Hot off the Press:Regression of Atherosclerotic Plaque Via High-Viscosity 2-Hydroxypropyl-Β-Cyclodextrin (Cavadex): A Multi-Center Retrospective Case Series

Just came across this multi-center retrospective case series (Jan 2026) on high-viscosity 2-hydroxypropyl-β-cyclodextrin (Cavadex) for regression of atherosclerotic plaque.**

Key points from the study:

  • Documented CAC reductions up to 320 points over ~12 months
  • One patient reversed from +27–28% annual progression to –10.5% regression
  • Includes cases of stenosis dropping from 70% to 27%
  • Rectal formulation—reports no hearing loss (unlike IV/IT routes)
  • Published in Cardiology Research and Cardiovascular Medicine (Gavin Publishers), not yet PubMed-indexed

I’m considering adding this to my own N-of-1 protocol (LAD calcification, ApoB 152, Lp(a) 176 9 (down 41%).

Curious if anyone here has

  • Read the full paper?
  • Tried Cavadex themselves?
  • Thoughts on the mechanistic plausibility or real-world traction?

Happy to share my full protocol and data if helpful. Just trying to get smarter before committing.

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I will look at the case studies. Generally people here have tried it without any luck. You can see the thread on it here: Cyclodextrins, Cavadex and Cyclarity for Reversing Atherosclerosis . I personally wouldn’t waste my time and money.

While the research around cyclodextrin is interesting as a starting point, from talking with researchers here in the SF Bay Area focused on this area, the current strategy by this company/researcher (Cavadex) is not believed to be effective.

I spoke to the founder/scientist of a company here called Cyclarity, focused on developing a custom molecule that overcomes the problems of the native cyclodextrin molecule. His thoughts on the Cavadex product:

See more on Cyclarity here - they look like our best bet for reversing plaque. They’ve finished phase 2 clinical trials in Australia recently and are moving on to phase 3 clinical trials:

I ran the case study paper you identified, through my Google Gemini research paper analysis prompt and here is what it says about the case studies:

Critical Limitations [Confidence: High]

  • Conflict of Interest: The lead author, Kyle Hodgetts, is the founder of the company (Cholrem) selling the intervention. The study is essentially a self-published white paper disguised as a clinical study.
  • Regulatory Red Flags: Cholrem and its products are currently the subject of warning letters from the TGA (Australia) and FDA regarding unapproved therapeutic claims. The paper mentions “customs seizures” as a “confounding variable,” which confirms the product is being imported via grey-market channels.
  • Methodological Weakness:
    • No Control Group: Without a placebo arm, the “symptomatic relief” is highly susceptible to the placebo effect, especially in a self-selected group of biohackers/early adopters.
    • Selection Bias: The cohort consists of patients who actively sought out an experimental therapy (n=50). Non-responders or those who dropped out early (excluded if <30 days) are not fully accounted for.
    • Data Standardization: Imaging data came from various independent clinics using different scanners/protocols, making quantitative comparison (e.g., “51 to 29.4” plaque volume) unreliable.
  • Safety Signals: While the paper claims no ototoxicity (a known risk of HPβCD in Niemann-Pick disease treatment), the monitoring for this specific side effect appears anecdotal rather than audiometrically rigorous.

Verdict: This paper presents a compelling hypothesis backed by legitimate mechanistic plausibility (Zimmer et al.), but the clinical data is anecdotal and commercially compromised. It serves as a signal for “N-of-1” experimentation rather than proof of efficacy.

Part 3: Claims & Verification

Claim 1: HPβCD induces rapid regression of established atherosclerotic plaque.

  • Evidence Level: Level D (Valid Preclinical)Level E (Human Anecdote)
  • Verification: The foundational mechanism is supported by high-quality mouse data in Science Translational Medicine Zimmer et al. (2016). However, the human efficacy data relies entirely on the self-published observational series by Hodgetts et al. in a predatory journal (Gavin Publishers appears on multiple watchlists). There are no independent Level A or B human trials confirming plaque regression.
  • Status: Translational Gap. Valid in mice; unproven in humans.

Claim 2: Rectal administration (Cavadex/RemChol) achieves systemic bioavailability sufficient for plaque regression.

  • Evidence Level: Level E (Manufacturer Claim)
  • Verification: Source unverified in live search. No independent pharmacokinetic (PK) studies exist for “RemChol” or “Quad Strength” formulations in PubMed or reputable databases. Standard rectal bioavailability of cyclodextrins is historically low (<5%) and variable. The claim of superior bioavailability due to “viscosity” is theoretically plausible but empirically unsupported outside the author’s own non-peer-reviewed assertions.

Claim 3: The therapy has a clean safety profile with “no ototoxicity” (hearing loss).

  • Evidence Level: Level E (Anecdotal) vs. External Refutation (Level B/C)
  • Verification: FALSE / DANGEROUS. External high-quality data explicitly identifies permanent sensorineural hearing loss as a primary risk of systemic HPβCD. In Niemann-Pick Type C trials, high-dose HPβCD caused permanent high-frequency hearing loss in humans and animals by destroying outer hair cells. The Hodgetts study likely failed to detect this because they did not perform high-frequency audiometry.

Claim 4: HPβCD acts via “bimodal” mechanisms: rapid anti-inflammatory (NLRP3) and delayed structural regression.

  • Evidence Level: Level D (Mechanistic Plausibility)
  • Verification: Supported by Zimmer et al. (2016). HPβCD was shown to solubilize cholesterol crystals, downregulating the NLRP3 inflammasome and IL-1β production in macrophages. This mechanism is scientifically sound in vitro and in vivo (mice), but the clinical timeline (“days” for symptom relief) is speculative extrapolation.

Claim 5: The “Quad Strength” formulation is superior due to enhanced mucosal retention.

  • Evidence Level: Level E (Marketing/Proprietary)
  • Verification: Source unverified in live search. No external comparative studies exist. This is a proprietary claim by the manufacturer (Cholrem).
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