Comparative efficacy of PCSK9i and ANGPTL3i on lipid profiles and lipoproteins
At a median follow-up of 12 months, using an inverse analysis model, the ANGPTL3i group had greater reduction of mean TC [–4.27 mmol/L (165.1 mg/dL) vs. –1.37 mmol/L (52.9 mg/dL); pfor subgroupmmol/L (69.9 mg/dL); pfor subgroup <0.001], and TG levels [–0.61 mmol/L (54.1 mg/dL) vs. –0.21 mmol/L (18.6 mg/dL); pfor subgroup <0.001] compared to the PCSK9i group. In contrast, HDL-C increased slightly, more with PCSK9i than with ANGPTL3i [0.08 mmol/L (3.09 mg/dL) vs. –0.21 mmol/L (-8.12 mg/dL); pfor subgroup = 0.001] (Figure S3 & S4, Graphical Abstract ). Likewise, Apo-B decreased more with ANGPTL3i compared to PCSK9i [–0.81 g/L vs. –0.21 g/L; p < 0.001], but Lp(a) reduction was comparable between the two groups (–9.3 vs. –12.9 mg/dl; p = 0.53), and Apo-A remained unaffected in both groups (p = 0.13; Figure S5 ). A summary of the efficacy of ANGPTL3 inhibitors and PCSK9 inhibitors is presented inFigure 1 . In the age-based subgroup analysis, PCSK9i resulted in a significantly greater reduction of mean LDL-C in adults compared to children [–1.87 mmol/L (–72.3 mg/dL) vs. –0.59 mmol/L (–22.8 mg/dL); p < 0.001]. In contrast, no significant age-related difference was observed with ANGPTL3i [–3.53 mmol/L (–136.5 mg/dL) vs. –3.40 mmol/L (–131.5 mg/dL); p = 0.22; Figure S6 ].