Evecetrapib as monotherapy or combined with statins for dyslipidemia

January 01, 0001

Evecetrapib as monotherapy or combined with statins for dyslipidemia

This group of US and Dutch researchers looked at the effect of evacetrapib, a cholesteryl ester transfer protein (CETP) inhibitor on the lipid profile when used in conjunction with statins. They performed a randomized controlled trial enrolling patients with elevated low-density lipoprotein cholesterol (LDL-C) or low high-density lipoprotein cholesterol (HDL-C) from several centers in the US and Europe (n=398). Enrollees were randomly assigned to evacetrapib monotherapy using 30mg, 50mg, or 100mg doses, statin therapy with simvastatin, atorvastatin, or rosuvastatin with or without evacetrapib 100mg, or placebo (n = 38), for 12 weeks.

The researchers found: "The mean baseline HDL-C level was 55.1 mg/dL and the mean baseline LDL-C level was 144.3 mg/dL. As monotherapy, evacetrapib produced dose-dependent increases in HDL-C of 30.0 to 66.0 mg/dL compared with a decrease with placebo of -0.7 mg/dL and decreases in LDL-C of -20.5 to -51.4 mg/dL compared with an increase with placebo of 7.2 mg/dL. In combination with statin therapy, evacetrapib, 100 mg/d, produced increases in HDL-C of 42.1 to 50.5 mg/dL and decreases in LDL-C of -67.1 to -75.8 mg/dL. Compared with evacetrapib monotherapy, the combination of statins and evacetrapib resulted in greater reductions in LDL-C but no greater increase in HDL-C. Although the study was underpowered, no adverse effects were observed."

The researchers concluded: "Compared with placebo or statin monotherapy, evacetrapib as monotherapy or in combination with statins increased HDL-C levels and decreased LDL-C levels. The effects on cardiovascular outcomes require further investigation."

Evecetrapib shows some promising effects on lipid profiles, but clinical outcomes and safety need to be examined further.

For the full abstract, click here.

JAMA 306(19):2099-2109, 16 November 2011 © 2011 American Medical Association
Effects of the CETP Inhibitor Evacetrapib Administered as Monotherapy or in Combination With Statins on HDL and LDL Cholesterol. Stephen J. Nicholls, H. Bryan Brewer, John J. P. Kastelein, et al.

Category: T. Endocrine/Metabolic/Nutritional. Keywords: evacetrapib, CETP, cholesteryl ester transfer protein, statin, HDL- C, randomized controlled trial, journal watch.
Synopsis edited by Dr Paul Schaefer, Toledo, Ohio. Posted on Global Family Doctor 29 November 2011

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.