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Treatment with proprotein convertase subtilisin-kexin type 9 (PCSK9) inhibitors reduce low density lipoprotein cholesterol (LDL-C) by approximately 45-60%, whether used alone or in combination with a statin. Two large cardiovascular outcomes trials have now reported that lowering LDL-C with a PCSK9 inhibitor when added to treatment with a statin reduces the risk of major cardiovascular events. We sought to compare the efficacy of PCSK9 inhibitors and statins for reducing the risk of cardiovascular events by comparing the results of the FOURIER and SPIRE trials with the results of the Cholesterol Treatment Trialists (CTT) meta-analysis of statin trials. n the FOURIER trial, 27 564 patients with cardiovascular disease and LDL-C levels above 1.8 mmol/L (70 mg/dL) on statin therapy were randomized to either 140 mg every 2 weeks (or 420 mg monthly) of evolocumab subcutaneously or matching placebo. At 48 weeks, treatment with evoloculmab reduced LDL-C by 59%, from a baseline level of 2.4 mmol/L (92 mg/dL) to 0.78 mmol/L (30 mg/dL). Using the CTT method of imputation for missing values, this translated into a 1.4 mmol/L (53.4 mg/dL) absolute difference in LDL-C between the two treatment groups. After a median follow-up of 26 months (2.2 years), treatment with evolocumab reduced the
Ference et al. (Fri,) studied this question.