12. December 2011 15:57
A scientific investigation team headed by Cleveland Clinic’s Stephen J. Nicholls, M.B.B.S., Ph.D., has found that the use of the drug Evacetrapib is associated with a large increase in “good cholesterol”, i.e., high-density lipoprotein cholesterol, or HDL-C, a substance that is known to be associated with a lower incidence of cardiovascular disease. Evacetrapib acted also to decrease“bad cholesterol” or low-density lipoprotein cholesterol, also known as LDL-C. 398 individuals who had sub-optimal levels of cholesterol – either abnormally low HDL-C or abnormally high LDL-C, were the subjects of the investigation.
Evacetrapib belongs to a class of substances that act to increase HDL-C and in some cases, reduce LDL-C, by means of inhibiting Cholesterol Ester Transfer Proteins, or CTEPs. The Nicholls study found that over the course of twelve weeks of treatment, HDL-C levels in the test subjects who were given doses of Evacetrapib shot up by dramatically, from 53.6% to 128.8% (from 30 mg/dL to 66 mg/dL). LDL-C levels dropped by -13.6% to -35.9%. The HDL-C boost was even more impressive in the test subjects who had lowerlevels of HDL-C to begin with. Placebos were found todecrease HDL-C by -3% in test subjects, and to either reduce LDL-C by -3.0% or increase it by 3.9%.
The study also looked at the effect of Evacetrapib when taken in conjunction with statins (cholesterol reducing drugs). When 100 mg/d of Evaceptrapib was taken along with statins, HDL-C levels increased by 78.5% to 88.5%, and LDL-C got reduced by -11.2% to -13.9%. Compared to exclusive statin therapy, (i) Evaceptrapib plus statins resulted in greater decrease of LDL-C and (ii) Evaceptrapib plus statins did not produce greater increase in HDL-C. These results are consistent with well known findings from other studies.
To put the Nicholls study in perspective: Evaceptrapib therapy is only one among many approaches to treating patients with low HDL-C. Christopher P. Cannon, M.D., of Brigham and Women's Hospital, Boston, notes that while lifestyle change with respect to diet, exercise, and cigarette smoking are known to deliver the desired result, i.e., higher HDL-C, existing guidelines counsel lowering LDL-C. This has benefits regardless of HDL levels. The use of Niacin to increase HDL-C is yet another approach, though the jury is still out on this one. Meanwhile, trials involving Niacin and CTEP inhibitors like Dalcetrapib, Anacetrapib and Evacetrapib are on the anvil.