Objective  To evaluate the efficacy, safety and cost-effectiveness of alirocumab for the treatment of hypercholesterolemia in a rapid health technology assessment (rHTA).

Methods  PubMed, Embase, Cochrane Library, CNKI, WanFang Data and health technology assessment (HTA) relative websites were electronically searched to collect HTA reports, systematic reviews/Meta-analyses and pharmacoeconomic literatures on the alirocumab for the treatment of hypercholesterolemia from inception to August 14th, 2022. Two reviewers independently screened the literature, extracted the data results and accessed the quality of included studies. Descriptive analysis and summary were then performed.

Results  A total of 38 documents were included, including 28 systematic reviews/Meta analyses, 7 pharmacoeconomic studies and 3 HTA reports. This study showed that, compared with placebo or other lipid lowering therapy, alirocumab lowered the levels of LDL-C, Lp(a), TC, TG, Apo B, non-HDL-C, increased the levels of HDL-C and Apo A1, reduced the risk of major adverse cardiovascular events (MACE), all-cause mortality, cerebrovascular events, and unstable angina, but did not reduce cardiovascular death, myocardial infarction or coronary revascularization. Safety studies showed that, compared with placebo or other lipid lowering therapy, alirocumab did not increase the risk of other adverse reactions but associated with higher injection site reactions. Pharmacoeconomic studies showed that alirocumab was cost-effective in patients with three branch coronary artery disease and acute coronary syndrome with LDL-C ≥ 2.59 mmol·L^-1.

Conclusion  Alirocumab is effective and safe for the treatment of hypercholesterolemia, and cost-effective for the patients of coronary arteriosclerotic heart disease with multi-vessel disease or with high base-line level of LDL-C.

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