Evidence map›Paper›PMID 40630126›Full record

SynthesisFrontiers in pharmacology2025

Indirect comparison of the efficacy and safety of alirocumab and evolocumab on major cardiovascular events: a systematic review and network meta-analysis.

Leyu Xu, Ming Lei, Liren Li, Yilei Li, Chunping Gu, Ping Zheng

Abstract readSystematic Review
In one paragraph

Synthesis in Frontiers in pharmacology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

6 authors.

Leyu Xu *Department of Pharmacy, Nanfang Hospital, Southern Medical University, Guangzhou, China.
Ming Lei *Department of Pharmacy, Nanfang Hospital, Southern Medical University, Guangzhou, China.
Liren LiDepartment of Pharmacy, Nanfang Hospital, Southern Medical University, Guangzhou, China.
Yilei LiDepartment of Pharmacy, Nanfang Hospital, Southern Medical University, Guangzhou, China.
Chunping GuDepartment of Pharmacy, Nanfang Hospital, Southern Medical University, Guangzhou, China.
Ping ZhengDepartment of Pharmacy, Nanfang Hospital, Southern Medical University, Guangzhou, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Alirocumab and evolocumab are proprotein convertase subtilisin/kexin type 9 inhibitors that significantly reduce the relative risk of cardiovascular events. However, the relative efficacy and safety of alirocumab and evolocumab in different patient groups still warrant further indirect comparison. This systematic review and network meta-analysis indirectly compared the efficacy and safety of alirocumab and evolocumab on major cardiovascular events. Methods: PUBMED, EMBASE, Web of Science, and Cochrane Central Register of Controlled Trials (CENTRAL) databases were comprehensively searched to extract randomized controlled trials (RCTs) regarding alirocumab and evolocumab published from inception to 17 August 2024. The meta-analysis was performed using Software Review Manager 5.4 and R 4.1.0 software. Results: This network meta-analysis included 26 RCTs with 64,921 patients. Among these, 13 RCTs included patients receiving alirocumab or placebo (n = 13,365) and 13 RCTs included patients receiving evolocumab or placebo (n = 22,048). Compared with the placebo, treatment with alirocumab and evolocumab significantly reduced the relative risk of major adverse cardiovascular and cerebrovascular events (MACCE), myocardial infarction, stroke, and coronary revascularization. Furthermore, alirocumab and evolocumab groups did not show significant differences in MACCE [relative risk (RR): 0.99, 95% confidence interval (CI): 0.88-1.11], cardiovascular death (RR: 0.83, 95% CI: 0.65-1.06), myocardial infarction (RR: 0.87, 95% CI: 0.74-1.03), stroke (RR: 0.96, 95% CI: 0.71-1.29), coronary revascularization (RR: 0.88, 95% CI: 0.77-1.01), and any adverse event (RR: 0.91, 95% CI: 0.76-1.09). Moreover, the all-cause mortality rates were lower for patients treated with alirocumab compared to those treated with evolocumab (RR: 0.84, 95% CI: 0.70-1.00), but the difference was not statistically significant. Conclusion: Alirocumab and evolocumab demonstrated comparable efficacy in reducing the relative risk of major cardiovascular events. The all-cause mortality rates were lower in patients treated with alirocumab compared to those treated with evolocumab but the differences were not statistically significant, probably due to heterogeneity in the sample size and follow-up duration between different studies. Both drugs exhibited comparable safety profiles. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/myprospero, identifier CRD42024505327.

Indexed as

alirocumabcardiovascular eventsefficacyevolocumabnetwork meta-analysisPCSK9 inhibitorssafety

Identifiers

PMID40630126
PMCPMC12234305

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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.