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Anacetrapib REVEALs "Modest" Effect on Cardiovascular Outcomes

The first major trial to show a significant reduction in outcomes with a cholesteryl ester transfer protein (CETP) inhibitor has shown a 9% relative risk reduction in major coronary events with anacetrapib when added to intensive statin therapy.

The REVEAL trial was presentedat at the European Society of Cardiology (ESC) 2017 Congress  and simultaneously published in the New England Journal of Medicine.

The REVEAL trial has shown for the first time that adding a CETP inhibitor to intensive statin therapy reduces the incidence of cardiovascular events in high-risk patients. Investigators suggested that the benefit appeared to be mediated by LDL reduction rather than an increase in HDL, the mechanism behind the development of this class of drugs.

Investigators thought that the reductions in LDL, [apolipoprotein B] apo B, and non-HDL cholesterol all line up with what you would expect in terms of the event-rate reductions seen, and they don"t seem to be seeing anything over and above this, even though there was a doubling of HDL cholesterol. But how exactly the drug is bringing about the event reduction is impossible to say.

The HPS3-TIMI55-REVEAL Collaborative Group. Effects of anacetrapib in patients with atherosclerotic vascular disease (REVEAL). N Engl J Med 2017; DOI:10.1056/NEJMoa1706444. Article