Residual Inflammatory Risk on Treatment With PCSK9 Inhibition and Statin Therapy
Authors' conclusion
In this post hoc analysis of the SPIRE trials of bococizumab in a stable outpatient population, evidence of residual inflammatory risk persisted among patients treated with both statin therapy and proprotein convertase subtilisin-kexin type 9 inhibition.
Study context
- Population
- Stable outpatients receiving both statin therapy and bococizumab in the SPIRE-1 and SPIRE-2 CV outcomes trials; High sensitivity C-reactive protein (hsCRP) and low-density lipoprotein cholesterol (LDL-C) measured 14 weeks after drug initiation
- Participants
- 9,738 outpatients
- Comparison
- On-treatment hsCRP categories in patients on statin plus bococizumab
- Primary endpoint
- Nonfatal MI, nonfatal stroke, hospitalization for unstable angina requiring urgent revascularization, or CV death
Methodological detailspost hoc analysis
- Post hoc analysis
Primary result
As reported in the abstract
Each group vs hsCRPOT <1 mg/LMultivariable adjusted hazard ratio (95% CI)
hsCRPOT 1 to 3 mg/L
1.16(0.81–1.66)
hsCRPOT >3 mg/L
1.62(1.14–2.30)
Further findings
Percentage change in LDL-C and hsCRP with bococizumab · 14 weeks
- LDL-C mean percentage change
- −60.5% (95% CI −61.2 to −59.8; P<0.001; median change −65.4%)
- hsCRP mean percentage change
- 6.6% (95% CI −1.0 to 14.1; P=0.09; median change 0.0%)
Primary end point by on-treatment LDL-C (<30, 30-50, >50 mg/dL)
- Adjusted HR, LDL-COT <30 mg/dL (reference)
- 1.0
- Adjusted HR, LDL-COT 30-50 mg/dL
- 0.87
- Adjusted HR, LDL-COT >50 mg/dL
- 1.21
- P-trend=0.16
Relative risk reduction with bococizumab across hsCRPOT groups
- Relative risk reductions with bococizumab similar across hsCRPOT groups
- P-interaction=0.87
Original publication
Residual Inflammatory Risk on Treatment With PCSK9 Inhibition and Statin Therapy. Circulation. Published 1 May 2018. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →