Ezetimibe - new anti-atherogenic properties?

Ezetimibe, a Niemann Pick C1-like1 inhibitor, inhibits cholesterol absorption. The drug has been shown to affect lipid raft function in monocytes and therefore may inhibit lipid accumulation in the atheromatous plaque with a mechanism that is unrelated to its effect in reducing cholesterol absorption. In this issue of the British journal of pharmacology, Gómez-Garre et al. demonstrate that ezetimibe and simvastatin both have a beneficial effect on the atheromatous plaque, which may be due to their effect on both monocyte/macrophage function and reduction in nuclear factor-kappaB activity. Whether these results in a rabbit model of atherosclerosis can be translated into human atherosclerosis awaits further studies.