Abstract
The actions of the cholesteryl ester transfer protein (CETP) inhibitors (torcetrapib, dalcetrapib and evacetrapib) include increasing high-density lipoprotein (HDL) cholesterol, but they do not reduce cardiovascular outcomes in subjects with high cardiovascular risk. Anacetrapib also inhibits CETP, increases HDL cholesterol and lowers low-density lipoprotein (LDL) cholesterol. Areas covered: This evaluation is of the REVEAL (Randomized Evaluation of the Effects of Anacetrapib through Lipid Modification) trial, which was a cardiovascular outcomes trial with anacetrapib in subjects with high cardiovascular risk. Consideration is given as to whether increasing HDL cholesterol, lowering LDL cholesterol or other mechanisms/factors underlying the positive outcome with this CETP inhibitor. Expert opinion: After three years, the REVEAL trial with anacetrapib, demonstrated cardiovascular benefits, but not a reduction in coronary artery deaths. The reductions were not significant in years one and two. Thus, in my opinion, the benefits of anacetrapib were not major, and may not apply in 'real' world populations where adherence to medicines is lower than in REVEAL. Also, lowering LDL cholesterol and off-target mechanisms of anacetrapib may...Continue Reading
References
Jan 1, 1989·Circulation·D J GordonH A Tyroler
Nov 7, 2007·The New England Journal of Medicine·Philip J BarterUNKNOWN ILLUMINATE Investigators
Jun 5, 2008·JAMA : the Journal of the American Medical Association·Ruth Frikke-SchmidtAnne Tybjaerg-Hansen
Nov 19, 2010·The New England Journal of Medicine·Christopher P CannonUNKNOWN Determining the Efficacy and Tolerability Investigators
May 23, 2012·Lancet·Benjamin F VoightSekar Kathiresan
Nov 7, 2012·The New England Journal of Medicine·Gregory G SchwartzUNKNOWN dal-OUTCOMES Investigators
Nov 6, 2013·The American Journal of Cardiology·Antonio M GottoUNKNOWN DEFINE Investigators
Jul 20, 2014·BMJ : British Medical Journal·Daniel KeeneDarrel P Francis
Nov 5, 2014·British Journal of Clinical Pharmacology·Mary A De VeraDiane Lacaille
Mar 7, 2015·Lancet·John J P KasteleinYale Mitchel
Aug 5, 2015·Circulation·G Kees HovinghS Matthijs Boekholdt
Sep 6, 2015·Journal of Lipid Research·Sam J L van der TuinYanan Wang
Mar 5, 2016·The Journal of Pharmacology and Experimental Therapeutics·Francisco J RiosRhian M Touyz
Feb 6, 2017·Atherosclerosis·Branko SimicThomas F Lüscher
Mar 18, 2017·The New England Journal of Medicine·Marc S SabatineUNKNOWN FOURIER Steering Committee and Investigators
Apr 19, 2017·European Heart Journal·Christian M MadsenBørge G Nordestgaard
May 17, 2017·Circulation Research·Akihiro NomuraSekar Kathiresan
May 18, 2017·The New England Journal of Medicine·A Michael LincoffUNKNOWN ACCELERATE Investigators
Aug 30, 2017·The New England Journal of Medicine·UNKNOWN HPS3/TIMI55–REVEAL Collaborative GroupMartin J Landray