Meta-analysis of nine RCTs in 3,706 patients: obicetrapib plus ezetimibe adds a further 17.8% LDL-C reduction over obicetrapib alone (J Clin Lipidol 2025)

Original title: Obicetrapib and its impact on lipid parameters: A comprehensive meta-analysis of the latest evidence

J Clin Lipidol · 1 January 2025 · 6

Bhatti MI, Safiullah M, Farhan K, Ali A, Abdullah S, Ali A, Ahmed R

A meta-analysis of nine randomised controlled trials (3,706 patients) evaluated the lipid-lowering efficacy of obicetrapib. Obicetrapib reduced LDL-C by a mean of 36.5% (95% CI, 31.9 to 41.1), apoB by 23.8%, non-HDL-C by 30.9% and Lp(a) by 36.1%, and raised HDL-C by 142.6%, with no significant change in triglycerides. Combination therapy with ezetimibe gave larger reductions than obicetrapib monotherapy: an additional 17.8% for LDL-C (95% CI, 12.05 to 23.6), 9.7% for apoB and 17.5% for non-HDL-C. Pooled trial evidence supporting obicetrapib, particularly combined with ezetimibe, as part of comprehensive lipid management.

Original abstract

Background: Dyslipidemia remains a central contributor to residual cardiovascular risk despite the widespread use of statins. Obicetrapib, a selective cholesteryl ester transfer protein (CETP) inhibitor, has shown potential as an adjunctive lipid-lowering therapy by favorably modifying key lipid parameters. This study aimed to systematically evaluate the lipid-lowering efficacy of obicetrapib based on current evidence from randomized controlled trials (RCTs).

Sources Of Material: A comprehensive literature search was conducted on PubMed, Embase, Scopus, and ClinicalTrials.gov to identify RCTs assessing the lipid-lowering effects of obicetrapib. Mean differences (MDs) with 95% CIs were calculated using a random-effects model.

Abstract Of Findings: Nine RCTs (n = 3706) were included. Patients treated with obicetrapib exhibited significant reductions in low-density lipoprotein cholesterol (LDL-C) (MD: -36.5% [95% CI: -41.1 to -31.9]), apolipoprotein B (Apo-B) (MD: -23.8% [95% CI: -28.2 to -19.3]), non-high-density lipoprotein cholesterol (non-HDL-C) (MD: -30.9% [95% CI: -34.6 to -27.1]), and lipoprotein (a) [Lp(a)] (MD: -36.1% [95% CI: -44.4 to -27.8]) compared to placebo. High-density lipoprotein cholesterol (HDL-C) levels significantly increased (MD: 142.6% [95% CI: 128.6-156.6]). Triglyceride levels did not differ significantly (MD: 0.13% [95% CI: -7.01 to 7.26]). Moreover, combination therapy with ezetimibe led to greater reductions in LDL-C by 17.8% (95% CI: 12.05-23.6), Apo-B by 9.7% (95% CI: 5.8-13.7), and non-HDL-C by 17.5% (95% CI: 12.3-22.8), compared to monotherapy.

Conclusion: Obicetrapib significantly improves key lipid parameters, including LDL-C, Apo-B, non-HDL-C, HDL-C, and Lp(a), with enhanced efficacy in lowering LDL-C, Apo-B, and non-HDL-C when combined with ezetimibe. These findings support its potential role in comprehensive lipid management strategies.

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