Work

Comparative effectiveness of cholesteryl ester transfer protein (CETP) inhibitors on cardiovascular outcomes: A comprehensive Bayesian network meta-analysis and network meta-regression

Year: 2026

Type: article

Study designs: Systematic Review, Meta-Analysis

Abstract: BACKGROUND: Cardiovascular disease remains the leading cause of mortality worldwide, with residual cardiovascular (CVS) risk remaining high despite pharmacological interventions. Cholesteryl ester transfer protein (CETP) inhibitors have shown promise in improving lipid profiles, but their comparative effectiveness in reducing CVS outcomes remains unclear. This network meta-analysis and network meta-regression aimed to evaluate the comparative effectiveness of CETP inhibitors (Evacetrapib, Anacetrapib, Dalcetrapib, and Torcetrapib) on CVS outcomes, including CVS mortality, all-cause mortality, major adverse cardiovascular events, myocardial infarction, need for revascularization, and stroke. METHODS: A Bayesian network meta-analysis was conducted, incorporating data from 10 randomized controlled trials with 84,134 patients diagnosed with cardiovascular disease or at high risk. We compared various CETP inhibitors for their effectiveness in reducing CVS events. Network meta-regression was used to assess the impact of covariates such as age, sex, and baseline lipid levels. RESULTS: Evacetrapib ranked highest for CVS mortality (relative risk [RR]: 0.92, 95% credible interval [CrI]: 0.39-1.87; Surface Under the Cumulative Ranking Curve [SUCRA]: 71.91%) and Anacetrapib for major adverse cardiovascular events (RR: 0.40, 95% CrI: 0.07-1.06; SUCRA: 84.25%). Dalcetrapib showed favorable effects on all-cause mortality (RR: 0.72, 95% CrI: 0.16-1.42; SUCRA: 67.51%) and stroke (RR: 0.75, 95% CrI: 0.41-1.26; SUCRA: 83.03%). Anacetrapib had the highest rank in reducing myocardial infarction (RR: 0.83, 95% CrI: 0.46-1.15; SUCRA: 86.06%). CONCLUSIONS: This analysis suggests that Evacetrapib and Anacetrapib are the most effective CETP inhibitors for improving CVS outcomes, with Dalcetrapib showing beneficial effects in certain outcomes. Further studies are needed to confirm these findings.

Source: Medicine

DOI: 10.1097/md.0000000000048627