The Trials and Tribulations of CETP Inhibitors
The development of CETP inhibitors has had a long and difficult course with three compounds failing in phase III clinical trials. Finally, the REVEAL trial has shown that the CETP inhibitor anacetrapib decreased coronary heart disease when added to statin therapy. While the result is different to earlier studies, this is likely related to the size and duration of the trial. The benefit of anacetrapib appears to be largely explained by lowering of non-HDL cholesterol, rather than increases in HDL cholesterol. Although the magnitude of benefit for CHD appeared to be moderate, in part this may have reflected aspects of the trial design. Anacetrapib treatment was associated with a small increase in BP, but was devoid of major side effects and was also associated with a small reduction in diabetes. Treatment with CETP inhibitors, either alone or in combination with statins, could provide another option for patients with coronary disease who require further reduction in LDL and/or non-HDL cholesterol.
- Received September 21, 2017.
- Revision received October 4, 2017.
- Accepted October 6, 2017.