Evidence mapPaperPMID 39521985Full record

SynthesisBMC cardiovascular disorders2024

Efficacy and safety of inclisiran versus PCSK9 inhibitor versus statin plus ezetimibe therapy in hyperlipidemia: a systematic review and network meta-analysis.

Shengxuan Zhang, Lei Sun, Xinyu Xu, Yanling Zhang, Qilan Chen

Abstract readComparative StudySystematic ReviewNetwork Meta-Analysis
In one paragraph

Synthesis in BMC cardiovascular disorders, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed
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

10 citing papers in PubMed.

  1. Review
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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

5 authors.

Shengxuan ZhangDepartment of Cardiology, Hangzhou Traditional Chinese Medicine Hospital, Affiliated to Zhejiang Chinese Medical University, No.453 Sports Stadium Road 310007, Hangzhou, Zhejiang Province, 310007, China.
Lei SunDepartment of Gastroenterology, Hangzhou Traditional Chinese Medicine Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, 310007, China.
Xinyu XuDepartment of Medical Oncology, Hangzhou Traditional Chinese Medicine Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, 310007, China.
Yanling ZhangDepartment of Cardiology, Hangzhou Traditional Chinese Medicine Hospital, Affiliated to Zhejiang Chinese Medical University, No.453 Sports Stadium Road 310007, Hangzhou, Zhejiang Province, 310007, China.
Qilan ChenDepartment of Cardiology, Hangzhou Traditional Chinese Medicine Hospital, Affiliated to Zhejiang Chinese Medical University, No.453 Sports Stadium Road 310007, Hangzhou, Zhejiang Province, 310007, China. cql13588750941@qq.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveHyperlipidemia plays a crucial role in increasing the risk of cardiovascular diseases such as atherosclerosis. Recent studies have established that inclisiran positively influences lipid regulation. Nevertheless, its effectiveness in comparison to conventional treatments is still questionable. Hence, a methodical assessment of its effectiveness and safety is required. This research evaluates the efficacy and safety of inclisiran, PCSK9 inhibitors, and the combination of statins with ezetimibe in the treatment of hyperlipidemia via a network meta-analysis of randomized controlled trials (RCTs).

methodsWe performed an extensive search of English-language publications in the PubMed, Medline, Embase, and Cochrane Library databases until April 2024. We conducted a web-based meta-analysis and reported in accordance with the guidelines. We selected the percentage change in low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), triglycerides (TG), and high-density lipoprotein cholesterol (HDL-C) as efficacy evaluation metrics and the incidence of adverse events as safety evaluation metrics for analysis and comparison.

resultWe incorporated 33 studies involving 23,375 patients, evaluating three interventions regarding their effects on LDL-C, TC, TG, HDL-C, and adverse events. All treatments improved metrics over placebo. Inclisiran significantly reduced LDL-C compared to statins (mean - 15.21, 95% CI [-25.19, -5.23]) but showed no significant difference from statin + ezetimibe. Surface under the cumulative ranking curve (SUCRA) rankings placed inclisiran highest for LDL-C reduction (26.2%). The combination of statin and ezetimibe was the most efficacious for triglyceride reduction (mean 17.2, 95% CI [10.22, 24.19]; mean 15.61, 95% CI [16.87, 24.35]). The safety profiles were comparable across treatments.

conclusionInclisiran with its superior LDL-C reduction and low frequency of administration, appears promising for hyperlipidemia treatment, particularly for patients with adherence issues or side effects from other medications. SYSTEMATIC REVIEW REGISTRATION: CRD42024550852.

Indexed as

BiomarkersEzetimibeHydroxymethylglutaryl-CoA Reductase InhibitorsHyperlipidemiasPCSK9 InhibitorsRNA, Small InterferingAnticholesteremic AgentsDrug Therapy, CombinationHumansLipidsProprotein Convertase 9Randomized Controlled Trials as TopicSerine Proteinase InhibitorsTreatment OutcomeALN-PCSAnticholesteremic AgentsBiomarkersEzetimibeHydroxymethylglutaryl-CoA Reductase InhibitorsLipidsPCSK9 InhibitorsPCSK9 protein, humanProprotein Convertase 9RNA, Small InterferingSerine Proteinase InhibitorsA systematic reviewEzetimibeHyperlipidemiaInclisiranNetwork meta-analysisPCSK9 inhibitorStatin

Identifiers

PMID39521985
PMCPMC11549808

What Socratic holds

Texttitle and abstract
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.