Meta-analysis of nearly 13,000 patients confirms evacetrapib lowers LDL-C by 34 mg/dL and raises HDL-C substantially (Prostaglandins Leukot Essent Fatty Acids 2021)

Original title: Safety and Efficacy of Evacetrapib in Patients with Inadequately-controlled Hypercholesterolemia and High Cardiovascular Risk; A meta-analysis of Randomized Placebo-controlled Trials

Prostaglandins Leukot Essent Fatty Acids · 12 April 2021 · 7

Bahbah EI, Shehata MSA, Alnahrawi SI, Sayed A, Menshawey A, Fisal A, Morsi M, Gabr ME, Elbasit MSA

Since CETP inhibition with evacetrapib may help patients who do not reach LDL-C goals with statins or cannot tolerate them, this meta-analysis pooled randomized placebo-controlled trials of evacetrapib in patients with inadequately controlled hypercholesterolemia and high cardiovascular risk, searching PubMed, Scopus, and Science Direct through March 2021. Five studies covering 12,937 patients were included. Pooled results showed evacetrapib significantly lowered LDL-C (mean difference -34.07 mg/dL, 95% CI -40.66 to -27.49, p less than 0.0001) and apoB (mean difference -22.64 mg/dL, 95% CI -30.70 to -14.58, p less than 0.0001) versus placebo, while significantly raising HDL-C (mean difference 93.31 mg/dL, 95% CI 56.07 to 130.56, p less than 0.0001). The authors conclude evacetrapib favorably raises HDL-C and apoA1 while lowering LDL-C and apoB, with an acceptable safety profile in this high-risk population.

Original abstract

Background: Low-density lipoprotein cholesterol (LDL-C) is causally related to cardiovascular disease. Inhibition of cholesteryl ester transfer protein with Evacetrapib may provide an additional treatment option for patients who do not reach their LDL-C goal with statins or patients who cannot tolerate statins. We aimed to evaluate the safety and efficacy of Evacetrapib in patients with inadequately-controlled hypercholesterolemia and high cardiovascular risk.

Method: A computer literature search for PubMed, Scopus, and Science Direct was carried out from inception to 2019 and was updated from January 2019 till March 2021. We included only RCTs. Data were pooled as a mean difference in a random-effect model using the Mantel-Haenzel (M-H) method. We used Open Meta [Analyst] software (by the center of evidence-based medicine, Oxford University, UK).

Results: Five studies (n = 12,937 patients) reported in five articles were included in this meta-analysis. The overall pooled estimate showed that LDL-C was significantly lower in the evacetrapib group than the placebo group (MD -34.07 mg/dL, 95% CI [-40.66, -27.49], p<0.0001). The pooled estimate showed that Apo-B was significantly lower in the evacetrapib130 mg group than the placebo group (MD -22.64 mg/dL, 95% CI [-30.70, -14.58], p<0.0001). HDL-C was significantly higher in the evacetrapib group over the placebo group (MD 93.31 mg/dL, 95% CI [56.07, 130.56], p<0.0001).

Conclusion: Current evidence from five RCTs (12,539 participants) suggests that evacetrapib has favorable outcomes in patients with inadequately-controlled Hypercholesterolemia and high cardiovascular risks. Evacetrapib could significantly increase the HDL and Apo-A1 levels and lower the LDL cholesterol and Apo-B levels with an acceptable safety profile.

Summary written by cetpinhibition.org from the published abstract; figures as published. Page updated 18 August 2026. Methods.