elevation in circulating HDL cholesterol levels to enhancement of the functional proper-ties of HDL, especially HDL-mediated reverse cholesterol transport and cellular cholesterol efflux.6,7 These events have focused the spotlight on HDL infusion therapies that transiently increase HDL particle number and enhance efflux capacity for cellular cholesterol; other defective fea