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Pexelizumab in ischemic heart disease: a systematic review and meta-analysis on 15,196 patients

L Testa1, W J Van Gaal, R Bhindi

  • 1Institute of Cardiology, John Radcliffe Hospital, Oxford, United Kingdom. luctes@gmail.com

The Journal of Thoracic and Cardiovascular Surgery
|October 29, 2008
PubMed

Insights

Pexelizumab did not improve outcomes for ST-elevation myocardial infarction patients. However, this C5 complement inhibitor reduced the risk of death in patients undergoing coronary artery bypass surgery.

Area of Science:

  • Cardiology
  • Immunology
  • Pharmacology

Background:

  • Pexelizumab, a humanized monoclonal antibody, targets the C5 complement pathway.
  • It was investigated for its potential to improve outcomes in ST-elevation myocardial infarction (STEMI) and coronary artery bypass grafting (CABG).

Purpose of the Study:

  • To evaluate the risk-benefit profile of pexelizumab in patients with STEMI or undergoing CABG.
  • To assess the efficacy of pexelizumab when added to current treatment protocols.

Main Methods:

  • A systematic review and meta-analysis of randomized controlled trials was conducted.
  • Searches included BioMedCentral, CENTRAL, mRCT, and PubMed up to October 2007.
  • Primary outcomes included major adverse events (death, myocardial infarction, stroke) and heart failure.

Main Results:

  • Across seven trials with 15,196 patients, pexelizumab showed no significant benefit for major adverse events in STEMI or CABG patients.
  • No improvement was observed for all-cause death, myocardial infarction, stroke, or heart failure in the overall analysis.
  • Pexelizumab demonstrated a significant 26% reduction in the risk of death for patients undergoing coronary artery bypass surgery (OR 0.74; P = .01), with a number needed to treat of 100.

Conclusions:

  • Pexelizumab does not offer additional benefits to current therapies for ST-elevation myocardial infarction.
  • Pexelizumab significantly reduces the risk of mortality in patients undergoing coronary artery bypass grafting.
Abstract

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