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PCSK9 inhibitors for treating dyslipidemia in patients at different cardiovascular risk: a systematic review and a

Alessandro Squizzato1,2, Matteo Basilio Suter3, Marta Nerone3

  • 1Department of Medicine and Surgery, Research Center on Dyslipidaemia, University of Insubria, U.O. Medicina Interna 1, ASST Settelaghi, Viale Borri 57, 21100, Varese, Italy. alessandro.squizzato@uninsubria.it.

Internal and Emergency Medicine
|July 12, 2017
PubMed

Insights

PCSK9 inhibitors significantly lower LDL-C in various patient groups. These inhibitors also reduced all-cause mortality, demonstrating their efficacy in cardiovascular risk management.

Area of Science:

  • Cardiovascular Medicine
  • Pharmacology
  • Clinical Research

Background:

  • Statin therapy is crucial for reducing cardiovascular events by lowering LDL-C.
  • Many patients do not achieve target LDL-C levels with statins alone.
  • PCSK9 inhibitors represent a novel therapeutic class for managing hypercholesterolemia.

Purpose of the Study:

  • To systematically review the efficacy and safety of PCSK9 inhibitors.
  • To evaluate PCSK9 inhibitors across diverse cardiovascular risk populations.
  • To assess the impact of PCSK9 inhibitors on LDL-C reduction and clinical outcomes.

Main Methods:

  • Systematic review of randomized controlled trials (RCTs) indexed in MEDLINE and EMBASE until January 2016.
  • Inclusion of 22 RCTs involving 8833 patients with varying cardiovascular risk profiles.
  • Meta-analysis using fixed-effects and random-effects models to determine pooled odds ratios (OR) and mean differences with 95% confidence intervals (CI).

Main Results:

  • PCSK9 inhibitors demonstrated a significant reduction in LDL-C by an average of 48.8% (95% CI -54.1, -43.4).
  • A statistically significant reduction in all-cause mortality was observed (OR = 0.34; 95% CI 0.17, 0.69).
  • A favorable trend towards reducing cardiovascular events was noted (OR = 0.79; 95% CI 0.61, 1.02).

Conclusions:

  • PCSK9 inhibitors effectively lower LDL-C in all patient groups studied, including those with familial hypercholesterolemia and statin intolerance.
  • PCSK9 inhibitors are associated with a significant reduction in all-cause mortality.
  • These findings support the role of PCSK9 inhibitors in managing cardiovascular risk, particularly in patients with elevated LDL-C levels.

Keywords:
DyslipidemiaLipid lowering drugsMonoclonal antibodiesPCSK-9 inhibitors

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