Evidence map›Paper›PMID 40841123›Full record

SynthesisOpen heart2025

PCSK9 targeting therapies for familial hypercholesterolaemia: a meta-analysis of efficacy on lipid biomarkers and safety in adults and children across 23 RCTs.

Vinh Q T Ho, Nghi Bao Tran, Nhan Nguyen, Giang Son Arrighini, David Downes, Mrunalini Dandamudi, Victoria Zecchin Ferrara, Tri Huynh Quang Ho, Hemank Walia, Alejandro Barbagelata and 2 more

Abstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in Open heart, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 2 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

4 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Efficacy and Safety of Ongericimab in Chinese Patients with Hypercholesterolemia: A Meta-analysis of Randomized Controlled Trials.American journal of cardiovascular drugs : drugs, devices, and other interventions · 2026
    Pooled it
  2. Pooled it
  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

12 authors.

Vinh Q T HoFaculty of Medicine, University of Debrecen, Debrecen, Hungary vinhhoquangtri@gmail.com.ORCID http://orcid.org/0009-0008-8434-552X
Nghi Bao TranFaculty of Medicine, University of Debrecen, Debrecen, Hungary.
Nhan NguyenFaculty of Medicine, University of Debrecen, Debrecen, Hungary.
Giang Son ArrighiniFaculty of Medicine and Surgery, University of Bologna, Bologna, Italy.
David DownesDepartment of Rural Medicine, University of New England, Armidale, New South Wales, Australia.
Mrunalini DandamudiSt Barnabas Health System Bronx, New York, New York, USA.
Victoria Zecchin FerraraFaculty of Medicine and Surgery, University of Padova, Padua, Italy.
Tri Huynh Quang HoSurgical Intensive Care Unit, Ho Chi Minh City Heart Institute, Ho Chi Minh City, Vietnam.
Hemank WaliaAdvocate Illinois Masonic Medical Center, Chicago, Illinois, USA.ORCID http://orcid.org/0009-0000-7832-6463
Alejandro BarbagelataUniversidad Catolica Argentina, Buenos AIres, Argentina.
Thorsten M LeuckerJohns Hopkins University, Baltimore, Maryland, USA.
Juliana GiorgiHospital Sirio-Libanes, São Paulo, Brazil.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundFamilial hypercholesterolaemia (FH) is a hereditary disorder characterised by elevated low-density lipoprotein cholesterol (LDL-C) levels, substantially increasing the risk of atherosclerotic cardiovascular disease. Proprotein convertase subtilisin/kexin type 9 (PCSK9) targeting therapies, including monoclonal antibodies and small interfering RNA (siRNA) agents, have emerged as effective lipid lowering therapies.

objectiveTo assess the efficacy and safety of PCSK9-targeting therapy on lipid biomarkers and adverse events in patients with FH, compared with placebo on the background of standard lipid-lowering therapy.

methodsA systematic review and meta-analysis were conducted, incorporating data from 23 randomised controlled trials involving adult and paediatric FH patients treated with PCSK9 inhibitors (PCSK9i) or siRNA, including alirocumab, bococizumab, evolocumab, tafolecimab and inclisiran. Eligible studies reported changes in LDL-C, apolipoprotein B (ApoB), lipoprotein a (Lp(a)), triglycerides (TGL) and adverse effects. Pooled mean differences (MDs) and ORs with 95% CIs were calculated using random-effects models, and heterogeneity was assessed with I² statistic. This meta-analysis was registered on PROSPERO (CRD42025631510).

resultsA total of 4282 patients were included. PCSK9-targeting therapies significantly reduced LDL-C levels compared with control therapies (MD=-46.64%; 95% CI -50.77% to -42.52%; p<0.00001) and TGL (MD=-15.18%; 95% CI -19.34% to -11.03%; p<0.00001). Significant reductions were also observed for ApoB (MD=-34.94%; 95% CI -40.89% to -28.99%; p<0.00001) and Lp(a) (MD=-22.7%; 95% CI -25.95% to -19.44%; p<0.00001). LDL-C, TGL and ApoB reduction were more significant in heterozygous FH patients than in homozygous patients. The safety profile of these therapies was favourable, with adverse event rates comparable to those of the controls.

conclusionsPCSK9i and Inclisiran demonstrate significant and sustained reductions in LDL-C, ApoB, Lp(a) and TGL in FH patients, especially in heterozygous FH patients. These agents are generally well-tolerated and represent effective treatment options for FH patients inadequately controlled by standard lipid-lowering therapies.

Indexed as

Anticholesteremic AgentsCholesterol, LDLHyperlipoproteinemia Type IILipidsPCSK9 InhibitorsSerine Proteinase InhibitorsAdolescentAdultBiomarkersChildFemaleHumansMaleProprotein Convertase 9Randomized Controlled Trials as TopicTreatment OutcomeAnticholesteremic AgentsBiomarkersCholesterol, LDLLipidsPCSK9 InhibitorsPCSK9 protein, humanProprotein Convertase 9Serine Proteinase InhibitorsAtherosclerosisBiomarkersPharmacology, Clinical

Identifiers

PMID40841123
PMCPMC12374655

What Socratic holds

Textmetadata
LicenceCC BY-NC
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.