APOE4 and Heart Health: A New Drug Shows Dual Promise for Brain and Arteries
Could one little pill help both your heart and your brain? That’s the big question behind a new drug called Obicetrapib, currently in clinical trials — and the early results are turning heads, especially for those of us carrying the APOE4 gene.
💊 What Is Obicetrapib?
Obicetrapib (pronounced oh-bi-SE-tra-pib) is part of a new class of drugs called CETP inhibitors. CETP is a protein in the body that helps move cholesterol around — especially from “good” HDL cholesterol to the “bad” LDL type that clogs arteries.
By blocking CETP, obicetrapib:
Raises HDL (the good stuff)
Lowers LDL (the bad stuff)
And may do something even more exciting — reduce key Alzheimer’s disease biomarkers in the blood.
The BROADWAY Trial: What They Found
In a recent large study called the BROADWAY trial, over 2,500 people with existing heart disease were given either obicetrapib or a placebo. Everyone in the study was already on cholesterol-lowering medication, but this new drug added even more benefit:
✅ 33% reduction in LDL cholesterol
✅ Mild, well-tolerated side effect profile
✅ And in a special sub-study… APOE4 carriers saw a significant drop in a key Alzheimer’s biomarker called p‑tau217 — a protein strongly linked to early brain changes in Alzheimer’s disease.
👀 Why This Matters for APOE4s
As APOE4 gene carriers, we know that our risk for both cardiovascular disease and Alzheimer’s is elevated. Many of us are already taking steps — from fasting and exercise to red light therapy and targeted supplements.
But Obicetrapib represents something new:
A pharmaceutical tool that might protect both the heart and brain at the same time
Early data shows APOE4s responded especially well
And importantly, no increase in side effects was seen in APOE4/4 users
This could eventually become an important dual-purpose option for prevention — especially for those of us seeking a well-rounded, science-based approach to managing APOE4 risk.
⏳ When Will It Be Available?
Right now, Obicetrapib is still in clinical trials. The next big one — called PREVAIL — is ongoing, and results are expected in late 2026.
If those results are positive, the drug could be approved by 2027.
The Takeaway
While it's not on the market yet, Obicetrapib is one to watch. It’s one of the first drugs to show meaningful Alzheimer’s biomarker improvement in APOE4 carriers, while also dramatically lowering LDL cholesterol. For many of us, it represents a hopeful glimpse into the future of targeted prevention — something that treats the underlying mechanisms driving both heart and brain disease.
I'll be following this closely and will update you as more data becomes available.