Reductions in Atherogenic Lipids and Major Cardiovascular Events: A Pooled Analysis of 10 ODYSSEY Trials Comparing Alirocumab With Control
Authors' conclusion
In a post hoc analysis from 10 ODYSSEY trials, greater percentage reductions in LDL-C and lower on-treatment LDL-C were associated with a lower incidence of MACE, including very low levels of LDL-C (<50 mg/dL).
Study context
- Population
- Patients in ODYSSEY trials, mainly on maximally tolerated statin
- Participants
- 4,974 patients · 10 trials
- Comparison
- Achieved low-density lipoprotein cholesterol (LDL-C) and LDL-C reduction and major adverse cardiovascular events (MACE)
- Alirocumabn = 3,182
- Placebon = 1,174reference
- Ezetimiben = 618reference
- Outcome
- MACE (CHD death, nonfatal MI, ischemic stroke or unstable angina requiring hospitalization) by achieved LDL-C and % LDL-C reduction
- Follow-up
- 24 to 104 weeks
Methodological detailsdouble-blind, multivariable analysis, 6699 patient-years of follow-up
- Double-blind
- Multivariable analysis
- 6699 patient-years of follow-up
Pooled result
As reported in the abstract
MACE
Estimate (95% CI)P value
Per 39 mg/dL lower achieved LDL-C24% lower risk
adjusted HR 0.76(0.63–0.91)
P = 0.0025Per additional 50% LDL-C reduction from baseline
HR 0.71(0.57–0.89)
P = 0.003Each row per its own increment, as printed
- Patients with MACE
- 104
- Median time to event
- 36 weeks
Further pooled results
| Outcome | Alirocumab | Placebo | Ezetimibe |
|---|---|---|---|
| Achieved average LDL-C <50 mg/dL | 44.7%-52.6% | 0% | 6.5% |
- Achieved average LDL-C <50 mg/dL — Pooled cohort
- 33.1%
Non-HDL-C and apolipoprotein B100 (achieved levels or % reductions) and MACE
- Strengths of association materially similar to LDL-C
Original publication
Reductions in Atherogenic Lipids and Major Cardiovascular Events: A Pooled Analysis of 10 ODYSSEY Trials Comparing Alirocumab With Control. Circulation. Published 24 October 2016. doi:10.
Summarised from the published abstract; every number is checked against it