Masson Walter, Barbagelata Leandro, Lobo Martin, Nogueira Juan Patricio, Handelsman Yehuda
Department of Cardiology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina (Masson, Barbagelata).
Department of Cardiology, Hospital Militar Campo de Mayo, Buenos Aires, Argentina (Lobo).
J Clin Lipidol. 2025 May-Jun;19(3):412-421. doi: 10.1016/j.jacl.2024.12.016. Epub 2024 Dec 30.
Obicetrapib is a next-generation, oral, selective cholesteryl ester transfer protein inhibitor known to significantly affect atherogenic lipoproteins, including low-density lipoprotein cholesterol (LDL-C), apolipoprotein B (ApoB), nonhigh-density lipoprotein cholesterol (Non-HDL-C), and lipoprotein(a) [Lp(a)].
To evaluate the lipid-lowering efficacy of obicetrapib based on available evidence.
This systematic review was drafted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A comprehensive literature search was conducted to identify randomized clinical trials assessing the lipid-lowering effects of obicetrapib compared to placebo. Fixed and random-effects models were used.
Five randomized clinical trials (n = 288 patients) were included in this analysis. Patients treated with obicetrapib exhibited significantly greater reductions in LDL-C (mean difference [MD]: 41.4% [95% CI: 45.7 to -37.1]; I²: 6%), ApoB (MD: 26.5% [95% CI: 31.3 to -21.6]; I²: 45%), and Non-HDL-C (MD: 34.5% [95% CI: 37.0 to -31.6]; I²: 80%) compared to those receiving a placebo. Additionally, HDL-C levels were significantly higher in the obicetrapib group (MD: 157.4% [95% CI: 142.2 to 172.6]; I²: 69%). While triglyceride levels did not differ significantly between the 2 groups, Lp(a) levels were notably reduced with obicetrapib treatment (MD: 39.5% [95% CI: 54.6 to -24.3]; I²: 67%).
Obicetrapib is associated with significant reductions in key atherogenic lipoproteins, including LDL-C, ApoB, Non-HDL-C and Lp(a). Further investigation is needed to assess its impact on cardiovascular risk.
奥贝胆酸是一种新一代口服选择性胆固醇酯转移蛋白抑制剂，已知可显著影响致动脉粥样硬化脂蛋白，包括低密度脂蛋白胆固醇（LDL-C）、载脂蛋白B（ApoB）、非高密度脂蛋白胆固醇（Non-HDL-C）和脂蛋白(a) [Lp(a)]。
根据现有证据评估奥贝胆酸的降脂疗效。
本系统评价根据系统评价和Meta分析的首选报告项目指南起草。进行了全面的文献检索，以确定评估奥贝胆酸与安慰剂相比降脂效果的随机临床试验。使用固定效应模型和随机效应模型。
本分析纳入了五项随机临床试验（n = 288例患者）。与接受安慰剂的患者相比，接受奥贝胆酸治疗的患者LDL-C（平均差异[MD]：41.4% [95% CI：45.7至-37.1]；I²：6%）、ApoB（MD：26.5% [95% CI：31.3至-21.6]；I²：45%）和Non-HDL-C（MD：34.5% [95% CI：37.0至-31.6]；I²：80%）的降低幅度显著更大。此外，奥贝胆酸组的HDL-C水平显著更高（MD：157.4% [95% CI：142.2至172.6]；I²：69%）。虽然两组之间的甘油三酯水平没有显著差异，但奥贝胆酸治疗可显著降低Lp(a)水平（MD：39.5% [95% CI：54.6至-24.3]；I²：67%）。
奥贝胆酸与关键致动脉粥样硬化脂蛋白的显著降低有关，包括LDL-C、ApoB、Non-HDL-C和Lp(a)。需要进一步研究以评估其对心血管风险的影响。
