{"id":"b00376946fd4","type":"article","url":"https://hartvaat.nl/2025/10/07/obicetrapib-en-mace-bij-hoogrisicopatienten-gepoolde-analyse/","title":"Obicetrapib en MACE bij hoogrisicopatiënten: gepoolde analyse","title_en":"Impact of Obicetrapib on Major Adverse Cardiovascular Events in High-Risk Patients: A Pooled Analysis.","category":"cholesterol","category_label":"Cholesterol","professions":["apotheker","cardioloog","internist"],"tags":["cetp-remmers","obicetrapib"],"journal":"Journal of the American College of Cardiology","doi":"10.1016/j.jacc.2025.07.056","source_url":"https://doi.org/10.1016/j.jacc.2025.07.056","authors":["Stephen J Nicholls","Adam J Nelson","Kausik K Ray","Christie M Ballantyne","Marc Ditmarsch","Douglas Kling","Andrew Hsieh","Michael Szarek","John J Kastelein","Michael H Davidson"],"significance":8,"published":"2025-10-07","source_date":"2025-10-07","image":"","kennis":["https://hartvaat.nl/kennis/lipiden/lpa-meten-wanneer-waarom/"],"congress":"","summary_en":"This pooled analysis suggested that obicetrapib may reduce MACE in high-risk patients, providing the first signal of clinical cardiovascular benefit from a CETP inhibitor after decades of setbacks with earlier agents in this class.","created":"2026-07-03T10:31:54Z","updated":"2026-07-03T13:30:54Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Gepoolde analyse suggereerde dat obicetrapib de MACE vermindert bij hoogrisicopatiënten. Dit is de eerste CETP-remmer met signalen voor klinisch voordeel, in afwachting van de definitieve uitkomsttrial.","abstract_original":"BACKGROUND: The cholesteryl ester transfer protein inhibitor obicetrapib decreases levels of atherogenic lipids and raises high-density lipoprotein cholesterol (HDL-C). OBJECTIVES: In this study, we sought to determine the effect of obicetrapib on cardiovascular events. METHODS: The effects of 10 mg obicetrapib and placebo daily on major adverse cardiovascular event (MACE) rates were investigated in a pooled analysis of 354 patients with heterozygous familial hypercholesterolemia (HeFH) and 2,530 patients with atherosclerotic cardiovascular disease (ASCVD) over 365 days. The association between on-treatment lipids and MACE were also investigated. RESULTS: The cohort (mean age 66 years, 36% female, ASCVD 82%, HeFH 27%, diabetes 35%) had median baseline levels of low-density lipoprotein cholesterol (LDL-C) 92 mg/dL, HDL-C 48 mg/dL, apolipoprotein B (ApoB) 88 mg/dL, non-HDL-C 116 mg/dL, and lipoprotein(a) (Lp(a)) 40.5 nmol/L. Obicetrapib produced greater reductions in LDL-C (-34.0 vs -4.0 mg/dL, -37.8% vs -4.6%), ApoB (-19.0 vs -3.0 mg/dL, -21.7% vs -3.6%), non-HDL-C (-36.0 vs -4.0 mg/dL, -32.4% vs -3.7%), and Lp(a) (-9.8 vs 0 nmol/L, -32.5% vs 0%) and increased HDL-C (+68.0 vs +1.0 mg/dL, +140.0% vs +1.5%). The rate of coronary heart disease death, myocardial infarction, ischemic stroke, or coronary revascularization was lower with obicetrapib (3.9% vs 5.0%; HR: 0.77; 95% CI: 0.54-1.11; P = 0.16), with a risk reduction in the second 6 months (HR: 0.60; 95% CI: 0.37-0.99; P = 0.04). The rate of coronary heart disease death, myocardial infarction, or coronary revascularization was lower with obicetrapib (3.2% vs 4.7%; HR: 0.68; 95% CI: 0.46-1.00; P = 0.048), with a risk reduction in the second 6 months (HR: 0.45; 95% CI: 0.26-0.77; P = 0.003). Achieved levels of LDL-C (P = 0.003), ApoB (P = 0.007), non-HDL-C (P = 0.01), Lp(a) (P = 0.003), and HDL-C (P = 0.0001) were associated with event rates. CONCLUSIONS: Obicetrapib treatment associated with a reduction in coronary events, evident beyond 6 months of treatment."}