Impact of conventional lipid-lowering therapy on circulating levels of proprotein convertase subtilisin/kexin type 9: A systematic review and meta-analysis of randomised controlled trials.
Conventional lipid-lowering drugs increase plasma PCSK9 levels by 23.25 ng/mL across all major drug classes including statins, ezetimibe, and fibrates. Meta-analysis of 14 RCTs with 1,313 participants across multiple treatment arms. This provides the first comprehensive quantification of PCSK9 elevation across all conventional lipid therapies, confirming a mechanistic concern that has lacked systematic evidence. Subgroup analyses show variation by drug intensity and type, but the overall signal is consistent.