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最新临床证据表明,PCSK9 单克隆抗体对家族性高胆固醇血症患者的疗效:一项更新的荟萃分析。

Latest clinical evidence about the effect of PCSK9 monoclonal antibodies in patients with familial hypercholesterolaemia: an updated meta-analysis.

机构信息

The Second People's Hospital of Nanning, the Third Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.

出版信息

Endokrynol Pol. 2022;73(1):110-120. doi: 10.5603/EP.a2021.0109.

Abstract

INTRODUCTION

Familial hypercholesterolaemia (FH) is the most common autosomal genetic disease of cholesterol metabolism disorder. Proprotein convertase subtilisin/kexin type 9 (PCSK9) monoclonal antibody (mAb) is a new target lipid-regulating drug related to cholesterol metabolism that has been developed in recent years. The reported rate of reduction varies widely, and comprehensive assessments of efficacy and safety are lacking. Therefore, we conducted this study to investigate the clinical effect of PCSK9 mAbs in patients with familial hypercholesterolaemia to provide a theoretical reference for clinical practice.

MATERIAL AND METHODS

We analysed the clinical data of patients, including the percentage change in LDL-C and the incidence rates of treatment-emergent adverse events (TEAEs) and serious adverse events (SAEs), from selected articles. Weighted mean differences (WMDs), risk ratios (RRs), and 95% confidence intervals (95% CIs) were calculated to compare the endpoints.

RESULTS

The results showed that, compared with placebo, the PCSK9 mAb reduced the percentage change in LDL-C in FH patients (WMD = -45.52, 95% CI: -49.70 to -41.34, I2 = 99.6%). In addition, there was no significant difference between the experimental and placebo groups in the incidence of TEAEs (RR = 1.03, 95% CI: 0.97 to 1.10, I2 = 19.1%) and SAEs (RR = 1.02, 95% CI: 0.72 to 1.44, I2 = 0.0%).

CONCLUSIONS

Overall, PSCK9 mAbs are an effective and safe method of LDL-C reduction in patients with FH.

摘要

简介

家族性高胆固醇血症(FH)是最常见的胆固醇代谢紊乱常染色体遗传病。前蛋白转化酶枯草溶菌素/柯萨奇蛋白酶 9(PCSK9)单克隆抗体(mAb)是近年来开发的一种与胆固醇代谢相关的新型调脂药物靶点。报道的降低率差异很大,缺乏对疗效和安全性的综合评估。因此,我们进行了这项研究,以调查 PCSK9 mAb 在家族性高胆固醇血症患者中的临床效果,为临床实践提供理论参考。

材料和方法

我们分析了选自文献的患者的临床数据,包括 LDL-C 的百分比变化和治疗中出现的不良事件(TEAEs)和严重不良事件(SAEs)的发生率。计算了加权均数差(WMDs)、风险比(RRs)和 95%置信区间(95% CIs),以比较终点。

结果

结果表明,与安慰剂相比,PCSK9 mAb 降低了 FH 患者 LDL-C 的百分比变化(WMD=-45.52,95%CI:-49.70 至-41.34,I2=99.6%)。此外,实验组和安慰剂组在 TEAEs(RR=1.03,95%CI:0.97 至 1.10,I2=19.1%)和 SAEs(RR=1.02,95%CI:0.72 至 1.44,I2=0.0%)的发生率方面无显著差异。

结论

总体而言,PCSK9 mAb 是降低 FH 患者 LDL-C 的有效且安全的方法。

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