A systematic review comparing PCSK9 inhibitors showed that while alirocumab reduced the risk of all cause mortality, evolocumab did not demonstrate the same effect. Specifically, evolocumab showed an 18% increased risk of mortality in lipid-lowering trials and a 12% increased risk in clinical outcome trials. The study also revealed a higher percentage of deaths in the evolocumab group compared to the placebo group, resulting in a number needed to harm of 213 over a median follow-up of 2.2 years.

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