Adding a PCSK9 Inhibitor or Ezetimibe to a Statin Lowers Cardiovascular Risk in High-Risk Patients

Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors and ezetimibe both lower LDL cholesterol levels and prevent some adverse cardiovascular events when added to statins in patients at high cardiovascular risk. Current guidelines recommend step-up therapy with ezetimibe, followed by PCSK9 inhibitors, if statins alone do not sufficiently lower LDL cholesterol. But the effects of these drugs on absolute cardiovascular risk for patients at various levels of baseline risk are unknown.

Investigators conducted a network meta-analysis of 14 randomized trials (≥83,000 patients) in which add-on therapy with PCSK9 inhibitors or ezetimibe was examined for patients at any cardiovascular risk level (with or without prior cardiovascular diseas…