title: Systematic review: Evaluating the effect of lipid-lowering therapy on lipoprotein and lipid values.
abstract: OBJECTIVE
  This systematic review was performed to summarize published experience using low density lipoprotein particle number (LDL-P) to monitor the efficacy of lipid-lowering pharmacotherapies.
  
  
  METHODS
  Studies were identified from a literature search of MEDLINE (January 1, 2000 - June 30, 2012); and abstract searches of select conferences. All accepted studies reported mean (or median) nuclear magnetic resonance (NMR)-based LDL-P values for at least 10 subjects receiving lipid lowering pharmacotherapy.
  
  
  RESULTS
  Searches revealed 36 studies (with 61 treatment arms) in which LDL-P measurements were reported pre- and post-treatment. Most studies also reported changes in low-density lipoprotein cholesterol (LDL-C), but fewer studies reported changes in apolipoprotein B (apoB)(n = 20) and non-HDL-C (n = 28). Treatments included statins (22 arms/15 studies), fibrates (7 arms/7 studies), niacin (7 arms/6 studies), bile acid sequestrants (5 arms/2 studies), an anti-apoB oligonucleotide (2 arms/2 studies), combination therapies (8 arms/6 studies), anti-diabetics (5 arms/4 studies), and, other treatments (5 arms/2 studies). Lipid-lowering pharmacotherapy resulted in reductions in mean LDL-P in all but two studies. In several statin studies, the percent reductions in LDL-P were smaller than reductions in LDL-C, comparable changes were reported when LDL-P and apoB, were reported.
  
