American Journal of Cardiovascular Drugs

, Volume 14, Issue 5, pp 367–376 | Cite as

Mipomersen is a Promising Therapy in the Management of Hypercholesterolemia: A Meta-Analysis of Randomized Controlled Trials

  • Na Li
  • Qing Li
  • Xia-Qiu Tian
  • Hai-Yan Qian
  • Yue-Jin Yang
Systematic Review

Abstract

Introduction

By inhibiting apolipoprotein B (ApoB) synthesis, mipomersen can significantly reduce ApoB-containing lipoproteins in hypercholesterolemic patients.

Objective

This study sought to ascertain both the extent to which mipomersen can decrease ApoB-containing lipoproteins and the safety of mipomersen therapy.

Methods

Studies were identified through PubMed, CENTRAL, Embase, Clinical Trials, reviews, and reference lists of relevant papers. The efficacy endpoints were the changes in low-density lipoprotein cholesterol (LDL-C), non-high-density lipoprotein cholesterol (non-HDL-C), ApoB, and lipoprotein (a) [Lp(a)]. The safety endpoints were the incidence of injection-site reactions, flu-like symptoms, and elevated transaminases.

Results

Six randomized controlled trials with 444 patients were included in the analysis. Compared with the placebo group, patients who received mipomersen therapy had a significant reduction in LDL-C (33.13 %), as well as a reduction in non-HDL-C (31.70 %), ApoB (33.27 %), and LP(a) (26.34 %). Mipomersen therapy was also associated with an obvious increase in injection-site reactions with an odds ratio (OR) of 14.15, flu-like symptoms with an OR of 2.07, and alanine aminotransferase levels ≥3 × the upper limit of normal with an OR of 11.21.

Conclusions

Mipomersen therapy is effective for lowering ApoB-containing lipoproteins in patients with severe hypercholesterolemia. Future studies exploring how to minimize side effects of mipomersen therapy are needed.

Notes

Acknowledgments

This work was supported by grants from the National Natural Science Foundation of China (81000091, 81170129).

Conflict of interest disclosures

None of the authors have any potential conflict of interest that might be relevant to this work.

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Copyright information

© Springer International Publishing Switzerland 2014

Authors and Affiliations

  • Na Li
    • 1
  • Qing Li
    • 1
  • Xia-Qiu Tian
    • 1
  • Hai-Yan Qian
    • 1
  • Yue-Jin Yang
    • 1
  1. 1.State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular DiseaseChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingPeople’s Republic of China

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