Bhatti Muhammad Imaz, Safiullah Muhammad, Farhan Kanza, Ali Ahmad, Abdullah Sofia, Ali Ahmed, Ahmed Raheel
Department of Medicine, King Edward Medical University, Lahore, Pakistan (Drs Bhatti, Safiullah, Ali, and Ali).
Department of Medicine, Sindh Medical College, Jinnah Sindh Medical University, Karachi, Pakistan (Dr Farhan).
J Clin Lipidol. 2025 Jul 17. doi: 10.1016/j.jacl.2025.07.003.
Dyslipidemia remains a central contributor to residual cardiovascular risk despite the widespread use of statins. Obicetrapib, a selective cholesteryl ester transfer protein (CETP) inhibitor, has shown potential as an adjunctive lipid-lowering therapy by favorably modifying key lipid parameters. This study aimed to systematically evaluate the lipid-lowering efficacy of obicetrapib based on current evidence from randomized controlled trials (RCTs).
A comprehensive literature search was conducted on PubMed, Embase, Scopus, and ClinicalTrials.gov to identify RCTs assessing the lipid-lowering effects of obicetrapib. Mean differences (MDs) with 95% CIs were calculated using a random-effects model.
Nine RCTs (n = 3706) were included. Patients treated with obicetrapib exhibited significant reductions in low-density lipoprotein cholesterol (LDL-C) (MD: -36.5% [95% CI: -41.1 to -31.9]), apolipoprotein B (Apo-B) (MD: -23.8% [95% CI: -28.2 to -19.3]), non-high-density lipoprotein cholesterol (non-HDL-C) (MD: -30.9% [95% CI: -34.6 to -27.1]), and lipoprotein (a) [Lp(a)] (MD: -36.1% [95% CI: -44.4 to -27.8]) compared to placebo. High-density lipoprotein cholesterol (HDL-C) levels significantly increased (MD: 142.6% [95% CI: 128.6-156.6]). Triglyceride levels did not differ significantly (MD: 0.13% [95% CI: -7.01 to 7.26]). Moreover, combination therapy with ezetimibe led to greater reductions in LDL-C by 17.8% (95% CI: 12.05-23.6), Apo-B by 9.7% (95% CI: 5.8-13.7), and non-HDL-C by 17.5% (95% CI: 12.3-22.8), compared to monotherapy.
Obicetrapib significantly improves key lipid parameters, including LDL-C, Apo-B, non-HDL-C, HDL-C, and Lp(a), with enhanced efficacy in lowering LDL-C, Apo-B, and non-HDL-C when combined with ezetimibe. These findings support its potential role in comprehensive lipid management strategies.
尽管他汀类药物已广泛应用,但血脂异常仍是心血管残余风险的主要促成因素。奥贝胆酸是一种选择性胆固醇酯转运蛋白(CETP)抑制剂,通过有利地改变关键血脂参数,已显示出作为辅助降脂治疗的潜力。本研究旨在基于随机对照试验(RCT)的现有证据,系统评价奥贝胆酸的降脂疗效。
对PubMed、Embase、Scopus和ClinicalTrials.gov进行了全面的文献检索,以确定评估奥贝胆酸降脂效果的RCT。使用随机效应模型计算95%置信区间(CI)的平均差异(MD)。
纳入9项RCT(n = 3706)。与安慰剂相比,接受奥贝胆酸治疗的患者低密度脂蛋白胆固醇(LDL-C)(MD:-36.5%[95%CI:-41.1至-31.9])、载脂蛋白B(Apo-B)(MD:-23.8%[95%CI:-28.2至-19.3])、非高密度脂蛋白胆固醇(non-HDL-C)(MD:-30.9%[95%CI:-34.6至-27.1])和脂蛋白(a)[Lp(a)](MD:-36.1%[95%CI:-44.4至-27.8])显著降低。高密度脂蛋白胆固醇(HDL-C)水平显著升高(MD:142.6%[95%CI:128.6 - 156.6])。甘油三酯水平无显著差异(MD:0.13%[95%CI:-7.01至7.26])。此外,与单药治疗相比,依折麦布联合治疗使LDL-C降低幅度更大,为17.8%(95%CI:12.05 - 23.6),Apo-B降低9.7%(95%CI:5.8 - 13.7),non-HDL-C降低17.5%(95%CI:12.3 - 22.8)。
奥贝胆酸显著改善关键血脂参数,包括LDL-C、Apo-B、non-HDL-C、HDL-C和Lp(a),与依折麦布联合使用时,在降低LDL-C、Apo-B和non-HDL-C方面疗效增强。这些发现支持了其在综合血脂管理策略中的潜在作用。