Lapaquistat (T-91485) is primarily investigated for its potential in managing cholesterol levels. It functions as an acetyl-CoA acetyltransferase 2 (ACAT2) inhibitor, which plays a role in cholesterol esterification. By inhibiting ACAT2, it reduces the formation of cholesterol esters, thereby lowering the amount of cholesterol that can be transported and deposited in the arteries. This mechanism makes it a candidate for treating hypercholesterolemia and potentially reducing the risk of atherosclerosis and related cardiovascular diseases. Research has focused on its efficacy and safety profile in clinical trials, aiming to provide an alternative or adjunct to existing lipid-lowering therapies like statins. Its application could be particularly beneficial for patients who are intolerant to statins or require additional cholesterol management options.