Impact of Proprotein Convertase Subtilisin/Kexin Type 9 Inhibitors on Lipoprotein(a)
Background: Lipoprotein(a) [Lp(a)] has been independently associated with increased cardiovascular risk. Objectives: The authors examined the effect of monoclonal antibody proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9is) on plasma Lp(a) levels across multiple trials. Methods: Studi...
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| Language: | English |
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Elsevier
2025-02-01
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| Series: | JACC: Advances |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2772963X24008305 |
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| author | Frederick Berro Rivera, MD Sung Whoy Cha, MD Cruz Linnaeus Louisse, MD Genquen Philip Carado, MD John Vincent Magalong, MD Vincent Anthony Tang, MD Mary Grace Enriquez, MD Martha Gulati, MD, MS Byambaa Enkhmaa, MD, PhD Neha Pagidipati, MD, MPH Nishant P. Shah, MD |
| author_facet | Frederick Berro Rivera, MD Sung Whoy Cha, MD Cruz Linnaeus Louisse, MD Genquen Philip Carado, MD John Vincent Magalong, MD Vincent Anthony Tang, MD Mary Grace Enriquez, MD Martha Gulati, MD, MS Byambaa Enkhmaa, MD, PhD Neha Pagidipati, MD, MPH Nishant P. Shah, MD |
| author_sort | Frederick Berro Rivera, MD |
| collection | DOAJ |
| description | Background: Lipoprotein(a) [Lp(a)] has been independently associated with increased cardiovascular risk. Objectives: The authors examined the effect of monoclonal antibody proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9is) on plasma Lp(a) levels across multiple trials. Methods: Studies were retrieved comparing the effect of PCSK9i vs placebo on Lp(a) levels. The primary outcome was percent change in Lp(a) levels. Factors associated with the treatment effect were determined by meta-regression analysis. Subgroup analyses were done to explore potential treatment effect differences. Results: PCSK9i reduced Lp(a) levels on average of −27% (95% CI: −29.8% to −24.1%, P < 0.001). Factors associated with the treatment effect included mean percent change in low-density lipoprotein cholesterol (P = 0.003, beta coefficient 0.34, 95% CI: 0.11-0.57, tau2 = 94.8, R2 = 11.82) and apolipoprotein B (P < 0.002, beta coefficient 0.4, 95% CI: 0.14-0.64, tau2 = 93.68, R2 = 11.86). Subgroup analyses revealed consistent treatment effect amongst comparators vs placebo: −27.69% (95% CI: −30.85% to −24.54%, P < 0.001), vs ezetimibe: −24.0% (95% CI: −29.95% to −18.01%, P < 0.001), type of PCSK9i, evolocumab: −29.35% (95% CI: −33.56% to −25.14%, P < 0.001) vs alirocumab: −24.50% (95% CI: −27.96% to −21.04%, P < 0.001), and presence of familial hypercholesterolemia: −25.63% (95% CI: −31.96% to −19.30%, P < 0.001 vs no familial hypercholesterolemia: −27.22%; 95% CI: −30.34% to −24.09%, P < 0.001). Varying treatment effects were noted in the duration of treatment (12 weeks or shorter: −32.43% [95% CI: −36.63% to −28.23% vs >12 weeks: −22.31%] [95% CI: −25.13% to −19.49%, P < 0.001]), P interaction < 0.01. Conclusions: PCSK9is reduce Lp(a) levels by an average of 27%. Mean percent change in low-density lipoprotein cholesterol and apolipoprotein B were associated with treatment effect. |
| format | Article |
| id | doaj-art-b667ce208d2940508f3f2e872efdb5f2 |
| institution | Kabale University |
| issn | 2772-963X |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JACC: Advances |
| spelling | doaj-art-b667ce208d2940508f3f2e872efdb5f22025-01-11T06:42:21ZengElsevierJACC: Advances2772-963X2025-02-0142101549Impact of Proprotein Convertase Subtilisin/Kexin Type 9 Inhibitors on Lipoprotein(a)Frederick Berro Rivera, MD0Sung Whoy Cha, MD1Cruz Linnaeus Louisse, MD2Genquen Philip Carado, MD3John Vincent Magalong, MD4Vincent Anthony Tang, MD5Mary Grace Enriquez, MD6Martha Gulati, MD, MS7Byambaa Enkhmaa, MD, PhD8Neha Pagidipati, MD, MPH9Nishant P. Shah, MD10Department of Medicine, Lincoln Medical Center, New York, New York, USA; Address for correspondence: Dr Frederick Berro Rivera, Department of Medicine, Lincoln Medical Center, 234 East 149th Street, The Bronx, New York 10451, USA.Department of Medicine, Cebu Institute of Medicine, Cebu City, PhilippinesUniversity of the Philippines, College of Medicine, Manila, PhilippinesDepartment of Medicine, University