  
  CONCLUSIONS
  Study-level data from this systemic review establish that different lipid lowering agents can lead to discordance between LDL-P and LDL-C, therefore, basing LDL-lowering therapy only on the achievement of cholesterol goals may result in a treatment gap. Therefore, the use of LDL-P for monitoring lipid-lowering therapy, particularly for statins, can provide a more accurate assessment of residual cardiovascular risk.
authors.affiliation: Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA, robert.rosenson@mssm.edu.
authors.forename: Robert S
authors.initials: RS
authors.lastname: Rosenson
authors.forename: James A
authors.initials: JA
authors.lastname: Underberg
mesh_terms: D002318:Cardiovascular Diseases / Q000097:blood / Q000188:drug therapy*; D058607:Fibric Acids / Q000627:therapeutic use; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D008077:Lipoproteins, LDL / Q000097:blood*; D009525:Niacin / Q000627:therapeutic use; D009841:Oligonucleotides / Q000627:therapeutic use
chemical_list: D058607:Fibric Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D007004:Hypoglycemic Agents; D008077:Lipoproteins, LDL; D009841:Oligonucleotides; D009525:Niacin
references.citation: J Clin Lipidol. 2009 Feb;3(1):45-50
references.pmid: 21291788
references.citation: Diabetes Care. 2007 Oct;30(10):2458-64
references.pmid: 17595355
references.citation: Atherosclerosis. 2008 Jan;196(1):425-433
references.pmid: 17196967
references.citation: J Cardiovasc Pharmacol. 2011 Apr;57(4):489-94
references.pmid: 21297494
references.citation: Clin Chem. 2009 Mar;55(3):407-19
references.pmid: 19168552
references.citation: J Atheroscler Thromb. 2004;11(5):278-85
references.pmid: 15557710
references.citation: Am Heart J. 2004 Apr;147(4):E18
references.pmid: 15077088
references.citation: Diab Vasc Dis Res. 2006 May;3(1):39-44
references.pmid: 16784180
references.citation: Am Heart J. 2012 Mar;163(3):515-21, 521.e1-3
references.pmid: 22424025
references.citation: Atherosclerosis. 2006 Oct;188(2):370-6
references.pmid: 16313908
references.citation: Am J Cardiol. 2003 Jun 15;91(12):1432-6
references.pmid: 12804729
references.citation: Diabetes Care. 2007 Aug;30(8):1945-51
references.pmid: 17483155
references.citation: J Clin Lipidol. 2011 Sep-Oct;5(5):338-67
references.pmid: 21981835
references.citation: Curr Cardiol Rep. 2009 Nov;11(6):468-75
references.pmid: 19863872
references.citation: J Am Coll Cardiol. 2007 Feb 6;49(5):547-53
references.pmid: 17276177
references.citation: Atherosclerosis. 2010 Nov;213(1):1-7
references.pmid: 20451205
references.citation: Eur Heart J. 2012 May;33(9):1142-9
references.pmid: 22507979
references.citation: Atherosclerosis. 2006 Apr;185(2):327-30
references.pmid: 16009365
references.citation: Am J Cardiol. 2001 Aug 1;88(3):270-4
references.pmid: 11472706
references.citation: BMC Clin Pharmacol. 2008 Oct 28;8:10
references.pmid: 18957124
references.citation: J Clin Lipidol. 2007 Dec;1(6):583-92
references.pmid: 19657464
references.citation: Am J Cardiol. 2002 Jul 15;90(2):89-94
references.pmid: 12106834
references.citation: J Cardiol. 2010 Jan;55(1):65-8
references.pmid: 20122550
references.citation: Am Heart J. 2009 Apr;157(4):687.e1-8
references.pmid: 19332196
references.citation: J Clin Lipidol. 2012 Jul-Aug;6(4):318-24
references.pmid: 22836068
references.citation: J Pediatr. 2008 Jun;152(6):873-8
references.pmid: 18492534
references.citation: Am J Cardiol. 2001 Jan 15;87(2):232-4, A9
references.pmid: 11152850
references.citation: Am Heart J. 2008 Mar;155(3):499.e9-16
references.pmid: 18294485
references.citation: J Clin Lipidol. 2009 Oct 1;3(5):322-331
references.pmid: 20161568
references.citation: Antivir Ther. 2006;11(8):1081-9
references.pmid: 17302378
references.citation: Am J Med. 1998 Feb;104(2):137-43
references.pmid: 9528731
references.citation: Lancet. 2012 Dec 8;380(9858):1995-2006
references.pmid: 23141812
references.citation: J Clin Lipidol. 2012 Nov-Dec;6(6):565-72
references.pmid: 23312052
references.citation: Metab Syndr Relat Disord. 2012 Aug;10(4):260-6
references.pmid: 22400810
references.citation: Circulation. 2006 Mar 28;113(12):1556-63
references.pmid: 16534013
references.citation: J Lipid Res. 2013 Feb;54(2):467-72
references.pmid: 23172660
references.citation: J Clin Lipidol. 2011 Mar-Apr;5(2):105-13
references.pmid: 21392724
references.citation: Circulation. 2002 Oct 8;106(15):1930-7
references.pmid: 12370215
references.citation: Circulation. 2009 Feb 24;119(7):931-9
references.pmid: 19204302
references.citation: Arterioscler Thromb Vasc Biol. 2006 Jan;26(1):182-8
references.pmid: 16284192
references.citation: Atherosclerosis. 2002 Jan;160(1):41-8
references.pmid: 11755921
references.citation: Cardiovasc Drugs Ther. 2012 Aug;26(4):349-58
references.pmid: 22622962
references.citation: Eur J Clin Invest. 2010 Dec;40(12):1081-93
references.pmid: 20701625
references.citation: Clin Chem. 1996 Apr;42(4):515-23
references.pmid: 8605667
references.citation: Clin Lab Med. 2006 Dec;26(4):847-70
references.pmid: 17110242
references.citation: Int J Cardiol. 2005 Jun 8;101(3):441-7
references.pmid: 15907413
references.citation: Am J Cardiol. 2004 Jan 1;93(1):31-9
references.pmid: 14697462
references.citation: Diabetes Care. 2009 Jun;32(6):1087-91
references.pmid: 19265025
references.citation: Endocr Pract. 2010 Jul-Aug;16(4):629-40
references.pmid: 20634175
references.citation: J Atheroscler Thromb. 2009 Mar;16(1):51-6
references.pmid: 19261998
references.citation: Atherosclerosis. 2003 Apr;167(2):243-55
references.pmid: 12818407