Evidence mapPaperPMID 28738813Full record

Trial reportLipids in health and disease2017

Efficacy and safety of proprotein convertase subtilisin-kexin type 9 (PCSK9) inhibitors, alirocumab and evolocumab, a post-commercialization study.

Joshua Choi, Amir M Khan, Michael Jarmin, Naila Goldenberg, Charles J Glueck, Ping Wang

Registry-linked trialOpen access · goldFull text readClinical Trial
In one paragraph

Trial report in Lipids in health and disease, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03634293 (PCSK9 Inhibitor), which is not on this map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.7field-weighted citation impact, top 27% 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.

NCT03634293 phase2 / phase3unknown statusnot on this mapstarted 2019, after this paper: background citation

PCSK9 Inhibitor: a New Tool to Fight Septic Shock

TypeinterventionalSponsorWolfson Medical CenterRan2019 to 2021Enrolled712ConditionsSepsis, Septic ShockArmsAlirocumab Injectable Product, Saline Solution
3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 7 citations in OpenAlex.

  1. Article
  2. Article
  3. Review
  4. Article
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.

Joshua ChoiGraduate Medical Education and Research, The Jewish Hospital- Mercy Health, Graduate Medical Education and Research, Cincinnati, USA.
Amir M KhanGraduate Medical Education and Research, The Jewish Hospital- Mercy Health, Graduate Medical Education and Research, Cincinnati, USA. AKhan@mercy.com.
Michael JarminGraduate Medical Education and Research, The Jewish Hospital- Mercy Health, Graduate Medical Education and Research, Cincinnati, USA.
Naila GoldenbergGraduate Medical Education and Research, The Jewish Hospital- Mercy Health, Graduate Medical Education and Research, Cincinnati, USA.
Charles J GlueckGraduate Medical Education and Research, The Jewish Hospital- Mercy Health, Graduate Medical Education and Research, Cincinnati, USA.
Ping WangGraduate Medical Education and Research, The Jewish Hospital- Mercy Health, Graduate Medical Education and Research, Cincinnati, USA.
Jewish Hospital · USMercy Health · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEfficacy-safety of proprotein convertase subtilisin-kexin type 9 (PCSK9) inhibitors, alirocumab (ALI) and evolocumab (EVO), have previously been evaluated through controlled clinical trials with selective patient groups. Post-commercially, in 69 patients with heterozygous familial hypercholesterolemia (HeFH) and/or cardiovascular disease (CVD) with suboptimal LDL cholesterol (LDLC) lowering on maximal tolerated LDLC therapy, we assessed efficacy and safety of ALI and EVO.

methodsPost-commercially, we started 29 patients on ALI 75 mg, 18 on ALI 150 mg, and 22 on EVO 140 mg every 2 weeks added to a maximally tolerated LDLC-lowering regimen. Since LDLC lowering did not differ between ALI 150 and EVO 140 mg, ALI 150-EVO 140 data were pooled (ALI-EVO). Changes in LDLC and AHA and NIH calculated 10-year CVD risks were assessed.

resultsOf the 69 patients, 25 had HeFH, 25 CVD, and 19 had both. At entry, 23 (33%) took statins and 46 (67%) were statin-intolerant. Mean ± SD and median follow-up were 49 ± 13 and 49 weeks on ALI 75 mg, and 37 ± 12 and 33 weeks on ALI-EVO. In the ALI-EVO group (n = 40), median LDLC fell from 165 mg/dl at entry to 70 mg/dl (median - 59%, p < .0001). AHA 10-year calculated CVD risk fell from 10.2 to 5.5% (median - 28%, p < .0001), and by the NIH calculator from 14.2 to 3.6% (median - 78%, p < .0001). In the ALI 75 mg group (n = 29), entry LDLC fell from 115 to 68 mg/dl (median - 39%, p < .0001). AHA 10-year calculated CVD risk fell from 11.5 to 7.3% (median - 20%, p = .004), and NIH 10-year risk from 12.9 to 5.1% (median 67%, p < .0001). Absolute and percent change in LDLC was independent of statin use. There were flu-like symptoms in 14% of patients. Adverse events did not differ (p > 0.05) between ALI 75 mg and ALI-EVO.

conclusionIn patients with HeFH and/or CVD, LDLC decreased from 115 to 68 mg/dl (39%) on ALI 75 mg with mean follow-up of 49 weeks, and from 165 to 70 mg/dl (59%) on ALI-EVO over 37 weeks, p < .0001 for both. Adverse events were minimal and tolerable. ALI and EVO represent paradigm shifts in LDLC lowering.

Indexed as

PCSK9 InhibitorsProduct Surveillance, PostmarketingAgedAntibodies, MonoclonalAntibodies, Monoclonal, HumanizedCardiovascular DiseasesCholesterol, HDLCholesterol, LDLFemaleHumansHydroxymethylglutaryl-CoA Reductase InhibitorsMaleMiddle AgedProprotein Convertase 9Risk FactorsTreatment OutcomealirocumabAntibodies, MonoclonalAntibodies, Monoclonal, HumanizedCholesterol, HDLCholesterol, LDLevolocumabHydroxymethylglutaryl-CoA Reductase InhibitorsPCSK9 InhibitorsPCSK9 protein, humanProprotein Convertase 9TriglyceridesAlirocumabCardiovascular riskEfficacyEvolocumabHypercholesterolemiaLow-density lipoproteinPCSK9 inhibitorSafety

Identifiers

PMID28738813
PMCPMC5525304
OpenAlexW2736442303

What Socratic holds

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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.