TORCETRAPIB: Reports from three manufacturer-sponsored studies of torcetrapib Ñ ILLUSTRATE, RADIANCE, and ILLUMINATE Ñ were published in 2007 suggesting that the drug increased blood pressure levels and failed to halt the progression of atherosclerosis. ILLUMINATE (torcetrapib) Stopped early due to incr mortality. This may be mediated activation of aldosterone and high BP and may be off-target and not class-specifc (drug-specific), which may open the door to other CETP inhibs. It is possible that it may also stimulate cortisol. These adverse events occurred despite a significant HDL incr and HDL red. However, rates of CHD death/MI were lowest in torcetrapib-treated patients with the biggest increases in HDL levels. Similar data were also presented from the ILLUSTRATE IVUS study, which showed that increasing levels of HDL from torcetrapib treatment were associated with a beneficial impact on atherosclerotic plaque progression. Reporting the results, Dr Steven Nicholls (Cleveland Clinic) said, "At the highest level of HDL, there was a clear regression of plaque. This was very clear-cut. We also found that in patients with reduced potassium levels, we no longer saw this benefit of high HDL, suggesting that stimulation of aldosterone is mitigating the benefit of raising HDL."