Financiado en parte por Amgen
Systematic Review and Network Meta-Analysis on the Efficacy of Evolocumab and Other Therapies for the Management of Lipid Levels in Hyperlipidemia
Toth PP, Worthy G, Gandra SR, Sattar N, Bray S, Cheng LI, Bridges I, Worth GM, Dent R, Forbes CA, Deshpande S, Ross J, Kleijnen J, Stroes ESG
Journal of the American Heart Association · 62 citas
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Cómo se estudió
- Diseño
- Metaanálisis (indexado por PubMed)
- Estudiado en
- Personas
- Resultado principal
- Marcadores de salud y funcionamiento
Quién lo pagó
- Financiación
- Financiado por la industria
- Empresa
- Amgen
- Autores
- Al menos un autor declara un vínculo económico con la industria
Según 1 financiador declarado y la declaración de financiación del texto completo.
Publicación
- Publicado
- 2017-10-03 · J Am Heart Assoc · vol. 6 · número 10
- Editorial
- Wiley
- Citado
- 92 citas · más que el 91% de estudios similares · 2.4× el promedio de su campo
- Impacto
- Entre el 10 % más citado de su campo
- Referencias
- 48 trabajos
- Acceso
- Acceso abierto (revista) · CC-BY-NC-ND
- Áreas de investigación
- Lipoproteins and Cardiovascular Health · Lipid metabolism and disorders · Cholesterol and Lipid Metabolism
- Palabras clave
- evolocumab, alirocumab, PCSK9 inhibitors, hyperlipidemia, LDL cholesterol lowering, ezetimibe, statin therapy, lipid-lowering therapy, adverse events
- MeSH
- humans, cardiovascular diseases, lipids, antibodies, monoclonal, anticholesteremic agents, hydroxymethylglutaryl-coa reductase inhibitors, serine proteinase inhibitors, treatment outcome, drug therapy, combination, risk factors, down-regulation, adult, aged, aged, 80 and over, middle aged, female, male, hyperlipidemias, randomized controlled trials as topic, antibodies, monoclonal, humanized, biomarkers, proprotein convertase 9, pcsk9 inhibitors
14 autores
- Peter Paul Toth🇺🇸Johns Hopkins University; CGH Medical Center
- Gillian Worthy🇺🇸🇬🇧Amgen (United States); Kleijnen Systematic Reviews (United Kingdom)
- Shravanthi R. Gandra🇺🇸Amgen (United States)
- Naveed A. Sattar🇬🇧University of Glasgow
- Sarah L Bray🇺🇸Amgen (United States)
- Lung‐I Cheng🇺🇸Amgen (United States)
- Ian M. Bridges🇺🇸Amgen (United States)
- Gavin M. Worth🇺🇸Amgen (United States)
- Ricardo E. Dent🇺🇸Amgen (United States)
- Carol A. Forbes🇬🇧Kleijnen Systematic Reviews (United Kingdom)
- Sohan Deshpande🇬🇧Kleijnen Systematic Reviews (United Kingdom)
- Janine Ross🇬🇧Kleijnen Systematic Reviews (United Kingdom)
- Jos Kleijnen🇳🇱🇬🇧Maastricht University; Kleijnen Systematic Reviews (United Kingdom)
- Erik S.G. Stroes🇳🇱University of Amsterdam
Resumen
El texto original del estudio, en el idioma en que se publicó.
Background
The proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors evolocumab and alirocumab substantially reduce low-density lipoprotein cholesterol (LDL-C) when added to statin therapy in patients who need additional LDL-C reduction.
Methods and results
We conducted a systematic review and network meta-analysis of randomized trials of lipid-lowering therapies from database inception through August 2016 (45 058 records retrieved). We found 69 trials of lipid-lowering therapies that enrolled patients requiring further LDL-C reduction while on maximally tolerated medium- or high-intensity statin, of which 15 could be relevant for inclusion in LDL-C reduction networks with evolocumab, alirocumab, ezetimibe, and placebo as treatment arms. PCSK9 inhibitors significantly reduced LDL-C by 54% to 74% versus placebo and 26% to 46% versus ezetimibe. There were significant treatment differences for evolocumab 140 mg every 2 weeks at the mean of weeks 10 and 12 versus placebo (-74.1%; 95% credible interval -79.81% to -68.58%), alirocumab 75 mg (-20.03%; 95% credible interval -27.32% to -12.96%), and alirocumab 150 mg (-13.63%; 95% credible interval -22.43% to -5.33%) at ≥12 weeks. Treatment differences were similar in direction and magnitude for PCSK9 inhibitor monthly dosing. Adverse events were similar between PCSK9 inhibitors and control. Rates of adverse events were similar between PCSK9 inhibitors versus placebo or ezetimibe.
Conclusions
PCSK9 inhibitors added to medium- to high-intensity statin therapy significantly reduce LDL-C in patients requiring further LDL-C reduction. The network meta-analysis showed a significant treatment difference in LDL-C reduction for evolocumab versus alirocumab.
Resumen vía Europe PMC. Los derechos de autor siguen siendo de los autores o la editorial (CC BY-NC-ND).
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