of the Philippines–Philippine General Hospital, Manila, PhilippinesUniversity of the Philippines, College of Medicine, Manila, PhilippinesDepartment of Medicine, University of the Philippines–Philippine General Hospital, Manila, PhilippinesUniversity of the Philippines, College of Medicine, Manila, PhilippinesDepartment of Cardiology, Barbra Streisand Women’s Heart Center, Cedars-Sinai Smidt Heart Institute, Los Angeles, California, USADivision of Endocrinology, Diabetes & Metabolism, UC Davis Health, Davis, California, USADivision of Cardiology, Department of Medicine, Duke University Medical Center, Durham, North Carolina, USA; Division of Cardiology, Duke Clinical Research Institute, Durham, North Carolina, USADivision of Cardiology, Department of Medicine, Duke University Medical Center, Durham, North Carolina, USA; Division of Cardiology, Duke Clinical Research Institute, Durham, North Carolina, USABackground: Lipoprotein(a) [Lp(a)] has been independently associated with increased cardiovascular risk. Objectives: The authors examined the effect of monoclonal antibody proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9is) on plasma Lp(a) levels across multiple trials. Methods: Studies were retrieved comparing the effect of PCSK9i vs placebo on Lp(a) levels. The primary outcome was percent change in Lp(a) levels. Factors associated with the treatment effect were determined by meta-regression analysis. Subgroup analyses were done to explore potential treatment effect differences. Results: PCSK9i reduced Lp(a) levels on average of −27% (95% CI: −29.8% to −24.1%, P < 0.001). Factors associated with the treatment effect included mean percent change in low-density lipoprotein cholesterol (P = 0.003, beta coefficient 0.34, 95% CI: 0.11-0.57, tau2 = 94.8, R2 = 11.82) and apolipoprotein B (P < 0.002, beta coefficient 0.4, 95% CI: 0.14-0.64, tau2 = 93.68, R2 = 11.86). Subgroup analyses revealed consistent treatment effect amongst comparators vs placebo: −27.69% (95% CI: −30.85% to −24.54%, P < 0.001), vs ezetimibe: −24.0% (95% CI: −29.95% to −18.01%, P < 0.001), type of PCSK9i, evolocumab: −29.35% (95% CI: −33.56% to −25.14%, P < 0.001) vs alirocumab: −24.50% (95% CI: −27.96% to −21.04%, P < 0.001), and presence of familial hypercholesterolemia: −25.63% (95% CI: −31.96% to −19.30%, P < 0.001 vs no familial hypercholesterolemia: −27.22%; 95% CI: −30.34% to −24.09%, P < 0.001). Varying treatment effects were noted in the duration of treatment (12 weeks or shorter: −32.43% [95% CI: −36.63% to −28.23% vs >12 weeks: −22.31%] [95% CI: −25.13% to −19.49%, P < 0.001]), P interaction < 0.01. Conclusions: PCSK9is reduce Lp(a) levels by an average of 27%. Mean percent change in low-density lipoprotein cholesterol and apolipoprotein B were associated with treatment effect.http://www.sciencedirect.com/science/article/pii/S2772963X24008305alirocumabapolipoprotein Batherosclerotic cardiovascular diseasecholesterolevolocumablow-density lipoprotein |
| spellingShingle | Frederick Berro Rivera, MD Sung Whoy Cha, MD Cruz Linnaeus Louisse, MD Genquen Philip Carado, MD John Vincent Magalong, MD Vincent Anthony Tang, MD Mary Grace Enriquez, MD Martha Gulati, MD, MS Byambaa Enkhmaa, MD, PhD Neha Pagidipati, MD, MPH Nishant P. Shah, MD Impact of Proprotein Convertase Subtilisin/Kexin Type 9 Inhibitors on Lipoprotein(a) JACC: Advances alirocumab apolipoprotein B atherosclerotic cardiovascular disease cholesterol evolocumab low-density lipoprotein |
| title | Impact of Proprotein Convertase Subtilisin/Kexin Type 9 Inhibitors on Lipoprotein(a) |
| title_full | Impact of Proprotein Convertase Subtilisin/Kexin Type 9 Inhibitors on Lipoprotein(a) |
| title_fullStr | Impact of Proprotein Convertase Subtilisin/Kexin Type 9 Inhibitors on Lipoprotein(a) |
| title_full_unstemmed | Impact of Proprotein Convertase Subtilisin/Kexin Type 9 Inhibitors on Lipoprotein(a) |
| title_short | Impact of Proprotein Convertase Subtilisin/Kexin Type 9 Inhibitors on Lipoprotein(a) |
| title_sort | impact of proprotein convertase subtilisin kexin type 9 inhibitors on lipoprotein a |
| topic | alirocumab apolipoprotein B atherosclerotic cardiovascular disease cholesterol evolocumab low-density lipoprotein |
| url | http://www.sciencedirect.com/science/article/pii/S2772963X24008305 |
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