What kind of drug decreases the delivery of intestinal cholesterol to the liver?

Cholesterol absorption inhibitors are designed to reduce the amount of cholesterol absorbed from the diet in the intestines. By inhibiting the absorption of cholesterol at the intestinal brush border, these agents consequently decrease the delivery of intestinal cholesterol to the liver. This mechanism results in a reduction of cholesterol levels in the bloodstream, as less dietary cholesterol is available for incorporation into lipoproteins and for hepatic uptake.

This class of medications works primarily by targeting a specific protein responsible for transporting cholesterol across the intestinal wall, leading to decreased levels of circulating low-density lipoprotein (LDL) cholesterol. As a result, the liver perceives a decrease in available cholesterol, which can lead to upregulation of its own cholesterol production and improved clearance of LDL from the bloodstream.

Other classes of lipid-lowering agents operate via different mechanisms. For example, fibrates primarily focus on lowering triglyceride levels and increasing high-density lipoprotein (HDL) cholesterol, while bile acid sequestrants work by binding bile acids in the intestine, which can indirectly promote cholesterol conversion into bile acids. Statins are known for their ability to inhibit cholesterol synthesis in the liver, effectively reducing overall cholesterol production rather than preventing its absorption. Each drug class has unique actions, but in the context of