Meta-Analysis of Inclisiran for the Treatment of Hypercholesterolemia

Autor: Sajjad Ahmad Khan, Muhammad Qamar Masood, Arshi Naz, Rahman Shah
Rok vydání: 2020
Předmět:
Male
Oncology
Myocardial Infarction
030204 cardiovascular system & hematology
law.invention
chemistry.chemical_compound
0302 clinical medicine
Randomized controlled trial
law
030212 general & internal medicine
RNA
Small Interfering
Creatine Kinase
Randomized Controlled Trials as Topic
Anticholesteremic Agents
Alanine Transaminase
Middle Aged
Stroke
Cholesterol
Cardiovascular Diseases
Meta-analysis
Cardiology
Kexin
Drug Therapy
Combination
Female
lipids (amino acids
peptides
and proteins)
Cardiology and Cardiovascular Medicine
medicine.medical_specialty
Hypercholesterolemia
03 medical and health sciences
Pharmacotherapy
Internal medicine
medicine
Humans
Aspartate Aminotransferases
Aged
Apolipoproteins B
business.industry
Cholesterol
HDL
Bilirubin
Cholesterol
LDL
Alkaline Phosphatase
Ezetimibe
Proprotein convertase
Confidence interval
Injection Site Reaction
chemistry
Relative risk
Hydroxymethylglutaryl-CoA Reductase Inhibitors
business
Zdroj: The American Journal of Cardiology. 134:69-73
ISSN: 0002-9149
Popis: Statin therapy is the gold standard for hypercholesterolemia. However, a significant number of patients cannot achieve their target low-density lipoprotein (LDL) levels despite a maximal dose of statin therapy, and some cannot tolerate statins at all. Approval of proprotein convertase subtilisin/kexin type 9 inhibitors has been revolutionary for those patients. However, the need for frequent injections limits patient compliance with their use. Recently, a twice-yearly injection of inclisiran, a small interfering RNA, has been shown to inhibit hepatic synthesis of proprotein convertase subtilisin/kexin type 9. However, patient randomized clinical trial has been underpowered for clinical end points, necessitating a meta-analysis of those trials. The weighted mean difference was used to describe continuous variables, and pooled risk ratios, calculated using a random effects model, were used to describe discrete variables. Data from 3 randomized clinical trials comprising 3,660 patients showed that inclisiran decreased LDL cholesterol levels by 51% (95% Confidence Interval, 48 to 53%; p0.001) compared with placebo. It was associated with a 24% lower major adverse cardiovascular events rate (risk ratios = 0.76; 95% Confidence Interval, 0.61 to 0.92). It also significantly decreased total cholesterol by 37%, apolipoprotein B by 41%, and non high-density lipoprotein (HDL) cholesterol by 45% (all p0.001). No differences were found in adverse events, abnormalities in liver function tests, or creatine kinase levels between the treatment strategies. However, a mild injection site reaction occurred more frequently in the inclisiran group. In conclusions, in patients with hypercholesterolemia, inclisiran decreased LDL level by 51% without significant adverse effects. Additionally, it was associated with a lower major adverse cardiovascular event rate.
Databáze: OpenAIRE
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