PCSK9-Targeting Therapies and Mortality: A Systematic Review and Meta-Analysis of Randomized Trials
Pooled result · All-cause mortalityResult — go to the resultIncidence rate ratio 0.88 95% CI 0.82–0.95Authors' conclusion
PCSK9-targeting therapies were associated with lower all-cause mortality and fewer ischemic events across trial populations. The predominant contribution of large cardiovascular outcome trials enrolling populations with known atherosclerosis and using PCSK9 antibodies limits the ability to infer a survival benefit in populations not selected on the basis of atherosclerosis status and across individual therapies, particularly inclisiran.
Study context
- Population
- Stable or clinically stabilized randomized trial populations
- Participants
- 77,178 participants32 trials
- Comparison
- Alirocumab, evolocumab or inclisiran with placebo or active control
- Outcome
- All-cause mortality
Methodological detailsrandom-effects models, prespecified subgroup analyses
- Random-effects models
- Prespecified subgroup analyses
Pooled result
As reported in the abstract
Incidence rate ratio
0.88
95% CI 0.82–0.95
PCSK9-targeting therapy vs Placebo or active control
IRR 0.88 (95% CI 0.82–0.95)
Further pooled results
| Outcome | IRR (95% CI) | |
|---|---|---|
| All-cause mortality, by trial-level known atherosclerosis status (subgroup)PCSK9-targeting therapy vs Placebo or active control · trials requiring known atherosclerosis for enrollment | 0.90 (0.83–0.98) | |
| All-cause mortality, by trial-level known atherosclerosis status (subgroup)PCSK9-targeting therapy vs Placebo or active control · trials without such an enrollment requirement | 0.78 (0.62–0.97) | |
| 0.512Incidence rate ratio (log scale) |
- All-cause mortality, by trial-level known atherosclerosis status (subgroup): interaction p = 0.21
- All-cause mortality, by trial-level known atherosclerosis status (subgroup): Individual atherosclerosis status could not be determined beyond trial-level eligibility criteria.
Myocardial infarction, stroke and coronary revascularization rates
- PCSK9-targeting treatment additionally reduced myocardial infarction, stroke, and coronary revascularization rates
Leave-one-out estimates
- Leave-one-out estimates remained directionally consistent
Original publication
PCSK9-Targeting Therapies and Mortality: A Systematic Review and Meta-Analysis of Randomized Trials. Eur J Prev Cardiol. Published 2 November 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →