Two randomized, controlled trials evaluated the efficacy and safety of obicetrapib, an oral cholesteryl ester transfer protein (CETP) inhibitor, in lowering low-density lipoprotein (LDL) cholesterol in patients at high risk for atherosclerotic cardiovascular disease (ASCVD).
- The first multinational trial investigated obicetrapib monotherapy (10 mg daily) in 2530 high-risk patients already on maximum tolerated lipid-lowering therapy. Over 84 days, obicetrapib reduced LDL-C by 29.9% compared to placebo, with a between-group difference of −32.6%. Additional improvements included an 18.9% reduction in apolipoprotein B, a 29.4% reduction in non-HDL cholesterol, and a 33.5% reduction in lipoprotein(a), as well as a 136.3% increase of HDL cholesterol. Adverse event rates were similar between the treatment and placebo groups.
- The second US trial evaluated a fixed-dose combination (FDC) of obicetrapib (10 mg) and ezetimibe (10 mg) in 407 patients with pre-existing or high risk for ASCVD. Over the same 84-day period, the FDC led to a 48.6% reduction in LDL-C versus placebo, outperforming both obicetrapib (31.9%) and ezetimibe (separately) in monotherapy arms. Safety outcomes, including adverse and serious adverse event rates, were comparable across treatment groups and consistent with prior data.
Both trials show that obicetrapib is effective in reducing LDL cholesterol, with enhanced efficacy when combined with ezetimibe. The FDC offers a potent oral treatment option for high-risk patients who need additional LDL-C lowering beyond standard therapy. These findings suggest that obicetrapib may be a useful adjunct to lipid lowering in high risk patients, and a cardiovascular outcomes trial is underway. Source: https://www.nejm.org/; https://www.thelancet.com/