Obicetrapib is a once-daily oral medication that lowers the "bad" cholesterol driving artery disease, for adults above their goals despite standard cholesterol medications or unable to tolerate them. This lowering is strong and well replicated. Signals of fewer heart attacks, less new diabetes and slower Alzheimer's-related blood changes remain unproven. Side effects were mostly close to placebo; genetic studies raise a possible long-term risk to central vision. (Full Review)
| Marker | Target | Why |
|---|---|---|
| LDL cholesterol (direct or Martin/Hopkins) | <55 mg/dL (ESC/EAS 2019 goal for very-high-risk patients) | Expected to change: main efficacy target |
| ApoB | <65 mg/dL (ESC/EAS 2019 goal for very-high-risk patients) | Expected to change: count of artery-clogging particles |
| Lipoprotein(a) | No established target; one baseline and one on-treatment value | Expected to change: falls about 37% |
| HDL cholesterol | No established target; expect a large rise | Expected to change: confirms drug effect and adherence |
| ALT and AST | Within laboratory reference range | Safety check: rise >3× upper limit of normal prompts review |
| Creatinine and eGFR | Creatinine within laboratory reference range; eGFR tracked against own baseline | Safety check and expected to change: kidney decline may slow |
| HbA1c | 4.0–5.6% | Expected to change: diabetes risk may fall |
| Blood pressure | Systolic 120–129 mmHg (ESC 2024 target for most treated adults) | Safety check: hypertension is a listed side effect |
| Retinal examination | No established target; track new drusen (retinal deposits) or macular changes | Safety check: theoretical macular degeneration risk |
Cadence: All markers at baseline; lipids and apoB at 4–12 weeks, then every 6–12 months; liver enzymes at 3 months, then yearly; creatinine, eGFR and HbA1c yearly; home blood pressure for the first 4–8 weeks, then at each visit; eye examination every 1–2 years