Evidence map›Paper›PMID 20525997›Full record

Trial reportJournal of lipid research2010

High-dose atorvastatin causes a rapid sustained increase in human serum PCSK9 and disrupts its correlation with LDL cholesterol.

Greg Welder, Issam Zineh, Michael A Pacanowski, Jason S Troutt, Guoqing Cao, Robert J Konrad

Registry-linked trialOpen access · hybridAbstract readClinical Trial
In one paragraph

Trial report in Journal of lipid research, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06381947 (Efficacy and Safety of Bempedoic Acid in Association With Anti-PCSK9 and Ezetimibe in Statin-intolerant Patients), which is not on this map. Cited by 97 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
97citing papers in PubMed, 3 pooled it
16.6field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06381947 phase4unknown statusstarted 2024, after this paper: background citation

Efficacy and Safety of Bempedoic Acid in Association With Anti-PCSK9 and Ezetimibe in Statin-intolerant Patients: a Randomized Crossover Trial

Ran2024Enrolled130Registered outcomes19Posted comparisons0ConditionsCardiovascular Diseases, Dyslipidemias, Lipid Metabolism Disorders, Statin Adverse ReactionArmsLipid-lowering therapy combination with PCSK9 inhibitors and ezetimibe, Lipid-lowering therapy combination with PCSK9 inhibitors, bempedoic acid and ezetimibe
Open the trial in the graph
3 · Its place in the literature

Who cites it

97 citing papers in PubMed, 3 syntheses or guidelines pooled it, 244 citations in OpenAlex.

  1. Pooled it
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  3. Lipid-lowering efficacy of atorvastatin.The Cochrane database of systematic reviews · 2015 · on this map
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37 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 2 institutions in 1 country.

Greg WelderUniversity of Florida, Gainesville, FL, USA.
Issam Zineh
Michael A Pacanowski
Jason S Troutt
Guoqing Cao
Robert J Konrad
Eli Lilly (United States) · USUniversity of Florida · US

Funding

WHITE MATTER AND COGNITION IN PARKINSON'S DISEASEM01RR000082 · NCRR · UNIVERSITY OF FLORIDA · PI BRANTLY, MARK LOUIS · 1985 to 2009
$29.7M
EXTRAMULAR RESEARCH FACILITIES CONSTRUCTIONC06RR017568 · NCRR · UNIVERSITY OF FLORIDA · PI RIFFEE, WILLIAM H · 2003 to 2003
$900k
NCRR NIH HHS C06 RR017568NCRR NIH HHS C06 RR-17568NCRR NIH HHS M01 RR000082
6 · The paper itself

Abstract

Proprotein convertase subtilisin kexin type 9 (PCSK9) is a key regulator of serum LDL-cholesterol (LDL-C) levels. PCSK9 is secreted by the liver into the plasma and binds the hepatic LDL receptor (LDLR), causing its subsequent degradation. We first demonstrated that a moderate dose of atorvastatin (40 mg) increases PCSK9 serum levels, suggesting why increasing statin doses may have diminished efficacy with regard to further LDL-C lowering. Since that initial observation, at least two other groups have reported statin-induced PCSK9 increases. To date, no analysis of the effect of high-dose atorvastatin (80 mg) on PCSK9 over time has been conducted. Therefore, we studied the time course of atorvastatin (80 mg) in human subjects. We measured PCSK9 and lipid levels during a 2-week lead-in baseline period and every 4 weeks thereafter for 16 weeks. We observed that atorvastatin (80 mg) caused a rapid 47% increase in serum PCSK9 at 4 weeks that was sustained throughout 16 weeks of dosing. Importantly, while PCSK9 levels were highly correlated with total cholesterol (TC), LDL-C, and triglyceride (TG) levels at baseline, atorvastatin (80 mg) completely abolished all of these correlations. Together, these results further suggest an explanation for why increasing doses of statins fail to achieve proportional LDL-C lowering.

Indexed as

AtorvastatinCholesterol, LDLFemaleHeptanoic AcidsHumansHydroxymethylglutaryl-CoA Reductase InhibitorsHypercholesterolemiaMaleProprotein Convertase 9Proprotein ConvertasesPyrrolesSerine EndopeptidasesTriglyceridesAtorvastatinCholesterol, LDLHeptanoic AcidsHydroxymethylglutaryl-CoA Reductase InhibitorsPCSK9 protein, humanProprotein Convertase 9Proprotein ConvertasesPyrrolesSerine EndopeptidasesTriglycerides

Identifiers

PMID20525997
PMCPMC2918453
OpenAlexW2126229169

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.