Statins
No statin type or dose meaningfully lowers Lp(a), a network meta-analysis of 23,605 patients across 20 trials (Pharmacol Res 2021)
Original title: Effect of different types and dosages of statins on plasma lipoprotein(a) levels: A network meta-analysis
This network meta-analysis (PROSPERO CRD42020167612) pooled 20 randomised controlled trials (23,605 participants, 11 statin interventions) examining statin effects on plasma Lp(a). In pairwise meta-analysis, high-intensity rosuvastatin showed a small but statistically significant difference from placebo (mean difference 1.81 mg/dL, 95% CI 0.43-3.19, P=0.01), but in the full network meta-analysis, no statin type or dosage showed a significant effect on Lp(a), with no meaningful difference between them; subgroup analyses by population and treatment duration found no significant findings either. Moderate-intensity pitavastatin trended toward the best Lp(a)-lowering effect, though this was not statistically significant. The findings confirm that statins, regardless of type or dose, have no clinically significant effect on lowering Lp(a).
Original abstract
Background And Aim: Studies differ with respect to the effects of statins and their on lipoprotein(a)[Lp(a)] levels. The aim of the present study was to resolve these differences by determining the effect of various types and dosages of statins on Lp(a) levels.
Methods: We searched PubMed, Embase and the Cochrane library for randomized controlled trials (RCTs) investigating the efficacy of statins on plasma Lp(a) levels. Study selection, data extraction and risk of bias assessment were conducted independently by four authors. We conducted pairwise meta-analysis and network meta-analysis (NMA). Consistency models were applied to NMA and the ranking probabilities for each treatment's efficacy were calculated. Node-splitting analysis was used to test inconsistency. This study was registered with PROSPERO, number CRD42020167612.
Results: Twenty RCTs with 23,605 participants were included, involving 11 interventions. Most of the included studies presented some risks of bias, especially risks of performance and detection bias. In the pairwise meta-analysis, pooled results showed a small but statistically significant difference between high-intensity rosuvastatin and placebo on Lp(a) levels (MD = 1.81, 95 % CI [0.43, 3.19], P = 0.01). In the NMA, different types and dosages of statins showed no significant effect on the level of Lp(a), and there was no obvious difference between them. Subgroup analysis based on different populations and treatment durations did not provide any statistically significant findings about different statins on Lp(a) levels. Node-splitting analysis showed that no significant inconsistency existed (P > 0.05).
Conclusions: Statins have no clinically significant effect on Lp(a) levels, and there is no significant difference in the effect on Lp(a) levels between different types and dosages of statins. Moderate-intensity pitavastatin tended to have the best effect on reducing Lp(a) levels; nevertheless, it was insignificant. Our findings highlight the necessity for further study of the effect of statins on Lp(a) levels in future studies.
Summary written by lp-a.org from the published abstract; figures as published. Page updated 18 August 2026. Methods.