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. 2021 Sep 7;17:527–542. doi: 10.2147/VHRM.S266244

Table 2.

Effects of Different Lipid-Lowering Drugs on Lp(a) Levels, Production and Catabolic Rates in Turnover Studies and Effects on CVD Outcomes Either Combined with LDL-C Changes or if Analyzed for Heterogeneity by Lp(a) Level Within Trials. Lp(a) Specific Studies are Quoted Separately

Intervention Baseline Lp(a) Change in Lp(a) Change in Production Rate (%) Change in Fractional Catabolic Rate (%) Change in CVD Events
Apheresis Usually >100nM NA NA NA 54–90% (include LDL-C effect)
Apheresis Lp(a) study76 108nM 68% NA NA 81% (includes LDL-C effect)
Statins Variable Nil but distribution shift NA NA No differential
Fibrates Variable −2.7mg/dL NA NA No differential
Niacin Variable −23% −50 −37 No differential
Niacin Lp(a) analysis (THRIVE)90 128nM −31% (12–34nM) NA NA No differential
PCSK9 inhibitor Mean 21 or 25nM −25 to 27% Reduced (monotherapy only) Reduced (combination with statin only) No clear differential
Mipomersen (apoB antisense oligonucleotide) Not stated −26% Nil −27 NA
CETP inhibitor Variable −5% dalcetrapib (low efficacy)
-30 to 40% (high efficacy)
−41% Nil No differential

Abbreviations: CETP, cholesterol ester transfer protein; MTP, microsomal transfer protein; PCSK9, proprotein convertase subtilisin kexin 9.