Lilly drug evacetrapib dramatically raises HDL cholesterol in trial

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Cardiovascular disease may just get the proverbial ‘kick in the butt’ from a new drug that significantly raises good cholesterol – the HDL kind – and lowers the so-called bad cholesterol, or LDL. In a phase II clinical trial, evacetrapib was found to be safe, while boosting good cholesterol as much as 128.8 percent at the highest dose.

The drug inhibits cholesteryl ester transfer protein (CETP), which transfers particles of good cholesterol to bad cholesterol.

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There are currently no strategies to raise HDL cholesterol levels. Statins can keep LDL cholesterol levels down, but drug therapies are lacking to raise high density lipoproteins.

Study results, involving evacetrapib, funded by Eli Lilly and led by researchers at the Cleveland Clinic, were presented at the American Heart Association's annual meeting in Orlando, Fla.

The finding is also published in the Journal of the American Medical Association (JAMA).

Stephen Nicholls MD PhD, Cardiovascular Director of the Cleveland Clinic Coordinating Center for Clinical Research says, in the Phase II clinical trial, “…evacetrapib was able to show striking increases in HDL while significantly lowering LDL.

The next step will be a large cardiovascular outcome trial to determine if this drug can reduce cardiovascular morbidity and mortality."

Though the drug appears to be safe, the phase II trial only 42 patients treated with the highest dose of 500 mg.

Patients in the study were randomized to receive 30, 100 or 500 mg of evacetrapib daily, placebo or statin therapy combined with the CEPT inhibitor.

Cholesterol lowering drugs used in the study included simvastatin 40 mg/day, atorvastatin 20 mg/day or rosuvastatin 10 mg/day. The study included 400 patients who were treated or part of the control group for 12 weeks.

Unlike the CEPT inhibitor torcetrapib, which failed in clinical trials, there were no adverse events with evacetrapib.

Dr Daniel J Rader who presented the study said the cholesterol altering results from evacetrapib are "impressive", but more studies have to be done to ensure the drug is safe and whether inhibiting CEPT will work to prevent cardiovascular events.

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