CETP-inhibitor does not reduce CV events
Impact of the Cholesteryl Ester Transfer Protein Inhibitor Evacetrapib on Cardiovascular Events: Results of the ACCELERATE trialStephen J. Nicholls (University of Adelaide, Australia)
Presented at ACC 2016
BackgroundThe potent cholesteryl ester transfer protein (CETP) inhibitor evacetrapib has been demonstrated to raise high-density lipoprotein cholesterol (HDL-C) by 54-129%, reduce low-density lipoprotein cholesterol (LDL-C) by 14-36% and enhance cellular cholesterol efflux capacity. The ACCELERATE trial
aimed to determine the impact of evacetrapib on major adverse cardiovascular outcomes in patients with high risk vascular disease. ACCELERATE was a phase 3, multicenter, randomized, double-blind trial in which 12,092 patients with either an acute coronary syndrome within the prior 30-365 days, cerebrovascular atherosclerotic disease, peripheral vascular disease or diabetes with coronary artery disease were randomized to evacetrapib 130 mg or placebo daily in addition to standard medical therapy for at least 1.5 years.
The primary efficacy endpoint was the time to first event of cardiovascular death, myocardial infarction, stroke, hospitalization for unstable angina or coronary revascularization.
- LDL-C levels were lowered with 37% in patients on evacetrapib, compared with placebo
- HDL-C levels were increased by 130% in patients on evacetrapib, compared with patients taking a placebo.
- However, there was no difference between the two groups in terms of the study’s primary endpoint (12.8% for evacetrapib vs. 12.7% for placebo; HR 1.01, 95% CI 0.91-1.12, P=0.85)
- A borderline significant reduction in all-cause mortality was observed in the evacetrapib group (3.8% vs. 4.1%; HR 0.84, 95% CI 0.71-1.01, P=0.06)
- The results raised no safety concerns for evacetrapib and did not reveal any major side effects.