Lipid-Lowering Efficacy and Safety of Obicetrapib Alone and as an Add on Therapy: A Meta-Analysis of Randomized Controlled Trials

Obicetrapib is a cholesteryl ester transfer protein inhibitor that demonstrated reductions in atherogenic lipoproteins. We systematically searched PubMed, Scopus, and Clinicaltrials.gov for relevant randomized controlled trials from inception until September 2, 2025 to evaluate the efficacy and safety outcomes of obicetrapib as a standalone and add-on therapy. The mean difference (MD) with 95% confidence intervals (CI) was pooled using a random effects model. A total of 3512 patients were included. Obicetrapib significantly reduced low-density lipoprotein cholesterol MD, −37.45 (95% CI, −43.76 to −31.15), P < 0.001, non-high-density lipoprotein (HDL) cholesterol MD, −32.04 (95% CI, −38.49 to −25.60), P < 0.001, apolipoprotein B MD, −24.71 (95% CI, −30.79 to −18.63), P < 0.001 and apolipoprotein A MD, −39.10 (95% CI, −45.35 to −32.85), P < 0.001. It significantly increased total cholesterol MD, +10.41 (95% CI, 3.68–17.15), P < 0.001, HDL cholesterol MD, +147.98 (95% CI, 129.23–166.54), P < 0.001, apolipoprotein A1 MD, 55.54 (95% CI, 43.37–67.71), and apolipoprotein E MD, 53.24 (95% CI, 39.04–67.44), P < 0.001. As an add-on therapy to ezetimibe, obicetrapib yielded greater reduction in low-density lipoprotein MD, −51.99 (95% CI, −61.61 to −42.37), P < 0.001 and non-HDL MD, −50.32 (−55.42 to −45.21), P < 0.001. No significant effects were observed when combined with statins.