Obicetrapib is an oral prescription medication that lowers artery-clogging cholesterol, approved in Europe in 2026. For health-focused adults above target despite treatment, or intolerant of standard cholesterol tablets, it offers a well-documented, injection-free drop. Benefit on heart attacks and strokes is not yet established; diabetes, kidney and brain hints rest on limited evidence. Short-term side-effect rates resemble an inactive tablet; an eye-disease question is unresolved; almost all evidence is developer-funded. (Full Review)
| Marker | Target | Why |
|---|---|---|
| LDL-C | <55 mg/dL (very high cardiovascular risk) | Main efficacy marker |
| ApoB | <65 mg/dL (very high cardiovascular risk) | Best marker of artery-clogging particle number |
| Non-HDL cholesterol | <85 mg/dL (very high cardiovascular risk) | Total artery-clogging cholesterol |
| Lp(a) | <75 nmol/L (<30 mg/dL); change from own baseline | Expected to fall about 35–45% |
| HDL-C | ≥40 mg/dL in men, ≥50 mg/dL in women; roughly a doubling from own baseline | Confirms drug exposure and adherence |
| HbA1c | 4.0–5.6% | May improve; also a safety check |
| Fasting glucose | Not specified in the ER | Usual paired test with HbA1c |
| Creatinine / eGFR | ≥60 mL/min/1.73 m² | Safety check |
| ALT / AST | ALT 7–56 U/L; AST 8–48 U/L | Safety check: a sustained rise changes use |
| Creatine kinase | About 30–200 U/L | Safety check if muscle pain appears |
| Blood pressure | No sustained rise | Hypertension reported in trials |
Cadence: Baseline before starting, including a week of home blood-pressure readings and a dilated retinal exam or retinal scan; lipids, apoB and blood pressure at 4–8 weeks, then every 6–12 months; HbA1c, eGFR and liver enzymes every 6–12 months; creatine kinase only if muscle symptoms appear; retinal examination every 1–2 years.