A once-daily oral medication that blocks the blood protein moving cholesterol into plaque-forming particles. It lowered every harmful cholesterol measure substantially, including an inherited particle type most oral medications leave untouched, with side effects over a year matching inactive treatment. Whether this means fewer heart attacks, strokes and deaths is still being tested. Nearly all evidence comes from its developer. (Full Review)
| Marker | Target | Why |
|---|---|---|
| Apolipoprotein B | < 60 mg/dL; < 50 mg/dL with established artery disease | Counts atherogenic particles; the primary success variable |
| LDL cholesterol | < 55 mg/dL with established artery disease; < 70 mg/dL otherwise | Tracks the endpoint used in every trial; needed for comparability |
| Lipoprotein(a) | < 75 nmol/L (< 30 mg/dL) | The genetically fixed risk component that obicetrapib uniquely lowers among oral agents |
| Non-HDL cholesterol | < 85 mg/dL with established artery disease | Captures cholesterol on all atherogenic particles including remnants |
| HDL cholesterol | Watch rather than target; note if above 100 mg/dL | Confirms pharmacological effect; flags entry into an unstudied range |
| High-sensitivity C-reactive protein | < 1.0 mg/L; < 0.5 mg/L optimal | Residual inflammatory risk, which lipid lowering does not address |
| Alanine aminotransferase and aspartate aminotransferase | ALT < 25 U/L (men), < 20 U/L (women) | Liver safety on a compound cleared hepatically and taken with a statin |
| Creatine kinase | Within laboratory reference range | Distinguishes statin myopathy from unrelated muscle symptoms |
| Creatinine with estimated glomerular filtration rate | eGFR > 90 mL/min/1.73 m² | Kidney function, where a favourable but unconfirmed signal exists |
| Potassium | 4.0–4.5 mmol/L | The specific laboratory signature of the torcetrapib failure |
| Glycated hemoglobin | 4.8–5.2% | Glycemic effect, monitored because statins worsen it and CETP inhibitors may not |
| Seated blood pressure | < 120/80 mm Hg | The parameter that revealed the class's most serious historical harm |
Cadence: Baseline before the first dose; full repeat panel at 12 weeks; confirmatory panel at 6 months; thereafter every 6 to 12 months indefinitely. Blood pressure at baseline, 12 weeks and annually. Dilated retinal examination every 24 months in those over 60 or with a family history of macular degeneration.