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Peer-reviewedCC BYFrontiers in pharmacology

Hybutimibe, an innovative cholesterol absorption inhibitor for lipid-lowering therapy: current evidence and future perspectives.

  1. 1Cardiometabolic Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China.

Abstract

Achievement of low-density lipoprotein cholesterol (LDL-C) targets is crucial for the prevention of atherosclerotic cardiovascular disease (ASCVD). As first-line lipid-lowering drugs, statins often fail to achieve adequate LDL-C control rates in clinical practice due to individual variations in efficacy, safety concerns, and poor long-term adherence. Cholesterol absorption inhibition mediated by the Niemann-Pick C1-like 1 (NPC1L1) pathway provides a complementary approach to statin-based lipid lowering regimens. Hybutimibe is an oral NPC1L1 inhibitor approved in China and has reported pharmacokinetic characteristics that differ from those of ezetimibe; however, the clinical relevance of these differences has not been established in direct comparative studies. Evidence from Phase I-III clinical trials and post-marketing real-world studies indicates that hybutimibe monotherapy or combination therapy with statins can achieve significant and sustained LDL-C reduction; in patients with inadequate response to statin monotherapy, combination with hybutimibe exhibits superior lipid-lowering efficacy compared to statin dose escalation, with favorable overall safety. However, available studies have primarily evaluated LDL-C and other lipid parameters as surrogate endpoints. No dedicated cardiovascular outcome trial has established whether hybutimibe reduces major adverse cardiovascular events, cardiovascular mortality, or all-cause mortality. This article systematically reviews the research and development background, pharmacological properties, mechanism of action, clinical efficacy, safety, and post-marketing real-world evidence of hybutimibe, exploring its application value as an adjuvant therapy in optimizing clinical LDL-C management.

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BibTeX
@article{li2026hybutimibe,
  title = {{Hybutimibe, an innovative cholesterol absorption inhibitor for lipid-lowering therapy: current evidence and future perspectives.}},
  author = {Sha Li and Hui-Hui Liu and Jian-Jun Li},
  journal = {Frontiers in pharmacology},
  year = {2026},
  month = oct,
  doi = {10.3389/fphar.2026.1936459},
  url = {https://europepmc.org/article/MED/42898767},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Hybutimibe, an innovative cholesterol absorption inhibitor for lipid-lowering therapy: current evidence and future perspectives.
AU  - Sha Li
AU  - Hui-Hui Liu
AU  - Jian-Jun Li
PY  - 2026
DA  - 2026/10/05
JO  - Frontiers in pharmacology
DO  - 10.3389/fphar.2026.1936459
UR  - https://europepmc.org/article/MED/42898767
AB  - Achievement of low-density lipoprotein cholesterol (LDL-C) targets is crucial for the prevention of atherosclerotic cardiovascular disease (ASCVD). As first-line lipid-lowering drugs, statins often fail to achieve adequate LDL-C control rates in clinical practice due to individual variations in efficacy, safety concerns, and poor long-term adherence. Cholesterol absorption inhibition mediated by the Niemann-Pick C1-like 1 (NPC1L1) pathway provides a complementary approach to statin-based lipid lowering regimens. Hybutimibe is an oral NPC1L1 inhibitor approved in China and has reported pharmacokinetic characteristics that differ from those of ezetimibe; however, the clinical relevance of these differences has not been established in direct comparative studies. Evidence from Phase I-III clinical trials and post-marketing real-world studies indicates that hybutimibe monotherapy or combination therapy with statins can achieve significant and sustained LDL-C reduction; in patients with inadequate response to statin monotherapy, combination with hybutimibe exhibits superior lipid-lowering efficacy compared to statin dose escalation, with favorable overall safety. However, available studies have primarily evaluated LDL-C and other lipid parameters as surrogate endpoints. No dedicated cardiovascular outcome trial has established whether hybutimibe reduces major adverse cardiovascular events, cardiovascular mortality, or all-cause mortality. This article systematically reviews the research and development background, pharmacological properties, mechanism of action, clinical efficacy, safety, and post-marketing real-world evidence of hybutimibe, exploring its application value as an adjuvant therapy in optimizing clinical LDL-C management.
SN  - 1663-9812
ER  -