Cholesterol treatment

Cholesterol Treatment Trialists (CTT) Collaborators (2005) Efficacy and safety of cholesterol-lowering treatment prospective meta-analysis of data from 90 056 participants in 14 randomised trials of statins. Lancet 366 1267-1278... 

The isomerization reaction is also encountered in chemical manipulations of steroids. Thus, many natural steroids contain a 5-en-3-ol combination of functionalities, e.g. cholesterol. Treatment of cholesterol with an oxidizing agent (aluminium isopropoxide is particularly suitable) leads to cholest -en-3-one, the tautomerism occurring spontaneously under the reaction conditions. 

The discovery history of cholesterol treatments illustrates how the understanding of biological systems has led to drugs, and how these drugs have served as tools to further elucidate the biological systems. A critical component of the success of this noble pursuit has been the creativity of chemists in the practice of the art of drug synthesis. 

In an analysis of the landmark randomized controlled trials, the Cholesterol Treatment Triallists Collaboration has shown a linear relationship between the reduction in cardiovascular events and amount of LDL cholesterol lowering (27), This is shown in Figure 4, For example, each I.Ommol/L reduction in LDL cholesterol was associated with a 13% reduction in all-cause mortality. More recent trials have specifically tested whether or... 

Lykkesfeldt, G. and Hoyer, H., Topical cholesterol treatment of recessive x-linked ichthyosis, Lancet, 2, 1337, 1983. 

See MeReC Briefing No. 28 (National Prescribing Centre, 2005) for further details of the evidence base relating to statins and also the Cholesterol Treatment Trialists (CTT) Collaborators (2005) meta-analysis. 

Elevated serum cholesterol levels and in particular LDL-cholesterol levels are strongly associated with cardiovascular mortality across the spectrum of epidemiologic studies and pharmacologic intervention studies in primary and secondary prevention trials (Ligure 4.4). In the Cholesterol Treatment Trialists Collaborators meta-analysis of >90,000 patients studied in 14 randomized trials of statin therapy, a reduction in LDL cholesterol of 1 mmol/L (39 mg/dL) was associated with a 12% proportional reduction in all-cause mortality, predominantly driven by a 19% proportional reduction in cardiovascular mortality (45). Among patients with pre-existing heart disease there were 14 fewer deaths per 1000 participants per mmol LDL cholesterol reduction, as well as an approximately 25% reduction in major adverse cardiac events. 

Figure 8. Growth curve (liquid media 50 ml in 250 ml flasks) of Phytophthora cactorum supplemented with 0.5 ppm of cholesterol at different times following inoculation and a control experiment set-up together with the cholesterol treatment. Cultures were Incubated at 20 C in the dark and seeded with a mycelial suspension previously grown in a sterol-free liquid media. The dry weights ranged by as much as 20 mg in mid to late log phase growth and 10 mg in early log and stationary phase growth.

Doxorubicin HCl liposome injection (intravenous infusion) MPEG-DSPE, fully hydrogenated soy [ os[ atidylchohne, cholesterol Treatment of AIDS-related Kaposi s sarcoma [260,261]... 

Cholesterol Treatment Triahsts (CTT) Collaboration. Efficacy and safety of more intensive lowering of LDL cholesterol a meta-analysis of data from 170 000 participants in 26 randomised trials. Lancet 2010 376 1670-81. 

Cholesterol Treatment Trialists (CTT) Collaborators. Lack of effect of lowering LDL cholesterol on cancer meta-analysis of individual data from 175,000 people in 27 randomised trials of statin therapy. PLoS One 2012 7 e29849. 

---