Evidence map›Paper›PMID 40347490›Full record

ArticleCardiovascular research2025

RNA interference versus antibody-based PCSK9 inhibition for the prevention of cardiovascular disease: a drug-target Mendelian randomization study.

Eloi Gagnon, Dipender Gill, Jérôme Bourgault, Émilie Gobeil, Patricia L Mitchell, Arnaud Girard, Audrey Paulin, Christian Couture, Yohan Bossé, Sébastien Thériault and 6 more

Abstract readComparative Study
In one paragraph

Article in Cardiovascular research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 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

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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

16 authors.

Eloi GagnonCentre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec - Université Laval, Y-3106, Pavillon Marguerite D'Youville, 2725 chemin Ste-Foy, Québec, QC, Canada G1V 4G5.ORCID 0000-0002-7483-1371
Dipender GillDepartment of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK.
Jérôme BourgaultCentre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec - Université Laval, Y-3106, Pavillon Marguerite D'Youville, 2725 chemin Ste-Foy, Québec, QC, Canada G1V 4G5.ORCID 0000-0002-5803-353X
Émilie GobeilCentre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec - Université Laval, Y-3106, Pavillon Marguerite D'Youville, 2725 chemin Ste-Foy, Québec, QC, Canada G1V 4G5.ORCID 0000-0002-5365-0731
Patricia L MitchellCentre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec - Université Laval, Y-3106, Pavillon Marguerite D'Youville, 2725 chemin Ste-Foy, Québec, QC, Canada G1V 4G5.ORCID 0000-0002-0773-1047
Arnaud GirardCentre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec - Université Laval, Y-3106, Pavillon Marguerite D'Youville, 2725 chemin Ste-Foy, Québec, QC, Canada G1V 4G5.ORCID 0000-0002-8219-9118
Audrey PaulinCentre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec - Université Laval, Y-3106, Pavillon Marguerite D'Youville, 2725 chemin Ste-Foy, Québec, QC, Canada G1V 4G5.ORCID 0000-0002-1224-9538
Christian CoutureCentre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec - Université Laval, Y-3106, Pavillon Marguerite D'Youville, 2725 chemin Ste-Foy, Québec, QC, Canada G1V 4G5.ORCID 0000-0003-1063-8780
Yohan BosséCentre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec - Université Laval, Y-3106, Pavillon Marguerite D'Youville, 2725 chemin Ste-Foy, Québec, QC, Canada G1V 4G5.ORCID 0000-0002-3067-3711
Sébastien ThériaultCentre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec - Université Laval, Y-3106, Pavillon Marguerite D'Youville, 2725 chemin Ste-Foy, Québec, QC, Canada G1V 4G5.ORCID 0000-0003-1893-8307
Patrick MathieuCentre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec - Université Laval, Y-3106, Pavillon Marguerite D'Youville, 2725 chemin Ste-Foy, Québec, QC, Canada G1V 4G5.ORCID 0000-0002-3805-2004
Marie-Claude VohlSchool of Nutrition, Université Laval, Québec, QC, Canada.ORCID 0000-0002-7017-5848
André TchernofCentre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec - Université Laval, Y-3106, Pavillon Marguerite D'Youville, 2725 chemin Ste-Foy, Québec, QC, Canada G1V 4G5.ORCID 0000-0002-2587-1000
Kausik K RayImperial Centre for Cardiovascular Disease Prevention, Department of Primary Care and Public Health, Imperial College London, London, UK.
John J P KasteleinDepartment of Vascular Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
Benoit J ArsenaultCentre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec - Université Laval, Y-3106, Pavillon Marguerite D'Youville, 2725 chemin Ste-Foy, Québec, QC, Canada G1V 4G5.ORCID 0000-0003-2240-8456

Funding

the Canadian Institutes of Health Research (CIHR)the Foundation of the IUCPQ
6 · The paper itself

Abstract

aimsRNA interference therapies targeting liver expression of the gene proprotein convertase subtilisin/kexin type 9 (PCSK9) lower LDL-cholesterol (LDL-C) and apolipoprotein B (apoB) levels. As opposed to monoclonal antibodies, which neutralise PCSK9 circulating protein, their effect on atherosclerotic cardiovascular disease (ASCVD) outcomes is unknown. We used genetic variants in the PCSK9 locus influencing PCSK9 function or gene expression in the liver to determine whether antibodies against PCSK9 and RNA interference therapies could have comparable effects on ASCVD. METHODS AND

resultsWe performed genome-wide genotyping and RNA sequencing of 504 human liver sample and identified a genetic variant (rs472495) explaining 5.6% of liver PCSK9 gene expression to mimic lifelong RNA interference of PCSK9. We used the PCSK9 R46L variant, known to alter PCSK9 function, to model antibody-based PCSK9 inhibition. For each standard deviation decrease in apoB levels, both variants were similarly associated with coronary artery disease risk: (odds ratio [OR] = 0.40, 95% confidence interval [CI]: 0.31-0.51, P = 3.7e-13 for rs472495 which affects liver PCSK9 expression) and (OR = 0.48, 95% CI: 0.43-0.55, P = 1.3e-28 for R46L which affects protein levels). Comparable effects of these two genetic inhibition approaches were observed for aortic stenosis, heart failure, ischemic stroke, Type 2 diabetes and glycemic traits as well as non-alcoholic fatty liver disease and liver enzymes.

conclusionFor a given reduction in apoB levels, genetically predicted reductions in PCSK9 function (mimicking PCSK9 neutralizing antibodies) and liver PCSK9 gene expression levels (mimicking PCSK9 RNA interference) were comparably associated with a lower risk of coronary artery disease. These genetic data suggest that LDL-C/apoB reductions may provide cardiovascular benefits, regardless of how PCSK9 function is inhibited.

Indexed as

Cardiovascular DiseasesDyslipidemiasPCSK9 InhibitorsProprotein Convertase 9RNA InterferenceRNAi TherapeuticsSerine Proteinase InhibitorsApolipoprotein B-100BiomarkersCholesterol, LDLFemaleGenetic Predisposition to DiseaseHumansLiverMaleMendelian Randomization AnalysisAPOB protein, humanApolipoprotein B-100BiomarkersCholesterol, LDLPCSK9 InhibitorsPCSK9 protein, humanProprotein Convertase 9Serine Proteinase InhibitorsAlirocumabApolipoprotein BCoronary artery diseaseEvolocumabInclisiranIschemic strokeLipoprotein(a)Low-density lipoproteinsMendelian randomizationProprotein convertase subtilisin/kexin type 9RNA interferenceType 2 diabetes

Identifiers

PMID40347490
PMCPMC12236069

What OpenQuestion holds

Texttitle and abstract
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Registered trials

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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 OpenQuestion graph.