dal-PLAQUE: phase 2b study of dalcetrapib which increases HDL cholesterol

dal-PLAQUE: phase 2b study of dalcetrapib which increases HDL cholesterol

dal-PLAQUE: phase 2b study of dalcetrapib: Initial studies of increasing HDL cholesterol with cholesteryl ester transfer protein (CETP) inhibitor torcetrapib were a failure and further development of the molecule was halted. Now another CETP modulator dalcetrapib has been evaluated in the dal-PLAQUE phase 2b trial regarding safety and efficacy [Fayad ZA et al. Safety and efficacy of dalcetrapib on atherosclerotic disease using novel non-invasive multimodality imaging (dal-PLAQUE): a randomised clinical trial. Lancet. 2011 Oct 29;378(9802):1547-59]. Multimodality imaging was used to assess the structural and inflammatory indices as primary end points. It was a randomized multicentric trial of patients with or high risk of coronary artery disease with either dalcetrapib 600 milligrams daily or placebo. Total vessel area, wall area, wall thickness, and normalised wall index of carotids were assessed using magnetic resonance imaging after two years. 18F-fluorodeoxyglucose (18F-FDG) positron emission tomographic (PET/CT) assessment of arterial inflammation within an index vessel (right carotid, left carotid, or ascending thoracic aorta) was done after 6 months. Total of one hundred and thirty patients were included in the study. Unlike in the case of torcetrapib, dalcetrapib did not increase the blood pressure. The authors found that there was no evidence of a pathological effect related to the arterial wall with dalcetrapib at two years. There is also a suggestion of beneficial vascular effects including the reduction in total vessel enlargement over two years. The long term safety and clinical efficacy of dalcetrapib needs to analysed further.