Obicetrapib Lowers LDL-C in Patients Taking High Intensity Statins - Results from the ROSE Clinical Trial

ElsevierVolume 16, Issue 3, Supplement, July–August 2022, Page e73Journal of Clinical LipidologyLead Author's Financial Disclosures

Nothing to disclose.

Study Funding

NewAmsterdam Pharma.

Background/Synopsis

Mendelian randomization studies have predicted that cholesteryl ester transfer protein (CETP) inhibition would reduce the risk of cardiovascular events. This was confirmed in REVEAL; by lowering LDL-C, anacetrapib was associated with a reduction in cardiovascular events. Early studies of the selective CETP inhibitor obicetrapib demonstrated LDL-C lowering up to 45% as monotherapy and 68% in combination with moderate intensity statin therapy.

Objective/Purpose

To assess the effects of obicetrapib on LDL-C and other lipid parameters in patients treated with high intensity statins.

Methods

Patients (n=120) with an LDL-C ≥70 mg/dL, despite treatment with high intensity statins, were randomized to treatment with obicetrapib 5 or 10mg or matching placebo for 8 weeks. The primary endpoint was the difference between groups in percent change in LDL-C from baseline to week 8. Secondary endpoints included changes in ApoB, non-HDL-C and HDL-C. Exploratory analyses evaluated differences in Friedewald and preparative ultracentrifugation measurement (PUC) of LDL-C. Safety assessment included biochemistry, vital signs, physical examinations, and adverse events.

Results

Patients had a median LDL-C of 88mg/dL at baseline. Compared with placebo, obicetrapib produced greater dose-dependent lowering of LDL-C (up to 50.8%, P<0.0001), which was comparable between PUC and Friedewald measures. Obicetrapib also produced greater lowering of apoB (up to 29.8%, P<0.0001) and non-HDL-C (up to 44.4%, P<0.0001) and raising of HDL-C (up to 165%, P<0.0001) in a dose-dependent fashion compared with placebo. (Table) Fewer patients in the obicetrapib arms (26%) experienced treatment emergent adverse events than in the placebo arm (48%). No patients in either obicetrapib arm experienced a treatment emergent SAE. There were no clinically significant changes in laboratory parameters, vital signs, or physical examinations in any study group.

Conclusions

Obicetrapib at doses of 5 and 10mg produced robust decreases in LDL-C, ApoB and Non-HDL-C and increases in HDL-C compared to placebo in patients treated with high intensity statins and was safe and well tolerated.

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