Therapeutic use of HMG-CoA reductase inhibitors: current practice and future perspectives

Results from large-scale clinical trials of lipid lowering with 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase inhibitors (statins) have led to a revolution in the management of hypercholesterolaemia and cardiovascular disease. In addition to their potent effect on serum lipid levels, statins influence several other cellular pathways, including the activation of prenylated proteins involved in several biological processes. This review analyses the patents published during the period 2000 – 2003 concerning statins, with particular emphasis on the new molecules of this class and their applications, not only directly related to their effect on lipid biology, but also on potential pleiotropic actions on endothelial function, smooth muscle cell proliferation, hypertension, bone metabolism, neurodegenerative disease and prevention of tumour growth.