Anacetrapib
The LDL-C and HDL-C effects of anacetrapib were smaller in Black than White DEFINE trial patients (J Clin Lipidol 2015)
Original title: Effects of anacetrapib on plasma lipids in specific patient subgroups in the DEFINE (Determining the Efficacy and Tolerability of CETP INhibition with AnacEtrapib) trial
This subgroup analysis of the DEFINE trial examined predictors of the LDL-C-lowering and HDL-C-raising response to anacetrapib 100 mg/day added to statin therapy in patients with coronary heart disease. Placebo-corrected changes in LDL-C (Friedewald-calculated) and HDL-C after 24 weeks were generally similar across subgroups defined by age, gender, diabetes status, lipid-modifying regimen, and baseline lipid levels. However, effects on LDL-C (-24% versus -41%) and HDL-C (+75% versus +139%) were smaller in Black than in White patients. The authors note the clinical impact of these lipid effects was being tested in the REVEAL cardiovascular outcomes trial.
Original abstract
Background: In the Determining the Efficacy and Tolerability of cholesteryl ester transfer protein (CETP) INhibition with AnacEtrapib (DEFINE) trial, anacetrapib added to statin produced robust low-density lipoprotein cholesterol (LDL-C)-lowering and high-density lipoprotein cholesterol (HDL-C)-raising vs placebo in patients with coronary heart disease (CHD). Predictors of the degree of LDL-C and HDL-C responses to anacetrapib, however, are poorly understood.
Objective: Lipid effects of anacetrapib in patient subgroups within the DEFINE trial (clinicaltrials.gov: NCT00685776) are reported.
Methods: The percent of placebo-corrected changes from baseline for LDL-C (estimated by Friedewald calculation [Fc-LDL-C]) and HDL-C after 24 weeks of anacetrapib 100 mg/day were compared among patients by age, gender, race, diabetes status, type of concomitant statin with or without other lipid therapies, and baseline HDL-C, Fc-LDL-C, and triglyceride (TG) levels.
Results: Percent decreases in Fc-LDL-C and increases in HDL-C with anacetrapib were similar (magnitude of difference generally <1/5 of the overall treatment effect) across subgroups by age, gender, diabetes status, lipid-modifying regimen, and baseline Fc-LDL-C, HDL-C, or TG. On the other hand, anacetrapib effects on Fc-LDL-C (-24% vs -41%) and HDL-C (+75% vs +139%) appeared to be less in black vs white patients, respectively.
Conclusion: Effects of anacetrapib on Fc-LDL-C and HDL-C were generally comparable across subgroups, including being relatively independent of baseline Fc-LDL-C, HDL-C, or TG levels. The clinical impact of the lipid-modifying effects of anacetrapib is being evaluated in the cardiovascular disease outcomes trial, Randomized EValuation of the Effects of Anacetrapib though Lipid-modification (REVEAL).
Summary written by cetpinhibition.org from the published abstract; figures as published. Page updated 18 August 2026. Methods.