Meta-analysis confirms the impact of obicetrapib on atherogenic lipid levels

Obicetrapib, compared with placebo, reduces low-density lipoprotein cholesterol (LDL-C), non-high-density lipoprotein cholesterol (HDL-C) and apolipoprotein B (ApoB) levels, while increasing HDL-C levels, according to a systematic review and meta-analysis presented by Dr Prutha R. Pathak (North Alabama Medical Center, AL, USA) [1].

The systematic literature review identified 802 records, of which 9 randomised controlled trials were included in the meta-analysis, comprising more than 3,700 patients. Random-effects meta-analyses using mean differences were conducted to assess the treatment effect of obicetrapib versus placebo on LDL-C, non-HDL-C, and ApoB levels. Dose-response analyses were also performed to determine the maximally effective dose of obicetrapib.

Overall, obicetrapib significantly improved all lipid parameters compared with placebo across the included trials. Mean reductions were -38.1% in LDL-C levels (95% CI -43.0 to -33.2; P<0.00001), -32.3% in non-HDL-C levels (95%CI -33.5, -29.0; P<0.00001), and -25.9% in ApoB levels (95% CI -30.3 to -21.4; P<0.00001). In addition, obicetrapib increased HDL-C levels by approximately 150%. Dose-response analyses demonstrated an increase in LDL-C reduction up to 8 mg/day, with a plateau observed at doses up to 10 mg/day.

In terms of safety, obicetrapib was well tolerated, with no off-target toxicity signals identified. There were no significant differences compared with placebo in live or haematologic markers, or in treatment discontinuation rates (RR 1.04; 95% CI 0.7–1.9).

Dr Pathak concluded that “obicetrapib produces robust reductions in LDL-C, non-HDL-C, and ApoB, while dose-response modelling suggests near-maximal benefit at approximately 7–8 mg/day. Safety and discontinuation rates were comparable to controls.”

Gill OA, et al. Efficacy and safety of obicetrapib in reducing atherogenic lipids: A systematic review and dose response meta-analysis with trial sequential analysis. ACC 2026, 28–30 March, New Orleans, LA, USA.