Related Experiment Video
Updated: May 20, 2026

Differential Effects of Lipid-lowering Drugs in Modulating Morphology of Cholesterol Particles
Published on: November 10, 2017
Comparative effectiveness of cholesteryl ester transfer protein (CETP) inhibitors on cardiovascular outcomes: A
Ibrahim Khalil1, M Rafiqul Islam2, Sunjida Amin Promi3
1Dhaka Medical College and Hospital, Dhaka, Bangladesh.
Insights
This network meta-analysis found Evacetrapib and Anacetrapib to be the most effective cholesteryl ester transfer protein (CETP) inhibitors for improving cardiovascular outcomes. Dalcetrapib also showed benefits for specific cardiovascular events.
Area of Science:
- Pharmacology
- Cardiovascular Medicine
- Biostatistics
Background:
- Cardiovascular disease (CVD) is a leading global cause of mortality.
- Residual cardiovascular risk persists despite current pharmacological treatments.
- Cholesteryl ester transfer protein (CETP) inhibitors show potential for lipid profile improvement, but comparative effectiveness for cardiovascular outcomes is unclear.
Purpose of the Study:
- To conduct a network meta-analysis and meta-regression evaluating the comparative effectiveness of CETP inhibitors.
- To assess the impact of Evacetrapib, Anacetrapib, Dalcetrapib, and Torcetrapib on cardiovascular outcomes.
- To identify the most effective CETP inhibitors for reducing cardiovascular mortality and major adverse cardiovascular events.
Main Methods:
- Bayesian network meta-analysis of 10 randomized controlled trials.
- Inclusion of 84,134 patients with cardiovascular disease or high cardiovascular risk.
- Network meta-regression to analyze the influence of covariates like age, sex, and baseline lipid levels.
Main Results:
- Evacetrapib demonstrated the highest ranking for reducing cardiovascular mortality (SUCRA: 71.91%).
- Anacetrapib showed the best performance in reducing major adverse cardiovascular events (SUCRA: 84.25%) and myocardial infarction (SUCRA: 86.06%).
- Dalcetrapib exhibited favorable effects on all-cause mortality (SUCRA: 67.51%) and stroke (SUCRA: 83.03%).
Conclusions:
- Evacetrapib and Anacetrapib emerge as the most promising CETP inhibitors for enhancing cardiovascular outcomes.
- Dalcetrapib may offer benefits for specific cardiovascular endpoints.
- Further research is warranted to validate these findings and guide clinical practice.
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.
Related Concept Videos
Lipid-Lowering Drugs: Statins and Miscellaneous Agents
Pharmacogenomics: Identification of New Drug Targets
Types of Biopharmaceutical Studies: Controlled and Non-Controlled Approaches
Non-controlled studies, commonly employed for initial exploration, lack a control group, rendering them susceptible to biases and external influences. In contrast, controlled...
Cholesterol: Significance and Regulation
Considering cholesterol and...
Antianginal Drugs: Calcium Channel Blockers and Ranolazine
CCBs, a diverse class that includes dihydropyridines (nifedipine) and diphenylalkylamines (verapamil and diltiazem), exert their effect by blocking calcium channels in cardiac and smooth muscle cells. This...
Hepatic Drug Clearance: Effect of Protein Binding
For low-extraction-ratio drugs that are less than 80% protein-bound, minor changes in protein binding...