Stuck in a Bind With Phosphate Binders

Scores of observational studies demonstrate that lower high-density lipoprotein cholesterol (HDL-C) concentrations are associated with cardiovascular risk. These associations are supported by mechanistic work in animal models. However, the New England Journal of Medicine recently published the disappointing results of a large clinical trial of evacetrapib, a cholesteryl ester transfer protein inhibitor.1 This medication increased HDL-C concentrations by a remarkable 133%, while reducing low-density lipoprotein cholesterol concentrations by 31%.

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