J Cardiovasc Pharmacol

Non-statin therapies show varying efficacy in LDL-C reduction

September 11, 2025

Study details: This updated network meta-analysis synthesized data from 20 randomized trials involving patients with ASCVD or high CV risk on maximally tolerated statins. The analysis compared LDL-C–lowering efficacy of non-statin therapies including ezetimibe, PCSK9 inhibitors (alirocumab, evolocumab), bempedoic acid, and inclisiran.

Results: Inclisiran demonstrated superior LDL-C reduction compared with ezetimibe and bempedoic acid (mean difference [MD], -44.2%; 95% credible interval [CrI], -51.8, -36.7). LDL-C lowering with inclisiran was comparable to alirocumab (MD, -1.9%; 95% CrI, -8.6, 4.2) and evolocumab (MD, 2.0%; 95% CrI, -4.6, 8.6).

Clinical impact: For patients unable to achieve LDL-C targets with statins alone, inclisiran, alirocumab, and evolocumab offer similar, robust LDL-C lowering, substantially greater than ezetimibe or bempedoic acid. These findings support individualized, risk-based lipid-lowering strategies beyond statins.

Source:

Burnett H, et al. (2025, May 13). J Cardiovasc Pharmacol. Comparative Efficacy of Non-Statin Lipid-Lowering Therapies in Patients With Hypercholesterolemia at Increased Cardiovascular Risk: An Updated Network Meta-Analysis. https://pubmed.ncbi.nlm.nih.gov/40358978/