Effects of Proprotein Convertase Subtilisin/Kexin Type 9 Antibodies in Adults With Hypercholesterolemia
Authors: Aris Liakos, Eleni Athanasiadou, Maria Mainou, Eleni Bekiari, Anna Bettina Haidich, Evangelos C. Rizos, Apostolos Tsapas
Journal: Annals of Internal Medicine (2015)

Letters4 August 2015Effects of Proprotein Convertase Subtilisin/Kexin Type 9 Antibodies in Adults With HypercholesterolemiaAris Liakos, MD, MSc, Eleni Athanasiadou, MSc, Maria Mainou, MD, Eleni Bekiari, MD, PhD, Anna Bettina Haidich, PhD, Evangelos C. Rizos, MD, PhD, and Apostolos Tsapas, MD, PhD, MScAris Liakos, MD, MScFrom Aristotle University Thessaloniki, Thessaloniki, Greece, and University of Ioannina, Ioannina, Greece.Search for more papers by this author, Eleni Athanasiadou, MScFrom Aristotle University Thessaloniki, Thessaloniki, Greece, and University of Ioannina, Ioannina, Greece.Search for more papers by this author, Maria Mainou, MDFrom Aristotle University Thessaloniki, Thessaloniki, Greece, and University of Ioannina, Ioannina, Greece.Search for more papers by this author, Eleni Bekiari, MD, PhDFrom Aristotle University Thessaloniki, Thessaloniki, Greece, and University of Ioannina, Ioannina, Greece.Search for more papers by this author, Anna Bettina Haidich, PhDFrom Aristotle University Thessaloniki, Thessaloniki, Greece, and University of Ioannina, Ioannina, Greece.Search for more papers by this author, Evangelos C. Rizos, MD, PhDFrom Aristotle University Thessaloniki, Thessaloniki, Greece, and University of Ioannina, Ioannina, Greece.Search for more papers by this author, and Apostolos Tsapas, MD, PhD, MScFrom Aristotle University Thessaloniki, Thessaloniki, Greece, and University of Ioannina, Ioannina, Greece.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L15-5118 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:In their systematic review, Navarese and colleagues (1) conclude that proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors reduce all-cause mortality (odds ratio [OR], 0.45 [95% CI, 0.23 to 0.86]) and rates of myocardial infarction and have a favorable, yet not statistically significant, effect on cardiovascular mortality (OR, 0.50 [CI, 0.23 to 1.10]) and unstable angina. They claim robustness of their findings based on similar results from several sensitivity analyses.We question these conclusions in light of a reanalysis of the all-cause mortality data. The authors excluded 0-total-event trials and used an inverse variance–weighted fixed-effects model for pooling ...References1. Navarese EP, Kolodziejczak M, Schulze V, Gurbel PA, Tantry U, Lin Y, et al. Effects of proprotein convertase subtilisin/kexin type 9 antibodies in adults with hypercholesterolemia A systematic review and meta-analysis. Ann Intern Med. 2015;163:40-51. [PMID: 25915661] doi:10.7326/M14-2957 LinkGoogle Scholar2. Sweeting MJ, Sutton AJ, Lambert PC. What to add to nothing? Use and avoidance of continuity corrections in meta-analysis of sparse data. Stat Med. 2004;23:1351-75. [PMID: 15116347] CrossrefMedlineGoogle Scholar3. Diamond GA, Bax L, Kaul S. Uncertain effects of rosiglitazone on the risk for myocardial infarction and cardiovascular death. Ann Intern Med. 2007;147:578-81. [PMID: 17679700] LinkGoogle Scholar4. Robinson JG, Farnier M, Krempf M, Bergeron J, Luc G, Averna M, et al; ODYSSEY LONG TERM Investigators. Efficacy and safety of alirocumab in reducing lipids and cardiovascular events. N Engl J Med. 2015;372:1489-99. [PMID: 25773378] doi:10.1056/NEJMoa1501031 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Aristotle University Thessaloniki, Thessaloniki, Greece, and University of Ioannina, Ioannina, Greece.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L15-0307. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoEffects of Proprotein Convertase Subtilisin/Kexin Type 9 Antibodies in Adults With Hypercholesterolemia Eliano Pio Navarese , Michalina Kołodziejczak , Volker Schulze , Paul A. Gurbel , Udaya Tantry , Yingfeng Lin , Maximilian Brockmeyer , David E. Kandzari , Julia M. Kubica , Ralph B. D'Agostino Sr. , Jacek Kubica , Massimo Volpe , Stefan Agewall , Dean J. Kereiakes , and Malte Kelm Effects of Proprotein Convertase Subtilisin/Kexin Type 9 Antibodies in Adults With Hypercholesterolemia Alessandro Battaggia , Alberto Donzelli , and Maria Font Effects of Proprotein Convertase Subtilisin/Kexin Type 9 Antibodies in Adults With Hypercholesterolemia John E. Cornell and Cynthia D. Mulrow Effects of Proprotein Convertase Subtilisin/Kexin Type 9 Antibodies in Adults With Hypercholesterolemia John E. Cornell and Cynthia D. Mulrow Effects of Proprotein Convertase Subtilisin/Kexin Type 9 Antibodies in Adults With Hypercholesterolemia Alessandro Battaggia , Alberto Donzelli , and Maria Font Metrics Cited byA Systematic Review of PCSK9 Inhibitors Alirocumab and Evolocumab 4 August 2015Volume 163, Issue 3Page: 241KeywordsDisclosureHospitalizationsMyocardial infarctionSafetySafety studiesStatinsSystematic reviewsUnstable angina ePublished: 4 August 2015 Issue Published: 4 August 2015 Copyright & PermissionsCopyright © 2015 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...