Apabetalone is an oral inhibitor of bromodomain and extraterminal (BET) proteins — epigenetic modulators with proposed roles in inflammatory and thrombogenic processes. The Phase 3 BETonMACE trial in patients with type 2 diabetes and high cardiovascular risk showed no statistical benefit of apabetalone on major adverse cardiovascular events (MACE). Now, a prespecified analysis of BETonMACE demonstrates that in the subgroup of patients with chronic kidney disease, apabetalone use was associated with a reduced risk of MACE (HR 0.50; 95% CI 0.26–0.96) and heart failure hospitalization (HR 0.25; 95% CI 0.07–0.92; P = 0.04).
