The first clinical trials with the new cholesteryl ester transfer protein (CETP) inhibitor, anacetrapib, have raised hopes that this agent may not be affected by the toxicity seen with the first drug in this class – torcetrapib.
Two phase I studies with anacetrapib (Lancet 2007;370:1907–14), show impressive effects on raising high-density lipoprotein cholesterol (HDL-C) and lowering low-density lipoprotein (LDL-C), with no signs of any increase in blood pressure.
The authors, from Merck, US, conclude: “Anacetrapib seems to exhibit HDL-C increases greater than those seen with other investigational drugs in this class and LDL-C-lowering effects similar to statins. Despite greater lipid-altering effects relative to other members of this class, anacetrapib seems not to increase blood pressure, suggesting that potent CETP inhibition by itself might not lead to increased blood pressure.” But they add: “Only continued assessment of anacetrapib in larger clinical studies can confirm the apparent lack of blood-pressure finding seen in our study”.
In an editorial accompanying the paper, Dr Patrick Duriez (INSERM, Lille, France) says, “The short-term safety of, anacetrapib … (which needs to be confirmed in the longer term) opens new perspectives in the study of the effect of CETP inhibition on atherogenesis and cardiovascular risk and may resuscitate the hope that CETP inhibitors could be an important new class of drugs that normalise lipidaemia”.