Bayesian network meta-analysis of 84,134 patients ranks evacetrapib and anacetrapib best for cardiovascular outcomes among CETP inhibitors (Medicine 2026)

Original title: Comparative effectiveness of cholesteryl ester transfer protein (CETP) inhibitors on cardiovascular outcomes: A comprehensive Bayesian network meta-analysis and network meta-regression

Medicine (Baltimore) · 15 May 2026 · 7

Khalil I, Islam MR, Promi SA, Joy AD, Sayed MA, Acharjee D, Al-Shammari AS, Rahman MT, Abrar S, Bin Jamil TS, Taseen M, Biswas S et al.

A Bayesian network meta-analysis and network meta-regression pooled ten randomised controlled trials (84,134 patients with cardiovascular disease or high risk) comparing evacetrapib, anacetrapib, dalcetrapib and torcetrapib on cardiovascular outcomes. Evacetrapib ranked highest for cardiovascular mortality (relative risk 0.92, 95% credible interval, 0.39 to 1.87, SUCRA 71.91%) and anacetrapib for major adverse cardiovascular events (relative risk 0.40, 95% credible interval, 0.07 to 1.06, SUCRA 84.25%) and myocardial infarction (relative risk 0.83, SUCRA 86.06%). Dalcetrapib ranked favourably for all-cause mortality (relative risk 0.72, SUCRA 67.51%) and stroke (relative risk 0.75, SUCRA 83.03%). The authors conclude evacetrapib and anacetrapib were the most effective of these four discontinued CETP inhibitors for cardiovascular outcomes, an indirect, class-historical comparison that does not include obicetrapib.

Original abstract

Background: Cardiovascular disease remains the leading cause of mortality worldwide, with residual cardiovascular (CVS) risk remaining high despite pharmacological interventions. Cholesteryl ester transfer protein (CETP) inhibitors have shown promise in improving lipid profiles, but their comparative effectiveness in reducing CVS outcomes remains unclear. This network meta-analysis and network meta-regression aimed to evaluate the comparative effectiveness of CETP inhibitors (Evacetrapib, Anacetrapib, Dalcetrapib, and Torcetrapib) on CVS outcomes, including CVS mortality, all-cause mortality, major adverse cardiovascular events, myocardial infarction, need for revascularization, and stroke.

Methods: A Bayesian network meta-analysis was conducted, incorporating data from 10 randomized controlled trials with 84,134 patients diagnosed with cardiovascular disease or at high risk. We compared various CETP inhibitors for their effectiveness in reducing CVS events. Network meta-regression was used to assess the impact of covariates such as age, sex, and baseline lipid levels.

Results: Evacetrapib ranked highest for CVS mortality (relative risk [RR]: 0.92, 95% credible interval [CrI]: 0.39-1.87; Surface Under the Cumulative Ranking Curve [SUCRA]: 71.91%) and Anacetrapib for major adverse cardiovascular events (RR: 0.40, 95% CrI: 0.07-1.06; SUCRA: 84.25%). Dalcetrapib showed favorable effects on all-cause mortality (RR: 0.72, 95% CrI: 0.16-1.42; SUCRA: 67.51%) and stroke (RR: 0.75, 95% CrI: 0.41-1.26; SUCRA: 83.03%). Anacetrapib had the highest rank in reducing myocardial infarction (RR: 0.83, 95% CrI: 0.46-1.15; SUCRA: 86.06%).

Conclusions: This analysis suggests that Evacetrapib and Anacetrapib are the most effective CETP inhibitors for improving CVS outcomes, with Dalcetrapib showing beneficial effects in certain outcomes. Further studies are needed to confirm these findings.

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