Summary of findings 2.

Summary of findings for PCSK9 compared with ezetimibe

PCSK9 Inhibitors compared to ezetimibe.
Patient or population: people at high risk of cardiovascular disease (history of CVD or high LDL‐C despite treatment) Setting: outpatient care settings Intervention: PCSK9 monoclonal antibodies Comparison: ezetimibe
Outcomes	Ilustrative comparative risk or mean (95% CI)		Relative effect (95%CI)	Mean difference (95% CI)	Number of participants (studies)	Quality of the evidence (GRADE)	Comments
	Assumed risk or mean biomarker using ezetimibe*	Corresponding risk or mean using PCSK9 inhibition†
LDL‐C reduction (LDL‐C) Follow up: 6 months	Mean LDL‐C reduction was ‐6.12 mean percentage change form baseline	Mean LDL‐C reduction in the intervention group was ‐36.32 (‐40.29 to ‐32.34) percentage change from baseline		‐30.20% (‐34.18 to ‐26.23) in percentage reduction from baseline	823 (2 RCTs)	⊕⊕⊕⊝ MODERATEa	Negative is beneficial
Cardiovascular disease (CVD)	Cardiovascular disease risk was 64 per 1000 participants						Data unavailable
All‐cause mortality (mortality)	All‐cause mortality risk was 6 per 1000 participants						Data unavailable
Any adverse events (adverse events)	Risk of any adverse events was 692 per 1000 participants						Data unavailable
CI: confidence interval
GRADE Working Group grades of evidence High quality: We are very confident that the true effect lies close to the estimate of effect Moderate quality: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of effect but may be substantially different Low quality: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of effect Very low quality: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect

^aHigh risk of other biases. Downgrading one level because of "limitations in the design and implementation of available studies suggesting high likelihood of bias"

^*Assumed risks or mean LDL‐C was based on the comparison arms of included trials

^†Corresponding risk or mean was based on the risk difference reported in Table 7 or the mean difference in LDL‐C.