Torcetrapib
A diabetes-dyslipidemia review predicts the disappointing torcetrapib results will renew interest in niacin therapy (Curr Opin Endocrinol Diabetes Obes 2008)
Original title: Targeting cardiovascular risk in patients with diabetes: management of dyslipidemia
This review examines the management of dyslipidemia in patients with diabetes, a key component of cardiovascular risk reduction, noting that atherogenic diabetic dyslipidemia often requires combination therapy targeting aspects of the lipid profile beyond LDL cholesterol. While clinical outcomes trials support statins for reducing cardiovascular events in type 2 diabetes, the review notes that the disappointing results of clinical trials with the HDL-raising CETP inhibitor torcetrapib may renew interest in niacin for managing atherogenic dyslipidemia, alongside emerging evidence that long-term fibrate therapy reduces all-cause, cancer, and cardiovascular mortality in this population. The review anticipates that full normalization of the lipid profile, beyond aggressive LDL control alone, may eventually become the standard of care for diabetic dyslipidemia.
Original abstract
Purpose Of Review: The management of dyslipidemia in patients with diabetes is a key component of cardiovascular risk reduction. In particular, the atherogenic dyslipidemia of diabetes often requires combination therapy to target aspects of the lipid profile beyond low-density lipoprotein cholesterol. This article will review the characteristics of dyslipidemia in diabetes, and discuss guidelines and strategies for treatment to reduce cardiovascular disease risk.
Recent Findings: A number of clinical outcomes trials supports the use of statins to reduce cardiovascular events in patients with type 2 diabetes mellitus. The disappointing results of clinical trials involving torcetrapib to increase high-density lipoprotein levels may lead to renewed interest and utilization of niacin for the management of atherogenic dyslipidemia. Long-term use of fibrate therapy in patients with atherogenic dyslipidemia has recently been associated with reduction in all-cause, cancer, and cardiovascular mortality rates. Ongoing trials are investigating whether addition of niacin or fibrate to statin therapy is superior to statin therapy alone in preventing cardiovascular events.
Summary: Aggressive low-density lipoprotein control continues to be the primary goal of therapy in dyslipidemia management. Given the growing body of evidence showing the cardiovascular benefits of treating other lipid components, however, it is easy to anticipate that full normalization of the lipid profile may become the standard of care for diabetic dyslipidemia.
Summary written by cetpinhibition.org from the published abstract; figures as published. Page updated 18 August 2026. Methods.