CETP (Cholesteryl Ester Transfer Protein) Inhibition With Anacetrapib Decreases Production of Lipoprotein(a) in Mildly Hypercholesterolemic Subjects
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Objective— Lp(a) [lipoprotein (a)] is composed of apoB (apolipoprotein B) and apo(a) [apolipoprotein (a)] and is an independent risk factor for cardiovascular disease and aortic stenosis. In clinical trials, anacetrapib, a CETP (cholesteryl ester transfer protein) inhibitor, causes significant reductions in plasma Lp(a) levels. We conducted an exploratory study to examine the mechanism for Lp(a) lowering by anacetrapib. Approach and Results— We enrolled 39 participants in a fixed-sequence, double-blind study of the effects of anacetrapib on the metabolism of apoB and high-density lipoproteins. Twenty-nine patients were randomized to atorvastatin 20 mg/d, plus placebo for 4 weeks, and then atorvastatin plus anacetrapib (100 mg/d) for 8 weeks. The other 10 subjects were randomized to double placebo for 4 weeks followed by placebo plus anacetrapib for 8 weeks. We examined the mechanisms of Lp(a) lowering in a subset of 12 subjects having both Lp(a) levels >20 nmol/L and more than a 15% reduction in Lp(a) by the end of anacetrapib treatment. We performed stable isotope kinetic studies using 2 H 3 -leucine at the end of each treatment to measure apo(a) fractional catabolic rate and production rate. Median baseline Lp(a) levels were 21.5 nmol/L (interquartile range, 9.9–108.1 nmol/L) in the complete cohort (39 subjects) and 52.9 nmol/L (interquartile range, 38.4–121.3 nmol/L) in the subset selected for kinetic studies. Anacetrapib treatment lowered Lp(a) by 34.1% ( P ≤0.001) and 39.6% in the complete and subset cohort, respectively. The decreases in Lp(a) levels were because of a 41% reduction in the apo(a) production rate, with no effects on apo(a) fractional catabolic rate. Conclusions— Anacetrapib reduces Lp(a) levels by decreasing its production. Clinical Trial Registration— URL: http://www.clinicaltrials.gov . Unique identifier: NCT00990808.
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CETP inhibitors, like anacetrapib, have shown promise in reducing Lp(a) levels, primarily through diminishing apo(a) production.
“CETP inhibitors, like anacetrapib, have shown promise in reducing Lp(a) levels, primarily through diminishing apo(a) production [17].”
From Residual Cardiovascular Risk: Role of Remnants Cholesterol, Monocyte/HDL Ratio and Lipoprotein Ratios on Personalized Cardiovascular Prevention (2024) · cites this paper as [17]
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New Horizons: Revival of Lipoprotein (a) as a Risk Factor for Cardiovascular Disease
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Therapeutic management of hyperlipoproteinemia (a)
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LP(a): The new marker of high cardiovascular risk
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Exploring the role of lipoprotein(a) in cardiovascular diseases and diabetes in Chinese population
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“CETP inhibitors, like anacetrapib, have shown promise in reducing Lp(a) levels, primarily through diminishing apo(a) production [17].”
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Lipoprotein(a)-lowering therapies: a promising future
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Interaction Between Lipoprotein(a) and Other Lipid Molecules: A Review of the Current Literature
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Pharmacotherapy for children with elevated levels of lipoprotein(a): future directions
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Lipoprotein(a) and Venous Thromboembolism: Association, Causality, and Medications
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Association of free-living diet composition with plasma lipoprotein(a) levels in healthy adults
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Self-citationAnacetrapib as a potential cardioprotective strategy
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Lower LDL is better – can this be achieved with CETP inhibition therapy?
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Supporting evidence for lipoprotein(a) measurements in clinical practice
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Self-citationCETP Inhibitors: Back With a New Target
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Influencia de la concentración de triglicéridos en la lipoproteína(a) en función de la dislipidemia
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Lipoprotein(a) Elevation: A New Diagnostic Code with Relevance to Service Members and Veterans.
