ArticleDiabetes, obesity & metabolism2026
Comparative Effects of Emerging Lp(a)-Lowering Agents and PCSK9-Directed Therapies on Lipoprotein(a): A Network Meta-Analysis of Randomised Clinical Trials.
Article in Diabetes, obesity & metabolism, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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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.
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Who cites it
1 citing paper in PubMed.
- Comparative Effects of Emerging Lp(a)-Lowering Agents and PCSK9-Directed Therapies on Lipoprotein(a): A Network Meta-Analysis of Randomised Clinical Trials.Diabetes, obesity & metabolism · 2026Article
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimsElevated lipoprotein(a) [Lp(a)] is a genetic ASCVD risk factor that often persists despite intensive LDL-C lowering. We compared the efficacy and safety of emerging Lp(a)-targeted therapies (siRNAs, antisense oligonucleotides and an oral assembly inhibitor) with PCSK9-directed therapies. MATERIALS AND
methodsWe searched PubMed, Embase, Web of Science and Cochrane CENTRAL through December 6, 2025, for randomised trials in adults (≥ 18 years) with ≥ 8-week follow-up reporting Lp(a). The primary outcome was placebo-adjusted mean difference (MD) in percent change from baseline in Lp(a) (percentage points, pp). Secondary outcomes included LDL-C, other lipid parameters and safety outcomes (injection-site reactions, serious adverse events (SAEs), discontinuations). We performed a frequentist random-effects network meta-analysis in R (netmeta) and ranked interventions using P-scores.
resultsFifty-one trials (17 810 participants) formed a 16-node network. Olpasiran 225 mg Q12W was associated with the greatest Lp(a) reduction versus placebo (MD -98.94 pp, 95% CI -114.36 to -83.52); pelacarsen, muvalaplin, zerlasiran and lepodisiran were also associated with large reductions. PCSK9-directed therapies were associated with more modest Lp(a) reductions (evolocumab 140 mg Q2W: MD -31.58 pp), but greater LDL-C lowering. The primary Lp(a) network showed high heterogeneity (I
conclusionsLp(a)-targeted therapies were associated with larger Lp(a) reductions than PCSK9-directed therapies, while PCSK9-directed therapies had greater LDL-C lowering. Given high heterogeneity, funnel plot asymmetry and low certainty for several estimates, these findings should be interpreted cautiously pending cardiovascular outcome trials.
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