Comparisons of three different doses of alirocumab application in patients with hypercholesterolemia: a meta-analysis.

INTRODUCTION: Low high-density lipoprotein cholesterol (HDL-C) and high low-density lipoprotein cholesterol (LDL-C) levels are associated with incidence of cardiovascular disease (CVD). Alirocumab has been considered as an efficacious, safe and promising therapeutic modality for hypercholesterolemia. The purpose of this study is to compare the differences of the three different doses of alirocumab in patients with hypercholesterolemia.

EVIDENCE ACQUISITION: Randomized controlled trials were identified from PubMed, EMBASE, PMC and Cochrane-library databases. The inter-comparison of different doses were performed by subgroups analysis. Meta-analyses were performed by the Review Manager 5.3 and STATA 13.0 software.

EVIDENCE SYNTHESIS: A total of nine studies involving 3870 patients were included in this meta-analysis. Alirocumab administered at 75-150 mg every 2 weeks (Q2W) resulted in a greater percent change from baseline in LDL-C concentrations (MD, -55.17; 95% CI: -64.35 to -45.99; P<0.05), and HDL-C levels (MD, 7.70; 95% CI 5.94 to 9.46; P<0.05) than other two doses (300 mg every 4 weeks [Q4W], 150 mg every 2 weeks [Q2W]). There was no difference in achieving the treatment goal of LDL-C (≤1.8 mmol/L), in other serum lipid parameters (total cholesterol [TC], triglyceride [TG]), and in the incidence of adverse events.

CONCLUSIONS: The results demonstrate that alirocumab at a dose of 75-150 mg Q2W should be preferred in patients with hypercholesterolemia.