Prevention & lipidsCohort study
Impact of PCSK9 inhibitors on lipoprotein(a) levels: a multi-centre study
- Retrospective cohort study
- multicentre
Authors' conclusion
PCSK9i are associated with modest Lp(a) lowering of approximately 17% in real-world clinical practice, with a consistent percent reduction by baseline Lp(a) level, PCSK9i type and Lp(a) assay type.
Study context
- Population
- Adults prescribed PCSK9i with Lp(a) measured before and after prescription, University of California Health Data Warehouse
- Participants
- 453 vs 6,750
- Exposure
- PCSK9 inhibitor use; change in Lp before vs after prescription
- PCSK9in = 453
- Controln = 6,750reference
- Outcome
- Change in Lp(a) from baseline and predictors of Lp(a) reduction
Main finding
As reported in the abstract
Lp(a) reduction
| Group | Value | Absolute reduction (median [IQR]) |
|---|---|---|
| PCSK9i | median 17.3 (IQR 35.3–0.0) % | 11.3 [31.7, 0.0] mg/dL |
| Control | median change 0.00 (IQR −2.00–3.00) mg/dL |
Observational data: associations, not effects.
Further findings
| Outcome | PCSK9i | Control |
|---|---|---|
| Lp(a) reduction, baseline Lp(a) >50 mg/dL (subgroup) | 17.7 (IQR 33.6–0.0) % | |
| Absolute reduction | 19.2 [42.0, 0.0] mg/dL | Not reported in the abstract |
Predictors of Lp(a) reduction
- Higher baseline Lp(a) predicted greater reduction (β −0.31)
- P < 0.001
- Female sex associated with less reduction (β 9.28)
- P = 0.02
- multivariable linear regression
Consistency and durability
- Consistent across Lp(a) assay types and PCSK9i type; sustained in those with serial Lp(a) measurements (n=274)
Original publication
Impact of PCSK9 inhibitors on lipoprotein(a) levels: a multi-centre study. Eur J Prev Cardiol. Published 18 November 2025. doi:10.1093/eurjpc/zwaf734
Summarised from the published abstract; every number is checked against it