#384 - Special episode — Obicetrapib: The CETP inhibitor with cardiovascular benefits and potential Alzheimer's prevention
Auto-extracted preview. These recommendations were transcribed and classified from the episode audio. Timestamps link to the source; classifications are not yet editorially verified.
What Peter Attia recommended
In transcript order-
Attia is enthusiastic about obicetrapib, a CETP inhibitor, for lowering LDL-C, ApoB, and Lp(a) on top of maximum lipid-lowering therapy in high-risk cardiovascular patients.
“I haven't been as excited about any drug... as I am with respect to this drug
Dosage10 mg daily added to maximum lipid-lowering therapy (statin ± ezetimibe)CaveatsNot yet FDA-approved in the US; awaiting PREVAIL outcome trial; European approval expected Q4 2026.Certaintyhedgedstrong endorsement -
Don't assume high HDL-C and low LDL-C confers safety—get a calcium score, since SR-B1 loss-of-function carriers can look favorable on lipids yet have severe coronary disease.
“do me a favor and just get a calcium score
Certaintyexplicitrecommendation -
Attia sees a biologically plausible signal that obicetrapib may attenuate Alzheimer's-related biomarker progression, especially in ApoE4 carriers, though this is speculative.
“this signal is strong enough to justify a dedicated prospective prevention trial
Dosage10 mg daily (as used in Broadway biomarker substudy over 12 months)CaveatsBiomarker study only, no cognitive outcomes yet; very small E4/E4 subgroup (n=29); short 12-month follow-up; mechanism uncertain.Certaintyspeculativerecommendation