Lipoprotein(a) reduction with inclisiran, alirocumab, evolocumab, enlicitide, and lerodalcibep: A systematic review and meta-analysis of randomized controlled trials
Mulligan MD, Gandhi RS, Vishwakarma R, Bhattacharya R
Journal of clinical lipidology · 0 citas
Cómo se estudió
- Diseño
- Metaanálisis (indexado por PubMed)
- Estudiado en
- Personas
- Resultado principal
- Marcadores de salud y funcionamiento
Quién lo pagó
- Financiación
- Financiación independiente
- Universidad u hospital
- Harvard University
- Universidad u hospital
- Harvard Catalyst
- Gobierno
- Irish Research Council
- Gobierno
- National Institutes of Health
- Gobierno
- National Center for Advancing Translational Sciences
- Gobierno
- NCATS NIH HHS
- Subvenciones
- Harvard University (1K12TR004381-01); Irish Research Council (GOIPG/2023/5216)
Según 6 financiadores declarados.
Publicación
- Publicado
- 2026-04-01 · J Clin Lipidol · vol. 20 · número 6 · págs. 1054–1064
- Editorial
- Elsevier BV
- Citado
- 8 citas · más que el 100% de estudios similares · 21.2× el promedio de su campo
- Impacto
- Entre el 10 % más citado de su campo
- Referencias
- 71 trabajos
- Acceso
- De pago
- Áreas de investigación
- Lipoproteins and Cardiovascular Health · Lipid metabolism and disorders · Cholesterol and Lipid Metabolism
- Palabras clave
- lipoprotein(a), PCSK9 inhibitors, inclisiran, alirocumab, evolocumab, atherosclerotic cardiovascular disease, agent selection, dosing frequency, lipid-lowering therapy, PCSK9 inhibition
- MeSH
- humans, lipoprotein(a), recombinant fusion proteins, antibodies, monoclonal, randomized controlled trials as topic, antibodies, monoclonal, humanized, proprotein convertase 9, pcsk9 inhibitors
4 autores
- Martin D. Mulligan🇮🇪Ollscoil na Gaillimhe – University of Galway
- Rahul S Gandhi🇳🇿Wellington Hospital; North Shore Hospital; Health New Zealand
- Rishabh Vishwakarma🇮🇪Trinity College Dublin
- Romit Bhattacharya🇺🇸 · autor de correspondenciaBroad Institute; Massachusetts General Hospital
Resumen
El texto original del estudio, en el idioma en que se publicó.
Background and aims
Lipoprotein(a) [Lp(a)] is a causal contributor to atherosclerotic cardiovascular disease (ASCVD). While no therapies are currently approved solely for lowering Lp(a), subgroup analyses suggest that individuals with elevated Lp(a) may gain added benefit from intensive lipid-lowering strategies. No prior meta-analysis has compared evolocumab, alirocumab, inclisiran, lerodalcibep, and enlicitide in their Lp(a)-lowering efficacy. We aimed to determine whether proprotein convertase subtilisin/kexin type 9 (PCSK9) targeted therapies differ significantly in Lp(a) reduction, or whether agent selection can be guided primarily by other factors such as dosing frequency, cost, and patient preference.
Sources of material
We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) reporting percent change in Lp(a) following treatment with the 5 PCSK9-targeted agents. A random-effects model calculated pooled estimates of percentage Lp(a) change, and mixed-effects meta-regression assessed differences between agents.
Abstract of findings
Thirty-one RCTs were included. PCSK9 inhibitors and inclisiran reduced Lp(a) by a pooled mean of -25.76% vs control (95% CI -29.54 to -21.99; P < .0001). Meta-regression revealed no significant differences between agents (alirocumab vs evolocumab: +3.3%, 95% CI -1.40 to 8.07, P = .16; inclisiran vs evolocumab: +4.9%, 95% CI -2.31 to 12.16, P = .18; inclisiran vs alirocumab: +1.6%, 95% CI -5.38 to 8.55, P = .65). Lerodalcibep and enlicitide demonstrated similar approximate 25% reductions; however, insufficient trial numbers precluded a powered head-to-head comparison.
Conclusions
No statistically significant differences in Lp(a) reduction were observed between currently available PCSK9-targeting medications. Agent selection may reasonably be based on non-efficacy factors, including administration frequency, cost, and patient preference.
Resumen vía Europe PMC. Los derechos de autor siguen siendo de los autores o la editorial.
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