Outcomes trials
CV risk, CV benefit, or both? A review takes stock of CETP inhibitors after preclinical promise met mostly disappointing outcome trials (Clin Pharmacol Ther 2018)
Original title: CETP-Inhibition and HDL-Cholesterol: A Story of CV Risk or CV Benefit, or Both
CETP inhibitors were developed for their ability to raise HDL cholesterol, and preclinical animal studies showed favourable effects on atherosclerotic plaque with CETP inhibition. This review takes stock of the class after clinical development: while these agents do raise HDL-C and lower LDL-C as intended, most have not reduced cardiovascular event rates in large outcomes trials. The author reviews the state of expert opinion following the full run of CETP inhibitor clinical trials to date, weighing whether the class still holds cardiovascular risk-reduction promise, poses unresolved risk, or some combination of both, without new experimental or trial data of its own.
Original abstract
Inhibitors of cholesteryl ester transfer protein (CETP) were developed due to their ability to raise HDL-C levels. Preclinical studies demonstrated favorable effects on atherosclerotic plaque with CETP inhibitory approaches in animal models. While these agents raise HDL-C and lower LDL-C, most have not proven to reduce cardiovascular event rates in large outcome trials. The state of opinion after all of these clinical trials is reviewed.
Summary written by cetpinhibition.org from the published abstract; figures as published. Page updated 18 August 2026. Methods.