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Lipoprotein(a): structural basis, bidirectional risk, and therapeutic frontiers
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Study of effect modifiers of genetically predicted CETP reduction
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Are we seeing the light at the end of the tunnel for high lipoprotein(a)? Lipoprotein(a)
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Influence of triglyceride concentration in lipoprotein(a) as a function of dyslipidemia
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Obicetrapib and CETP inhibition: An exception to the rule?
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Lipoprotein(a): Metabolism, Pathophysiology, and Impact on Diabetes Mellitus
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Therapy of Elevated Lipoprotein(a)
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Contemporary Aspects of Lp(a) Metabolism and Therapies Based on Tracer Kinetic Studies in Humans
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Self-citationEspoirs et place prochaine potentielle des inhibiteurs de la Lp(a)
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Lp(a). Lo que sabemos, lo que desconocemos y lo que esperamos
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Self-citationApproches biochimique, épidémiologique et clinique du métabolisme intégré de la Lipoprotéine (a)
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- Authors
- Thomas, T., Zhou, H., Karmally, W., Ramakrishnan, R., Holleran, S., Liu, Y., Jumes, P., Wagner, J. A., Hubbard, B., Previs, S. F., Roddy, T., Johnson-Levonas, A. O., Gutstein, D. E., Marcovina, S. M., Rader, D. J., Ginsberg, H. N., Millar, J. S., & Reyes-Soffer, G.
- Affiliations
- Merck & Co., Inc., Rahway, NJ, USA (United States) (US)
- From the Columbia University, New York (T.T., W.K., R.R., S.H., H.N.G., G.R.-S.); Merck & Co, Inc, Kenilworth, NJ (H.Z., Y.L., P.J., J.A.W., B.H., S.F.P., T.R., A.O.J.-L., D.E.G.); University of Washington, Seattle (S.M.M.); and University of Pennsylvania, Philadelphia (D.J.R., J.S.M.).
- ORCID
- Venue
- Arteriosclerosis, Thrombosis, and Vascular Biology
- Published
- 2017-09
- Volume
- 37
- Issue
- 9
- Pages
- 1770-1775
- ISSN
- 1079-5642 (ISSN-L)
- 1524-4636
- PMC
- PMC5567403
- OpenAlex
- W2736338239
- Cited by
- 96
- References
- 36
- Citations by year
- 2026: 6 · 2025: 9 · 2024: 13 · 2023: 19 · 2022: 14 · 2021: 8 · 2020: 4 · 2019: 8 · 2018: 7 · 2017: 8
- FWCI
- 7.57
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by
- Locations
- Arteriosclerosis Thrombosis and Vascular Biology (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Columbia Academic Commons (Columbia University)
- Funders
- Amgen
- Eli Lilly and Company
- Pfizer
- Sanofi
- Regeneron Pharmaceuticals
- Kowa Company
- National Institutes of Health (KL2TR000081)
- National Center for Advancing Translational Sciences
- Topics
- Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
- Health Sciences › Medicine › Surgery › Cholesterol and Lipid Metabolism
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Lipid metabolism and disorders
- Keywords
- anacetrapib, CETP inhibition, lipoprotein(a), apolipoprotein B, HDL metabolism, atorvastatin, hypercholesterolemia, cardiovascular risk factors, aortic stenosis
- MeSH terms
- Adult, Aged, Anticholesteremic Agents, Chromatography, Liquid, Double-Blind Method, Female, Humans, Hypercholesterolemia, Male, Middle Aged, New York City, Pennsylvania, Severity of Illness Index, Time Factors, Biomarkers, Down-Regulation, Treatment Outcome, Lipoprotein(a), Oxazolidinones, Cholesterol Ester Transfer Proteins, Tandem Mass Spectrometry
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