Barter - Figure 26 - ILLUMINATE vs DEFINE

This Figure compares the published endpoint results from the ILLUMINATE trial[25] (with torcetrapib) and the DEFINE trial[26] (with anacetrapib). This is not a formal analysis, it simply a comparison. As illustrated in the Figure, the combined endpoint in ILLUMINATE was an overall statistically significantly negative result with the CETP inhibitor, whereas in DEFINE, although the results for 2 of the outcomes crossed the line of unity (except for revascularization alone) and so were not statistically significant, nevertheless the trend was clearly for a positive outcome with CETP inhibition. This negative versus positive overall profile holds true, whether looking at

total cardiovascular events, cardiovascular disease, MI, or unstable angina
revascularization
death, MI, stroke, unstable angina, or revascularization

Thus these results with anacetrapib were clearly sufficiently encouraging to suggest that it is worthwhile to proceed with a real outcomes trial designed to test the hypothesis that in patients well-treated with statins, and who still have residual risk, that residual risk will be reduced by treatment with a CETP inhibitor that is apparently safe.

Barter P. J Clin Lipidol. 2011; 5(6).

Complete references for all slides

References

[25]Barter PJ, Caulfield M, Eriksson M, et al. Effects of Torcetrapib in Patients at High Risk for Coronary Events. N Engl J Med 2007;357:2109-22.

[26]Cannon CP et al. Safety of anacetrapib in patients with or at high risk of coronary heart disease. N Engl J Med 2010; 363: 2406–13.