Agent
Anacetrapib
Status Development discontinued 2017 despite a positive outcomes trial
The only CETP inhibitor to complete a cardiovascular outcomes trial and win. REVEAL randomised 30,449 patients on atorvastatin and reported a significant reduction in major coronary events. Merck discontinued development anyway, citing the modest size of the benefit and the drug's accumulation in adipose tissue. It is the most important negative decision in the field's history.
Mechanism. A potent, long-acting CETP inhibitor that both raises HDL-C substantially and lowers non-HDL-C and apoB.
The trial. REVEAL (NCT01252953) is the largest CETP trial ever run: 30,449 patients with atherosclerotic vascular disease, all on intensive atorvastatin, randomised to anacetrapib 100 mg daily or placebo and followed for a median of just over four years. It met its primary endpoint.
Why it was stopped. Merck's own judgement was that the absolute benefit did not justify a filing. Two facts weighed against it: the effect size was modest once LDL-C was already controlled, and anacetrapib deposits in adipose tissue, remaining detectable years after the last dose. A drug that cannot be cleared is a difficult drug to defend in primary prevention.
Why it still matters. REVEAL is the proof of principle that inhibiting CETP can reduce cardiovascular events. Every later argument for the class, obicetrapib included, is built on it, and every honest account of the class has to explain why a positive trial produced no drug.
anacetrapibLDL and apoBoutcomes trialssafety
Page updated 18 August 2026.