#384 - Special episode — Obicetrapib: The CETP inhibitor with cardiovascular benefits and potential Alzheimer's prevention
Release Date: 03/16/2026
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The Peter Attia Drive
In this “Ask Me Anything” (AMA) episode, Peter answers listener questions across a wide range of topics, focusing on how to think through real-world trade-offs and apply scientific evidence in practice. He explores how to build and interpret a meaningful family health history, how individual risk tolerance influences decisions around testing and treatment, and why heart disease remains poorly prevented despite available tools. He also examines whether it’s possible to carry excess body fat while remaining metabolically healthy, outlines the minimum effective dose for strength training...
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#386 - Aging clocks—what they measure, how they work, and their clinical and real-world relevance
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#385 - AMA #82: Applying the tools of longevity in the real world: disease prevention, DEXA scans, artificial sweeteners, injury recovery, stability training, habit formation, protein intake and mTOR activation, and more
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In this “Ask Me Anything” (AMA) episode, Peter answers listener questions across a wide range of topics, focusing on practical decision-making and real-world application. He explores how health priorities and strategies should evolve across different decades of life, which chronic diseases are most challenging to manage and how to think about risk hierarchies, and which emerging interventions—beyond exercise—show the most promise for dementia prevention. Peter also breaks down the utility of wearables and explains how to use and interpret DEXA scans effectively. He discusses the...
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#384 - Special episode — Obicetrapib: The CETP inhibitor with cardiovascular benefits and potential Alzheimer's prevention
The Peter Attia Drive
In this special episode, Peter takes a deep dive into obicetrapib, an investigational drug that has captured his attention and renewed interest in an entire class of therapies known as CETP inhibitors. He explains what obicetrapib is and how it works, revisits the history of CETP inhibitors and why earlier versions of these drugs failed—sometimes dramatically—and breaks down the key clinical trials designed to evaluate their impact on cardiovascular risk. Peter examines how obicetrapib influences major lipid biomarkers, including LDL cholesterol and lipoprotein(a) [Lp(a)], and discusses...
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#379 - AMA #79: A guide to cardiorespiratory training at any fitness level to improve healthspan, lifespan, and long-term independence
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#378 ‒ Women’s health and performance: how training, nutrition, and hormones interact across life stages | Abbie Smith-Ryan, Ph.D.
The Peter Attia Drive
Abbie Smith-Ryan is a leading researcher in exercise physiology whose work focuses on how training and nutrition influence body composition, metabolism, cardiovascular health, and women’s health across the lifespan, with particular attention on perimenopause and post-menopause. In this episode, Abbie explains how early exercise and play help build the foundation for bone health, muscle development, and cardiorespiratory fitness in girls, as well as how puberty and menstruation shape athletic performance, motivation, and recovery. She also explores how women can tailor training and...
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In this special episode, Peter takes a deep dive into obicetrapib, an investigational drug that has captured his attention and renewed interest in an entire class of therapies known as CETP inhibitors. He explains what obicetrapib is and how it works, revisits the history of CETP inhibitors and why earlier versions of these drugs failed—sometimes dramatically—and breaks down the key clinical trials designed to evaluate their impact on cardiovascular risk. Peter examines how obicetrapib influences major lipid biomarkers, including LDL cholesterol and lipoprotein(a) [Lp(a)], and discusses emerging evidence from a study that explored the drug’s effects on Alzheimer’s-related blood biomarkers. He also highlights intriguing findings in individuals carrying the APOE4 allele and reflects on what these early results may mean for both cardiovascular disease prevention and potential implications for Alzheimer’s risk, as well as how he is thinking about this therapy in the context of caring for his own patients.
We discuss:
- Introducing obicetrapib: CETP inhibitor history, lipid biology, and early Alzheimer’s biomarker signals in APOE4 carriers [2:15];
- CETP biology explained: lipoproteins, reverse cholesterol transport, and how CETP inhibition alters HDL and LDL particles [5:15];
- The early CETP inhibitor story: why raising HDL cholesterol alone failed to deliver cardiovascular protection [13:45];
- The rise and fall of early CETP inhibitors: torcetrapib, dalcetrapib, evacetrapib, and anacetrapib [18:30];
- Why obicetrapib may succeed where earlier CETP inhibitors failed [23:30];
- The BROADWAY trial: obicetrapib’s effects on LDL, ApoB, Lp(a), and residual cardiovascular risk [26:00];
- Brain lipid metabolism and APOE4: how CETP inhibition may influence cholesterol transport in Alzheimer’s disease [30:45];
- Findings from the substudy of the BROADWAY trial which looked at changes in biomarkers of Alzheimer’s disease [40:00];
- Interpreting the BROADWAY Alzheimer’s biomarker results: limitations, cautious optimism, and the need for a dedicated prevention trial [46:45];
- Why Peter is optimistic about obicetrapib: cardiovascular benefits, Lp(a) reduction, and the path toward approval [50:00]; and
- More.
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