Evidence mapPaperPMID 36073669Full record

SynthesisJournal of the American Heart Association2022

Network Meta-Analysis of Randomized Trials Evaluating the Comparative Efficacy of Lipid-Lowering Therapies Added to Maximally Tolerated Statins for the Reduction of Low-Density Lipoprotein Cholesterol.

Peter P Toth, Sarah Bray, Guillermo Villa, Tamara Palagashvili, Naveed Sattar, Erik S G Stroes, Gavin M Worth

Abstract readSystematic ReviewNetwork Meta-Analysis
In one paragraph

Synthesis in Journal of the American Heart Association, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
30citing papers in PubMed, 5 pooled it
field-weighted citation impact
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

30 citing papers in PubMed, 5 syntheses or guidelines pooled it.

  1. Efficacy of PCSK9 Inhibitors on Clinical Outcomes in Patients with Established Atherosclerotic Cardiovascular Disease: A Network Meta-analysis.American journal of cardiovascular drugs : drugs, devices, and other interventions · 2026 · on this map
    Pooled it
  2. Pooled it
  3. Guideline
  4. Pooled it
  5. Pooled it
  6. Trial
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  14. Review
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  17. Review
  18. Monoclonal Anti-PCSK9 Antibodies: Real-World Data.Journal of clinical medicine · 2024
    Article
  19. Article
  20. Inclisiran for hypercholesterolaemia.Australian prescriber · 2024
    Review
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

7 authors.

Peter P TothCicarrone Center for the Prevention of Cardiovascular Disease Johns Hopkins University School of Medicine Baltimore MD.ORCID 0000-0001-5810-5460
Sarah BrayAmgen Ltd Cambridge UK.
Guillermo VillaAmgen (Europe) GmbH Rotkreuz Switzerland.
Tamara PalagashviliAmgen Inc Thousand Oaks CA.
Naveed SattarUniversity of Glasgow United Kingdom.ORCID 0000-0002-1604-2593
Erik S G StroesFaculty of Medicine University of Amsterdam The Netherlands.ORCID 0000-0001-9555-6260
Gavin M WorthAmgen (Europe) GmbH Rotkreuz Switzerland.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background Lowering low-density lipoprotein cholesterol (LDL-C) levels decreases major cardiovascular events and is recommended for patients at elevated cardiovascular risk. However, appropriate doses of statin therapy are often insufficient to reduce LDL-C in accordance with current guidelines. In such cases, treatment could be supplemented with nonstatin lipid-lowering therapy. Methods and Results A systematic literature review and network meta-analysis were conducted on randomized controlled trials of nonstatin lipid-lowering therapy added to maximally tolerated statins, including statin-intolerant patients. The primary objective was to assess relative efficacy of nonstatin lipid-lowering therapy in reducing LDL-C levels at week 12. Secondary objectives included the following: LDL-C level reduction at week 24 and change in non-high-density lipoprotein cholesterol and apolipoprotein B at week 12. There were 48 randomized controlled trials included in the primary network meta-analysis. All nonstatin agents significantly reduced LDL-C from baseline versus placebo, regardless of background therapy. At week 12, evolocumab, 140 mg every 2 weeks (Q2W)/420 mg once a month, and alirocumab, 150 mg Q2W, were the most efficacious regimens, followed by alirocumab, 75 mg Q2W, alirocumab, 300 mg once a month, inclisiran, bempedoic acid/ezetimibe fixed-dose combination, and ezetimibe and bempedoic acid used as monotherapies. Primary end point results were generally consistent at week 24, and for other lipid end points at week 12. Conclusions Evolocumab, 140 mg Q2W/420 mg once a month, and alirocumab, 150 mg Q2W, were consistently the most efficacious nonstatin regimens when added to maximally tolerated statins to lower LDL-C, non-high-density lipoprotein cholesterol, and apolipoprotein B levels and facilitate attainment of guideline-recommended risk-stratified lipoprotein levels.

Indexed as

Anticholesteremic AgentsHydroxymethylglutaryl-CoA Reductase InhibitorsApolipoproteinsCholesterolCholesterol, LDLDicarboxylic AcidsDouble-Blind MethodEzetimibeFatty AcidsHumansRandomized Controlled Trials as TopicTreatment Outcome8-hydroxy-2,2,14,14-tetramethylpentadecanedioic acidAnticholesteremic AgentsApolipoproteinsCholesterolCholesterol, LDLDicarboxylic AcidsEzetimibeFatty AcidsHydroxymethylglutaryl-CoA Reductase Inhibitorsalirocumabbempedoic acidevolocumabezetimibeinclisiran

Identifiers

PMID36073669
PMCPMC9683660

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

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.