CETP inhibitors target cholesteryl ester transfer protein (CETP), which facilitates the exchange of cholesteryl ester and triglycerides between HDL and lipoproteins containing apolipoprotein B100. By inhibiting CETP, these drugs decrease cholesterol esters incorporated into LDL-C, increase HDL, and enhance hepatic LDL-C recycling.
Despite promising impacts on HDL-C and LDL-C in animal models, phase III trials of CETP inhibitors have yielded disappointing results. Trials like ILLUMINATE, dal-OUTCOMES, and ACCELERATE were terminated early due to futility or adverse events, while REVEAL showed positive outcomes. Various theories have been proposed to explain the mixed results, including off-target effects, underestimation of LDL-C levels, and timing of treatment initiation.
Due to mixed safety and efficacy findings, no CETP inhibitors have received FDA approval, and they are not recommended in the AHA/ACC guidelines at this time.
Given the lack of FDA approval and mixed findings on safety and efficacy, there is no literature available to assess the cost-effectiveness of CETP inhibitors.
© The AtheroPrev Team (2024)
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