Anacetrapib
Meta-analysis of 62,431 patients across 11 RCTs finds CETP inhibitors do not reduce major adverse cardiovascular events (RR 0.97) (Cardiology 2020)
Original title: Cholesteryl Ester Transfer Protein Inhibitors and Cardiovascular Outcomes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
A systematic review and meta-analysis pooled 11 placebo-controlled randomised controlled trials of CETP inhibitors (dalcetrapib, anacetrapib, evacetrapib, TA-8995) with at least 6 months of follow-up, totalling 62,431 patients (dalcetrapib 16,612, anacetrapib 33,682, evacetrapib 12,092). Anacetrapib and evacetrapib raised HDL-C by about 100 to 130%, versus about 30% for dalcetrapib, and lowered LDL-C by about 30%, while dalcetrapib did not affect LDL-C. Pooled across the class, CETP inhibitors were not associated with major adverse cardiovascular events (risk ratio 0.97, 95% CI, 0.91 to 1.04), with non-significant trends toward less nonfatal myocardial infarction (risk ratio 0.93) and cardiovascular death (risk ratio 0.92). A pre-obicetrapib synthesis of the early outcomes trials for this drug class, concluding no excess cardiovascular risk but no clear benefit either.
Original abstract
Background: Cholesteryl ester transfer protein (CETP) inhibitors increase serum high-density lipoprotein cholesterol (HDL-c) concentration; however, their impact on cardiovascular outcomes is not clear. This systematic review examines the effect of CETP inhibitors on serum lipid profiles, cardiovascular events, and all-cause mortality.
Methods: We searched MEDLINE, Embase, and the Cochrane Library of Clinical Trials for placebo-controlled randomized controlled trials (RCTs) that examined the effect of a CETP inhibitor (dalcetrapib, anacetrapib, evacetrapib, or TA-8995) on all-cause mortality, major adverse cardiovascular events (MACE), or the components of MACE at ≥6 months. Data were pooled using random-effects models.
Results: A total of 11 RCTs (n = 62,431) were included in our systematic review; 4 examined dalcetrapib (n = 16,612), 6 anacetrapib (n = 33,682), and 1 evacetrapib (n = 12,092). Compared to dalcetrapib, ana-cetrapib and evacetrapib were more efficacious at raising HDL-c levels (∼100-130 vs. ∼30%). Anacetrapib and evacetrapib also decreased low-density lipoprotein cholesterol (LDL-c) by approximately 30% while dalcetrapib did not affect the LDL-c level. Overall, CETP inhibitors were not associated with the incidence of MACE (pooled relative risk [RR]: 0.97; 95% confidence interval [CI]: 0.91-1.04). CETP inhibitors may decrease the risks of nonfatal myocardial infarction (MI) (RR: 0.93; 95% CI: 0.87-1.00) and cardiovascular death (RR: 0.92; 95% CI: 0.83-1.01), though these trends did not reach statistical significance.
Conclusions: CETP inhibitors are not associated with an increased risk of MACE or all-cause mortality. There is a trend towards small reductions in nonfatal MI and cardiovascular death, though the clinical im-portance of such reductions is likely modest.
anacetrapibthe classdalcetrapibevacetrapiboutcomes trials
Summary written by cetpinhibition.org from the published abstract; figures as published. Page updated 18 August 2026. Methods.