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Evacetrapib was a drug under development by Eli Lilly & Company
(investigational name LY2484595) that inhibits cholesterylester
transfer protein (CETP), which transfers and thereby increases
high-density lipoprotein and lowers low-density lipoprotein (CETP
inhibitor]. It is thought that modifying lipoprotein levels
modifies the risk of cardiovascular disease. The first CETP
inhibitor, torcetrapib, was unsuccessful because it increased
levels of the hormone aldosterone and increased blood pressure,
which led to excess cardiac events when it was studied. Evacetrapib
does not have the same effect. When studied in a small clinical
trial in people with elevated LDL and low HDL, significant
improvements were noted in their lipid profile.
Evacetrapib evaluation for treatment of high-risk vascular disease
was discontinued due to lack of efficacy, as had already happened
in the past with two other CETP inhibitors (torcetrapib and
dalcetrapib) due to increased deaths and little identifiable
cardiovascular benefit (despite substantial increases in HDL). Some
hypothesize that CETP inhibitors may still be useful in the
treatment of dyslipidemia, though significant caution is warranted.
Anacetrapib is the fourth CETP inhibitor being tried for
cardiovascular benefit