Impact of Proprotein Convertase Subtilisin/Kexin Type 9 Inhibitors on Lipoprotein(a)

Frederick Berro Rivera, MD; Sung Whoy Cha, MD; Cruz Linnaeus Louisse, MD; Genquen Philip Carado, MD; John Vincent Magalong, MD; Vincent Anthony Tang, MD; Mary Grace Enriquez, MD; Martha Gulati, MD, MS; Byambaa Enkhmaa, MD, PhD; Neha Pagidipati, MD, MPH; Nishant P. Shah, MD

JACC: Advances (Feb 2025)

Impact of Proprotein Convertase Subtilisin/Kexin Type 9 Inhibitors on Lipoprotein(a)

Frederick Berro Rivera, MD,
Sung Whoy Cha, MD,
Cruz Linnaeus Louisse, MD,
Genquen Philip Carado, MD,
John Vincent Magalong, MD,
Vincent Anthony Tang, MD,
Mary Grace Enriquez, MD,
Martha Gulati, MD, MS,
Byambaa Enkhmaa, MD, PhD,
Neha Pagidipati, MD, MPH,
Nishant P. Shah, MD

Affiliations

Frederick Berro Rivera, MD: Department of Medicine, Lincoln Medical Center, New York, New York, USA; Address for correspondence: Dr Frederick Berro Rivera, Department of Medicine, Lincoln Medical Center, 234 East 149th Street, The Bronx, New York 10451, USA.
Sung Whoy Cha, MD: Department of Medicine, Cebu Institute of Medicine, Cebu City, Philippines
Cruz Linnaeus Louisse, MD: University of the Philippines, College of Medicine, Manila, Philippines
Genquen Philip Carado, MD: Department of Medicine, University of the Philippines–Philippine General Hospital, Manila, Philippines
John Vincent Magalong, MD: University of the Philippines, College of Medicine, Manila, Philippines
Vincent Anthony Tang, MD: Department of Medicine, University of the Philippines–Philippine General Hospital, Manila, Philippines
Mary Grace Enriquez, MD: University of the Philippines, College of Medicine, Manila, Philippines
Martha Gulati, MD, MS: Department of Cardiology, Barbra Streisand Women’s Heart Center, Cedars-Sinai Smidt Heart Institute, Los Angeles, California, USA
Byambaa Enkhmaa, MD, PhD: Division of Endocrinology, Diabetes & Metabolism, UC Davis Health, Davis, California, USA
Neha Pagidipati, MD, MPH: Division of Cardiology, Department of Medicine, Duke University Medical Center, Durham, North Carolina, USA; Division of Cardiology, Duke Clinical Research Institute, Durham, North Carolina, USA
Nishant P. Shah, MD: Division of Cardiology, Department of Medicine, Duke University Medical Center, Durham, North Carolina, USA; Division of Cardiology, Duke Clinical Research Institute, Durham, North Carolina, USA

Journal volume & issue: Vol. 4, no. 2
p. 101549

Abstract

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Background: Lipoprotein(a) [Lp(a)] has been independently associated with increased cardiovascular risk. Objectives: The authors examined the effect of monoclonal antibody proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9is) on plasma Lp(a) levels across multiple trials. Methods: Studies were retrieved comparing the effect of PCSK9i vs placebo on Lp(a) levels. The primary outcome was percent change in Lp(a) levels. Factors associated with the treatment effect were determined by meta-regression analysis. Subgroup analyses were done to explore potential treatment effect differences. Results: PCSK9i reduced Lp(a) levels on average of −27% (95% CI: −29.8% to −24.1%, P 12 weeks: −22.31%] [95% CI: −25.13% to −19.49%, P < 0.001]), P interaction < 0.01. Conclusions: PCSK9is reduce Lp(a) levels by an average of 27%. Mean percent change in low-density lipoprotein cholesterol and apolipoprotein B were associated with treatment effect.

Published in JACC: Advances

ISSN: 2772-963X (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Internal medicine: Specialties of internal medicine: Diseases of the circulatory (Cardiovascular) system; Medicine: Internal medicine: Medical emergencies. Critical care. Intensive care. First aid
Website: https://www.sciencedirect.com/journal/jacc-advances

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