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If Lp(a) is cleared by the LDL receptor, similar to LDL-C, then one would expect PCSK9 inhibition to induce a concordant LDL-C\/Lp(a) response in an approximately 2:1 ratio. We aim to determine the prevalence of discordant plasma LDL-C\/Lp(a) response to the PCSK9 inhibitor alirocumab.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This is a post hoc, pooled analysis of 10 randomized controlled trials from the ODYSSEY Phase 3 clinical trial program for alirocumab. Patients enrolled in the trials were high cardiovascular risk and\/or with heterozygous familial hypercholesterolemia. The primary end point was prevalence of discordant LDL-C\/Lp(a) response to alirocumab at 24 weeks. Discordant response was defined as LDL-C reduction &amp;gt;35% and Lp(a) reduction \u226410%, or LDL-C reduction \u226435% and Lp(a) reduction &amp;gt;10%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 1709 patients in the pooled study cohort, 62.4% were male, and the mean age was 59.2 (SD: 11.0) years. Baseline mean LDL-C was 126.5 (SD: 46.3) mg\/dL and baseline median Lp(a) was 46.9 (interquartile range: 21.8-89.0) mg\/dL. Total prevalence of discordant LDL-C\/Lp(a) response was 21.5% (12.6% with LDL-C &amp;gt;35% reduction and Lp(a) \u226410% reduction; 8.9% with LDL-C \u226435% reduction and Lp(a) &amp;gt;10% reduction). Baseline Lp(a) and familial hypercholesterolemia status did not affect discordance.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>A high prevalence of discordant LDL-C\/Lp(a) response was observed with alirocumab, further suggesting that PCSK9 inhibitor therapy with alirocumab reduces plasma Lp(a) through alternative pathways to LDL receptor clearance.<\/jats:p><\/jats:sec>","DOI":"10.1177\/2047487320915803","type":"journal-article","created":{"date-parts":[[2020,4,11]],"date-time":"2020-04-11T06:21:27Z","timestamp":1586586087000},"page":"816-822","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":25,"title":["Discordant responses of plasma low-density lipoprotein cholesterol and lipoprotein(a) to alirocumab: A pooled analysis from 10 ODYSSEY Phase 3 studies"],"prefix":"10.1093","volume":"28","author":[{"given":"Tahir","family":"Mahmood","sequence":"first","affiliation":[{"name":"Oregon 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