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Succinobucol is a small molecule drug developed as a derivative of probucol with antioxidant, anti-inflammatory, antihyperglycemic, and antiplatelet properties. It was designed to act as a vascular protectant and has been investigated primarily for the treatment of atherosclerosis and coronary artery disease. Succinobucol inhibits TNF-α-induced expression of VCAM-1 and MCP-1 in vitro, reduces tissue factor expression in human monocytic cells and endothelial cells (independently from the nuclear factor κB pathway), lowers total cholesterol and LDL cholesterol while increasing HDL cholesterol in animal models, decreases inflammatory mediators, and reduces atheroma area. Despite promising preclinical results, clinical trials did not demonstrate significant cardioprotective effects or reduction in cardiovascular endpoints. The drug also showed some undesired metabolic effects such as lowering HDL cholesterol; diarrhea is an expected adverse effect[1][4][7].
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