Obicetrapib: Reversing the Tide of CETP Inhibitor Disappointments

Curr Atheroscler Rep. 2024 Feb;26(2):35-44. doi: 10.1007/s11883-023-01184-1. Epub 2023 Dec 22.

Abstract

Purpose of review: To discuss the history of cardiovascular outcomes trials of cholesteryl ester transfer protein (CETP) inhibitors and to describe obicetrapib, a next-generation, oral, once-daily, low-dose CETP inhibitor in late-stage development for dyslipidemia and atherosclerotic cardiovascular disease (ASCVD).

Recent findings: Phase 1 and 2 trials have evaluated the safety and lipid/lipoprotein effects of obicetrapib as monotherapy, in conjunction with statins, on top of high-intensity statins (HIS), and with ezetimibe on top of HIS. In ROSE2, 10 mg obicetrapib monotherapy and combined with 10 mg ezetimibe, each on top of HIS, significantly reduced low-density lipoprotein cholesterol (LDL-C), non-high-density lipoprotein cholesterol (non-HDL-C), apolipoprotein B, total LDL particles, small LDL particles, small, dense LDL-C, and lipoprotein (a), and increased HDL-C. Phase 3 pivotal registration trials including a cardiovascular outcomes trial are underway. Obicetrapib has an excellent safety and tolerability profile and robustly lowers atherogenic lipoproteins and raises HDL-C. As such, obicetrapib may be a promising agent for the treatment of ASCVD.

Keywords: Atherosclerotic cardiovascular disease (ASCVD); Cardiovascular outcomes trial; Cholesteryl ester transfer protein (CETP) inhibitor; High-density lipoprotein cholesterol (HDL-C); Low-density lipoprotein cholesterol (LDL-C); Obicetrapib.

Publication types

  • Review

MeSH terms

  • Atherosclerosis* / drug therapy
  • Cholesterol Ester Transfer Proteins
  • Cholesterol, HDL
  • Cholesterol, LDL
  • Ezetimibe
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors* / therapeutic use
  • Lipoproteins

Substances

  • Cholesterol Ester Transfer Proteins
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Cholesterol, LDL
  • Cholesterol, HDL
  • Lipoproteins
  • Ezetimibe
  • CETP protein, human