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Efficacy and Safety of Alirocumab and Evolocumab As Proprotein Convertase Subtilisin/Kexin Type 9 (Pcsk9) Inhibitors in Familial Hypercholesterolemia: A Systematic Review and Meta-Analysis Publisher Pubmed



Ghasempour G1 ; Zamanigarmsiri F2 ; Shaikhnia F3 ; Soleimani AA2 ; Fard SRH2 ; Leila J4 ; Teimuri S5 ; Parvaz N6 ; Mohammadi P1 ; Najafi M6, 7
Authors
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Authors Affiliations
  1. 1. Davee Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
  2. 2. Department of Clinical Biochemistry, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Department of Clinical Biochemistry, Faculty of Medicine, Uraemia University of Medical Sciences, Uraemia, Iran
  4. 4. Department of Biostatistics, School of Public Health, Iran University, of Medical Sciences, Tehran, Iran
  5. 5. Institute of Cell Biology, University of Bern, Bern, Switzerland
  6. 6. Department of Clinical Biochemistry, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
  7. 7. Microbial Biotechnology Research Center, Iran University of Medical Sciences, Tehran, Iran

Source: Current Medicinal Chemistry Published:2024


Abstract

Background: Familial hypercholesterolemia (FH) is a prevalent and potentially fatal illness that causes a substantial elevation in low-density lipoprotein cholesterol (LDL-C). Objective: The aim of this study was to investigate the effects of monoclonal antibodies alirocumab and evolocumab on LDL-C and other lipid parameters, as well as their safety in familial hypercholesterolemia patients. Methods: A comprehensive search was done on PubMed/MEDLINE, EMBASE, Web of Science (WOS/ ISI), Scopus, ClinicalTrials (www.ClinicalTrials.gov), and conferences/ congress research papers. Random effect models were used to calculate mean differences (%) and risk ratios (RRs), and confidence intervals (95%). Results: Ten studies (n=1489 patients) were included in this study. PCSK9 inhibitors decreased the levels of LDL-C by-49.59% (95%CI-55.5%,-43.67%) as compared to placebo. They also didn’t alter the Treatment-Emergent Adverse Event (TEAE) and neuronal events by RR 0.92 (0.75, 1.13) and 1.31 (0.66, 2.59), respectively. PCSK9 inhibitors were effective and safe in treating patients with FH. Conclusion: There was high-quality evidence showing that monoclonal antibodies (alirocumab & evolocumab) lower LDL-C (GRADE: high), lipoprotein (a) (GRADE: High), triglycerides (TG) (GRADE: High), total cholesterol (GRADE: High), non-high-density lipoprotein cholesterol (nonHDL-C) (GRADE: Moderate), and apolipoprotein B (GRADE: High), and increase the HDL-C (GRADE: High) as well as apolipoprotein A1 (GRADE: High). Comparing PCSK9 inhibitors against placebo, neither TEAE (GRADE: high) nor neuronal events (GRADE: moderate) were changed. © 2024 Bentham Science Publishers.
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