title: Dalcetrapib--restoring belief in modulating CETP as a beneficial mechanism in cardiovascular disease.
abstract: BACKGROUND
  As low HDL cholesterol levels are a risk factor for cardiovascular disease, raising HDL cholesterol substantially by inhibiting or modulating cholesteryl ester transfer protein (CETP) may be useful in coronary artery disease. The first CETP inhibitor that went into clinical trial, torcetrapib, was shown to increase the levels of HDL cholesterol, but it also increased cardiovascular outcomes, probably due to an increase in blood pressure and aldosterone secretion, by an off-target mechanism/s.
  
  
  OBJECTIVE
  Dalcetrapib is a new CETP modulator that increases the levels of HDL cholesterol, but does not increase blood pressure or aldosterone secretion. The objective was to evaluate a paper describing the effects of dalcetrapib on carotid and aortic wall thickness in subjects with, or at high risk of, coronary artery disease, the dal-PLAQUE study.
  
  
  RESULTS
  dal-PLAQUE showed that dalcetrapib reduced the progression of atherosclerosis and may also reduce the vascular inflammation associated with this, in subjects with, or with high risk of, coronary heart disease, who were already taking statins.
  
  
  CONCLUSIONS
  These results suggest that modulating CETP with dalcetrapib may be a beneficial mechanism in cardiovascular disease. The results of the dal-HEART series, which includes dal-PLAQUE 1 and 2, and dal-OUTCOMES, when complete, will provide more definitive information about the benefit, or not, of dalcetrapib in coronary artery disease.
authors.affiliation: Queensland University of Technology, Discipline of Medical Sciences, Faculty of Science and Technology, GPO 2434, QLD 4001, Brisbane, Australia. sheila.doggrell@qut.edu.au
authors.forename: Sheila A
authors.initials: SA
authors.lastname: Doggrell