Combo of obicetrapib plus ezetimibe effective adjunct therapy for dyslipidemia patients

USA: A recent study has highlighted the potential of obicetrapib plus ezetimibe as an effective adjunct to high-intensity statin therapy for patients with dyslipidemia and increased LDL-C levels. Dyslipidemia is a condition characterized by abnormal lipid levels in the blood. 

By combining these two agents, clinicians may optimize lipid management further and reduce the risk of cardiovascular (CV) events associated with atherogenic lipids and lipoproteins.

The study, published in the Journal of Clinical Lipidology, evaluated the safety and efficacy of combining obicetrapib and ezetimibe with high-intensity statin therapy. It revealed significant reductions in low-density lipoprotein cholesterol (LDL-C), non-high-density lipoprotein cholesterol (non-HDL-C), and other lipid-related markers.

Obicetrapib, a selective cholesteryl ester transfer protein (CETP) inhibitor, has been shown to effectively reduce LDL-C levels, lipoprotein particles, and apolipoproteins when used in combination with high-intensity statins. In this phase 2 trial, researchers Christie M. Ballantyne and team sought to determine the safety and lipid-altering efficacy of obicetrapib plus ezetimibe as an adjunct to high-intensity statin therapy.

The double-blind, randomized trial involved 119 patients with dyslipidemia already receiving stable high-intensity statin therapy. The participants were assigned to receive either 10 mg of obicetrapib plus 10 mg of ezetimibe, 10 mg of obicetrapib alone, or a placebo for 12 weeks. The study measured various lipid parameters, including LDL-C, apolipoproteins, lipoprotein particles, and proprotein convertase subtilisin kexin type 9 (PCSK9), and assessing safety and tolerability.

● The results were highly promising.

● The combination therapy of obicetrapib plus ezetimibe led to a remarkable 63.4% reduction in LDL-C levels from baseline to week 12.

● In comparison, the monotherapy group experienced a 43.5% reduction, while the placebo group showed only a 6.35% decrease.

● The combination therapy achieved LDL-C levels below key targets, with 100% of patients reaching levels below 100 mg/dL, 93.5% below 70 mg/dL, and 87.1% below 55 mg/dL.

● Both the combination therapy and obicetrapib monotherapy demonstrated significant reductions in non-HDL-C, apolipoprotein B, and total and small LDL particles. 

● The therapy was well tolerated by patients, with no safety concerns identified throughout the trial.

As further research is conducted and larger clinical trials are undertaken, this novel combination therapy could transform the landscape of dyslipidemia treatment. However, clinicians must exercise caution and engage in comprehensive treatment planning when considering this therapy for their patients. Collaborative discussions between healthcare providers and patients are vital to ensure the best possible outcomes while minimizing potential risks.

Reference:

Ballantyne, C. M., Ditmarsch, M., Kastelein, J. J. P., Nelson, A. J., Kling, D., Hsieh, A., Curcio, D. L., Maki, K. C., Davidson, M. H., & Nicholls, S. J. (2023). Obicetrapib plus ezetimibe as an adjunct to high-intensity statin therapy: A randomized phase 2 trial. Journal of Clinical Lipidology. https://doi.org/10.1016/j.jacl.2023.05.098.