Efficacy and Safety of Recaticimab in Patients With Dyslipidemia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials With GRADE Assessment.

Abstract

Low-density lipoprotein cholesterol (LDL-C) is the principal target for preventing atherosclerotic cardiovascular disease, yet many patients do not reach treatment goals with statins, and established proprotein convertase subtilisin/kexin type 9 (PCSK9) antibodies require injections every 2-4 weeks. Recaticimab is a humanized anti-PCSK9 monoclonal antibody designed for dosing intervals of up to 12 weeks. We searched PubMed, Scopus, Web of Science, and the Cochrane Library up to March 3, 2026, for randomized controlled trials comparing recaticimab with placebo in adults with dyslipidemia. Four double-blind trials (1657 randomized participants) were included. At week 12, recaticimab reduced LDL-C by 47.31 percentage points relative to placebo (95% confidence interval [CI], -49.87 to -44.75; I2 = 0%), with similar reductions for 150 mg every 4 weeks (-49.63), 300 mg every 8 weeks (-49.43), and 450 mg every 12 weeks (-45.50) (P for subgroup difference = 0.29). Recaticimab also reduced non-high-density lipoprotein cholesterol (-45.17), apolipoprotein B (-42.31), lipoprotein(a) (-31.06), the total cholesterol/high-density lipoprotein cholesterol ratio (-36.94), and the apolipoprotein B/apolipoprotein A1 ratio (-45.28), whereas the change in triglycerides was not significant (-10.05; 95% CI, -20.18 to 0.08).